World Taekwondo President Chungwon Choue s Message

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1 World Taekwondo President Chungwon Choue s Message 2017 U.S. Junior Taekwondo Championship Dear members of the global taekwondo family, I would like to extend my congratulations to the organizers on the opening of the 2017 U.S. Junior Taekwondo Championship. Since its inception in 2006, the annual event has become a major taekwondo championship in the region of California, USA, drawing over 1,300 athletes aged 4 to 17 from local taekwondo clubs. As you may be well aware of, the 2017 World Taekwondo Championships wrapped up its week-long event in a great success late last month, drawing athletes from a record 183 countries and territories. The Muju championships also attracted great interest from the international media and the public as Korean President Moon Jae-in attended the opening ceremony of the championships, together with the International Taekwondo Federation demonstration team. IOC President Thomas Bach also attended the closing ceremony of the event. I strongly believe that some of you will compete at the world senior championships and the taekwondo competition at the Olympic Games. You are the future of taekwondo. Once again, I wish to thanks the organizers for their efforts to make this event a success. Sincerely yours, Chungwon Choue President World Taekwondo

2 Welcome It is with great excitement and honor that I welcome you back to the 2017 U.S. Jr. Taekwondo Championship. For those of you who are new, I m sure you will leave with the same enthusiasm and satisfaction as everyone else who keeps coming back! The U.S. Junior Taekwondo Championship was designed to create a competition ground for all masters to bring their students with the confidence that they will compete in a fair and cheerful event. It is a championship that encourages the Dojang to prepare with its own U.S. Junior Taekwondo Championship Team in order to create strong teamwork and loyalty within their schools. It's the only tournament that promotes competition by providing assistance to Dojang owners. This tournament is more than just a competition, not only is it an opportunity for you to show the world all the hard work and dedication you and your students have put into perfecting your technique, but also this tournament has become a non-profit organization. We look forward to seeing all of you at what will be an exciting and rewarding tournament. Thank you all for your active participation in making this an exciting and successful event for our competitors and their families! Master Y.K. Han U.S. Junior Taekwondo Championship Director

3 2017 U.S. JUNIOR TAEKWONDO CHAMPIONSHIP Saturday, October 7, 2017 The Felix Event Center AZUSA PACIFIC UNIVERSITY For More Information: Application Deadline: September 30, 2017 Mailing Adderss: 1418 S. Azusa Ave. D2 West Covina, CA SCHEDULE OF EVENTS TIME EVENT (Saturday October 7, 2017) LOCATION 06:50 am STAFF MEETING Pick-up Competitor Cards (MANDATORY) / (No Weigh-In) 07:30-08:30 am IMPORTANT: ONE Representative Per Dojang Only- is required to claim the I.D. envelope for their students at the Check-in Table. I.D. Cards will not be issued to competitors individually at the Check-In Table. 08:00-08:20 am Referee & Volunteer Meeting 08:30-11:30 am Individual Poomsae/Sparring Competition ( Age 14-17, Age 4-7) /18 and Up Poomsae Only Pair/Team/Group Poomsae and Opening Ceremony After Opening Ceremony Poomsae/Sparring Competition ( Age 8-13) ** NO LUNCH BREAK** the Opening Ceremony will immediately follow Pair/Team/Club Poomsae Competitions Qualifications: Special Award: Admission Fees: CASH &CREDIT CARD ONLY A.P.U. The Felix Event Center GENERAL INFORMATION Taekwondo practitioners ages 4 to 17, all ranks including White Belt, who have trained and understand the WTF Taekwondo competition rules. Exception would be for the Senior Division Special Poomsae Event for 18+. Grand Champion Trophy: For any competitor that wins 1 st Place in both individual Poomsae and Sparring division. Adults: $15 Children (ages 5 to 12): $10 4 & Under: FREE Parking: Free (We will provide Special Parking Permit for VIP/KWANJANGS) Coaching: Coach Pass is $20 if applied through Dojang, $35 if purchased at the door. Free Coaches Pass to each participating school,(one Free Coach Pass per 1-5 Competitors). Max. 5 Passes per Dojang (1 coach per ring- Total 8 Rings) Age Eligibility: Competitors will compete in the age division that they are at the time of the tournament: October 7, Junior: 4-17 old all belts can compete in Poomsae and/or Sparring Senior: 18 old and older can compete in Poomsae division Only Floor Access: Kwanjang /Master: All Floor Access (FREE), Coaching Permitted Master, VIP, Guest VIP & Guest: No Floor Access & Coaching is Prohibited. Instructors 2 Free admissions per registered Dojang *No Floor Access *No coaching allowed. (Coach Pass Needed) School (Dojang) Awards: Mandatory Equipment: Most Participants Award: 1 st through 3 rd place trophies will be presented to the schools with the most participants. OFFICIAL DOJANG UNIFORM may be worn. All Sparring competitors must wear WTF approved sparring gear: We will provide red or blue head gear, Only blue chest protector, forearm guard, shin/instep protector, groin cup (males only/females option) worn on the inside and a clear mouthpiece. Mouth Pieces ARE MANDATORY. Each competitor must provide his or her own equipment. Necessary equipment will be sold at the tournament site. All competitors will be subject to inspection prior to being allowed on the competition floor. Mandatory Dojang Online Registeration by Master (* Students Cannot Register Online) Make Checks Payable to: JRTKD Online (Website) / We recommend Offline registration by School with excel list **Downloadable from Website Early Registration Deadline: September 23, 2017, $105/One Event Add $20 for Second Event Final Registration Deadline: September 30, 2017, $115/One Event Add $20 for Second Event Late Registration After September 30, 2017, $150/One Event Add $20 for Second Event ** *After deadline: ALL LATE tournament registrations must be processed at the door.

4 COMPETITION RULES & REGULATIONS TAEGEUK BASIC or 1 1,2 or 3 2,3 or 4 5 or 6 7 or 8 RANK (GUP) USAT BELT COLORS WHITE YELLOW GREEN BLUE RED OTHER BELT COLORS WHITE YELLOW / ORANGE / PURPLE ORANGE / PURPLE / GREEN BLUE / BROWN RED / BLACK & RED POOMSAE COMPETITORS MUST PERFORM ONLY THE POOMSAE DESIGNATED FOR THEIR SPECIFIC RANK AND COMPETITORS WILL CHOOSE ONLY ONE FORM. Scores will be based on: Proper order, time, beauty, grace, rhythm, accuracy, power, technique and attitude. Authorized Poomsae are those approved by the World Taekwondo H.Q. Taegeuk 1-8, Palgue 1-8 and black belt Poomsae: Koryo, Keumgang, Taebaek etc. Authorized Poomsae *Authorized Poomsae refers to the Poomsae standard formulated by KUKKIWON.(TAEGEUK/PALGUE) *Contest time: more than 30 seconds, and less than 90 seconds. *Attire: Dojang Uniform 1) Individual Poomsae: Qualifying run consists of a group of three competitors separated by age and gender for a gold, silver, bronze medal. Individual Sports Poomsae U.S. JR. TAEKWONDO CHAMPIONSHIP uses Cut-off Tournament Format at World Class Poomsae Competition. Rules: Scoring shall be made in accordance with the USAT Poomsae and WTF Competition Rules The cut-off tournament is a competition format that has a maximum of three rounds, a preliminary, semi-final and final round. If the division has 20 or more competitors the competition shall start from the preliminary round. - The division may be split into groups, with each group judged by different judges in the preliminary round. - The order of the competitors in the preliminary round and in each subsequent round is randomly determined. - In the preliminary round, each contestant performs one or two assigned forms randomly selected from the Compulsory Poomsae by the Referee Chair. All competitors perform the same form(s). Scores are totaled for each contestant. Those with scores in the top 50% advance to the semi-final round. - If the number of contestants in the division or groups is odd, then the number of contestants advancing to the next round will be rounded up. For example if there are 23 contestants in the group, then the 23 contestant number is rounded up to 24, and the 12 contestants with the highest scores shall advance to semi-final round. If there are 9 to 19 contestants, the competition shall start from the semi-final round. - In the semi-final round, each contestant will perform two forms (one form may be performed) randomly selected from the Compulsory Poomsae (with the form(s) from the preliminary round excluded), and the 8 contestants with the highest scores advance to the final round. - When 8 or fewer contestants are participating, the competition shall start from the final round. - In the final round the contestants perform the two randomly selected forms from the Compulsory Poomsae that were not performed in the previous round. In the case where there are 8 or fewer contestants the final round is also the first round, and two Compulsory Poomsae randomly selected forms shall be performed. - The top four contestants shall be awarded prizes based on their points. - 3rd and 4th places are awarded bronze medals. Recognized Poomsae: 1) Accuracy (4 points) a. Accuracy of basic movements b. Balance c. Accuracy of details of each Poomsae 2) Presentation (6 points) a. Speed and power. b. Strength/speed/rhythm c. Expression of energy 3) Allotted Scoring Chart for Recognized Poomsae Scoring Criteria Detail of Scoring Criteria Point Accuracy(4.0) Accuracy of detail of each Poomsae Other accuracy details including basic movements & balance 4.0 Speed and power 2.0 Presentation(6.0) Strength/Speed/Rhythm 2.0 Expression of energy 2.0 Forms: Sparring: Grand Champion: There will be one 1 st, one 2 nd, and one 3 rd place winner. There will be one 1 st, one 2 nd, and two 3 rd place winners. 1ST PLACE IN BOTH INDIVIDUAL POOMSAE AND SPARRING DIVISION *Tournament director may modify individual Sports Poomsae rules according to the local condition*

5 Sparring Info & Divisions. Sparring Rules For Competitors Age 4-11 Years Old All Belts/ Age Years Old Color Belts((No Head Contact) Age / Rank Duration Quantity Rules Age 11 & Under (All Color/Black Belts) 1min. 2 Rounds No Head Contact Age (All Color Belts) 1min. 2 Rounds No Head Contact Sparring competitors, ages 4-11 All Belts & old Color Belts, may not make head contact at any time during the competition. A competitor who executes a technique to the head area will be subject to one of the following actions: Any technique attempted to the head area but does not make contact, will be given a warning by the referee (Kyong-go). Any technique which makes any contact with the head area will result in a one-point deduction by the referee (Gamjeom). If the competitor cannot continue because of contact to the head area, the attacker will be disqualified. Inability to continue competition because of fright, crying, or loss of will following a legal kick to the body, does not constitute grounds for disqualification of the attacker. Sparring Rules For Competitors Age Years Old Black Belts: USAT Junior Safety Rules (Cadet Black Belts) Age / Rank Duration Quantity Rules Age (All Black Belts) 1min. 2 Rounds USAT Junior Safety Rules (Cadet Black Belts) JSR: No head kicks with any turning kicks (spin hook kicks, back kick, turning round house kick, etc.) The competitor is encouraged to attempt kicks to the facial area, however absolute control must be exercised or the appropriate penalty shall be invoked. The competitor who executes a successful technique (light contact without causing injury) shall be awarded one point. The competitor who executes a kick to the face or neck, which results in a minor injury, shall receive a one-point deduction. A minor injury is defined as an abrasion or bleeding caused by excessive contact. The competitor who executes a kick to the face or neck, which results in the inability of the opponent to continue because of injury, shall be disqualified. The jury, referee, and judges, after consultation with the tournament physician, if necessary, shall make this determination. (Note: Inability to continue because of fright, crying or loss of will, following a legal kick to the head, does not constitute grounds for disqualification of the attacker). However, if referee and judges feel an injury was due to a malicious attack (with anger or the intent to injure), the attacker will be disqualified Year Old Black Belts World Class Black Belt divisions will follow Adult Rules Age / Rank Duration Quantity Rules Age (All Black Belts) 90 Sec. 3 Rounds WTF (Full Contact) World Class Division will be refereed by WTF International Referees. Full head contact is allowed for YEAR OLD BLACK BELTS ONLY with three points being awarded for legal head contact or 4 point for any spinning techniques Excessive contact to the facial or head area: Even in the absence of visible injury, such as slight bleeding or abrasion, the referee may deem the contact to be excessive, and declare the appropriate penalty. The current W.T.F. competition rules will govern this championship. The Organizing Committee may modify some rules according to the local conditions. It also reserves the right to combine or divide weight categories depending on the size of the group. Head kicks for the juniors (light contact only) will be allowed in addition to head kicks for senior divisions. Daedo TK-STRIKE PSS An Electronic Protector for Authentic Taekwondo Daedo TK-STRIKE is a Protector & Scoring System designed to adapt to the current WTF competition rules and Taekwondo techniques, allowing the best performance in Taekwondo training and competition. It evaluates technique, speed and power, and delivers a clear and precise scoring, altogether encouraging a more dynamic and real Taekwondo. Special A-Match Competitions: Kyorugi(Sparring) Black Belts Only Junior **Certain rules and/or regulations are subject to change at the discretion of the tournament director.**

6 All contestants shall wear an approved trunk protector, head protector, groin guard, forearm protector, shin-instep protector, and a mouth protector. (Gloves are mandatory for the World Class Division; all other divisions are optional) Jewelry is to be removed and finger/toenails are to be neatly trimmed. Legal Scoring Area Body The blue or red colored area of the body protector Head The area above the collar bone (i.e. whole part of the head including both ears and the back of the head) The valid points are divided as follows: One (1) point Valid attack on the trunk protector Three (3) points Valid turning kick to the trunk protector Three (3) points Valid kick to the head Four (4) points Valid turning kick to the head One(1) point Awarded for every two Kyung-gos or every one Gam-jeom given to the opposing contestant Warnings (Kyong-go) Two Kyong-go shall be counted as a deduction of one (1) point. However, the odd Kyong-go shall not be counted in the grand total Lifting the knee to block or/and impede the opponent s kicking attack, or lifting a leg for more than 3 seconds, without execution of any attacking technique, to impede opponent s attacking movements Crossing the Boundary Line Falling down Avoiding or delaying the match Grabbing, holding or pushing the opponent Kicking below the waist Attacking the opponent after Kal-yeo Hitting the opponent s head with the hand Butting or attacking with the knee Attacking the fallen opponent Misconduct of contestant or coach Deduction (Gam-Jeom) A Gam-Jeom shall be counted as minus one (1) point Not complying with the referee s command or decision Inappropriate protesting or criticizing of officials decisions Inappropriate attempts to disturb or influence the outcome of the match Fleeing from the competition area to avoid normal technical exchange. If a contestant attempts to avoid a normal technical exchanges by behavior such as crossing the boundary line or intentionally falling down in repeated manner, the referee may give a Gam-jeom, after a Kyong-go Provoking or insulting the opposing contestant or coach Only accredited team doctor/physician are allowed to be seated in the doctor s position. Unaccredited doctor/physicians or other team officials found to be seated in the doctors position shall be ordered to leave the FOP, and the athlete shall be penalized with a Gam-jeom Any other severe misconduct or unsportsmanlike conduct from a contestant or coach Clear intentional punch to the opponent s face Clear intentional attack the opponent after kal-yeo Clear intentional attack to a fallen opponent Clear intentional attack below the waist Disqualification Total of 5 Points Deductions (10 warnings) Competitor or coach intentionally disobeys the referee, the competition rules, displays unsportsmanlike Conduct, or does not show up in time for the match Heavy contact to the head with the hand or foot that results in an injury, or injuring any opponent and rendering him or her unable to continue. (Junior Safety Rules) Foul (Profanity) language by coach/player/ parent; bad conduct/behavior; verbal abuse *Tournament director may modify individual Sports Poomsae rules according to the local condition*

7 Please Check Appropriate Box: 2017 U.S. JUNIOR TAEKWONDO CHAMPIONSHIP Saturday, October 7, 2017 The Felix Event Center AZUSA PACIFIC UNIVERSITY For More Information: Application Deadline: September 30, 2017 Mailing Adderss: 1418 S. Azusa Ave. D2 West Covina, CA REFEREE APPLICATION (If Registered & Attended Referee Seminar Only) Official Referee (WTF, USAT,CUTA ): $100 ($75+Dinner $25) (8:30 am 7:30 pm) International Referee: $175 ($150+Dinner $25) (8:30 am 7:30 pm) Unofficial Referee (Volunteer ): $50 (Age 16+ ) (8:30 am 7:30 pm) Benefits: 1) U.S. Junior Taekwondo Championship Referee Neck Tie ($30 Value) 2) Invitation to lunch. - Must be Black Belt, Ages 16+ Only (Official) & Must be Black Belt, Ages (Unofficial) - Dress Code: Taekwondo shoes and black dress pants, White dress shirts must be worn by the individuals. (We will provide T-Shirt for Assist. Referee Only) REFEREE SEMINAR DATE: October 6, Free Meal (Lunch) TIME: LOCATION: 06:30 pm - 8:30 pm U.S. BLACK BELT CENTER 2408 S. Azusa Ave. West Covina Ca, All Referees must attend the Referee Meeting on Sat. Oct. 7, 8:00 am at the A.P.U. Gym. Referee Volunteer s Benefits - Referee Certificate (Must stay and actively participate for the duration of event.) APPLICANT INFORMATION EXCEPT FOR SIGNATURES, PLEASE PRINT IN CAPITAL OR TYPE ONLY! LAST NAME: FIRST NAME: CELL PHONE#: TAEKWONDO DOJANG: PERSONAL KWANJANG/MASTER PHONE NO #: SEX: MALE FEMALE DAN# INTERNATIONAL REFEREE RANK: Release Of Claims Personal Injury and Assumption of Risk In consideration of your acceptance of my application, I do hereby, for myself, my heirs, executors and administrators waive, release and forever discharge any and all rights and claims for damages which I may have, or which may accrue to me, against us black belt., inc, and it s Tournament Organizing Committee, and all members of the championship, or their respective officers, agents, representatives, successors, and/or assigns, and against any competitor for any and all damages which may be sustained by me in connection with my association with or entry in the above athletic meet, and in connection with any medical services I may be provided in connection with such injury or illness. I understand that the competition rules are based on the rules of the WTF. I agree to all the tournament competition rules and understand that if I do not follow these rules, I knowingly forfeit all applicable registration fees. I further understand that any pictures taken of me in connection with the 2017 U.S. JUNIOR TAEKWONDO CHAMPIONSHIP may be used by the Tournament Director for publicity or promotion without compensation. I hereby agree to all the terms and conditions of the liability waiver above.. I understand that in case of injury, only basic first aid will be made available on site, and that I am fully responsible for any and all resulting medical or other expenses. Note: THIS RELEASE, CONSENT AND ASSUMPTION OF RISK HAVE IMPORTANT LEGAL CONSEQUENCES. IF UNDER 18, THIS DOCUMENT MUST BE EXECUTED BY PARENT OR LEGAL GUARDIAN. Signature of Applicant:

8 2017 U.S. JUNIOR TAEKWONDO CHAMPIONSHIP Saturday, October 7, 2017 The Felix Event Center AZUSA PACIFIC UNIVERSITY For More Information: Application Deadline: September 30, 2017 Mailing Adderss: 1418 S. Azusa Ave. D2 West Covina, CA VOLUNTEER APPLICATION U.S. JUNIOR TAEKWONDO CHAMPIONSHIP WOULD BE HONORED TO HAVE YOU SERVE AS TOURNAMENT VOLUNTEER AT THE UPOMING EVENT AT The Felix Event Center Volunteers will receive 1) A tournament Staff T-Shirt. 2) Lunch Send Application to: US BLACK BELT CENTER S. Azusa Ave. D2 West Free Staff T-Shirt Covina, Ca DATE: October 6, 2017 and/or October 7, 2017 TIME: October 6, :30 pm / October 7, :00 am Register On-line at: LOCATION: The Felix Event CenterAZUSA PACIFIC UNIVERSITY Please Pick Up Staff Shirt at the Door EXCEPT FOR SIGNATURES, PLEASE PRINT IN CAPITAL OR TYPE ONLY! APPLICANT INFORMATION LAST NAME: FIRST NAME: TAEKWONDO DOJANG: CELL PHONE NO#: DOJANG PHONE NO#: PERSONAL SEX: MALE FEMALE I prefer to serve as: RING CREW MEDICAL COMPUTER SECURITY INFORMATIO N ADMISSION NO PREFERENCE We will only select the first 40 registered volunteers. Your support for U.S. JUNIOR TAEKWONDO CHAMPIONSHIP is greatly appreciated. 10/6/2017 SET UP ONLY 10/7/2017 TOURNAMENT ONLY LIABILITY WAVER 10/6/17 10/7/17 SET UP & TOURNAMENT In consideration of your acceptance of my application, I do hereby, for myself, my heirs, executors and administrators waive, release and forever discharge any and all rights and claims for damages which I may have, or which may accrue to me, against us black belt., inc, and it s Tournament Organizing Committee, and all members of the championship, or their respective officers, agents, representatives, successors, and/or assigns, and against any competitor for any and all damages which may be sustained by me in connection with my association with or entry in the above athletic meet, and in connection with any medical services I may be provided in connection with such injury or illness. I understand that the competition rules are based on the rules of the WTF. I agree to all the tournament competition rules and understand that if I do not follow these rules, I knowingly forfeit all applicable registration fees. I further understand that any pictures taken of me in connection with the U.S. JUNIOR TAEKWONDO CHAMPIONSHIP may be used by the Tournament Director for publicity or promotion without compensation. I hereby agree to all the terms and conditions of the liability waiver above.. I understand that in case of injury, only basic first aid will be made available on site, and that I am fully responsible for any and all resulting medical or other expenses. Note: THIS RELEASE, CONSENT AND ASSUMPTION OF RISK HAVE IMPORTANT LEGAL CONSEQUENCES. IF UNDER 18, THIS DOCUMENT MUST BE EXECUTED BY PARENT OR LEGAL GUARDIAN. Signature of Applicant: Signature of Parent/Legal Guardian: (Signature of Parent or Legal Guardian required if applicant is under 18 old)

9 2017 U.S. JUNIOR TAEKWONDO CHAMPIONSHIP Saturday, October 7, 2017 The Felix Event Center AZUSA PACIFIC UNIVERSITY For More Information: Application Deadline: September 30, 2017 Mailing Adderss: 1418 S. Azusa Ave. D2 West Covina, CA VIP/KWANJANG(DOJANG OWNER) / MASTER / INSTRUCTOR /COACH VIP: GUEST AND 6TH DAN BLACK BELT OR HIGHER KWAN JANGS: MASTERS: INSTRUCTOR: COACH: DATE: October 7, 2017 TIME: LOCATION: VIP ID BADGE.. DOJANG OWNERS MUST HAVE OWN DOJANG(TAEKWONDO SCHOOL) MUST BE 4TH DAN BLACK BELT OR HIGHER NO FLOOR ACCESS, Admission or Coach pass required $20 (I.D. and Wristband ) ** Apply to your Dojang ** We do not accept coaching without coach pass and Wristband I.D. Badge 8:00 am 8:30 am The Felix Event CenterAZUSA PACIFIC UNIVERSITY Please Pick Up I.D. Badge at the Door EXCEPT FOR SIGNATURES, PLEASE PRINT IN CAPITAL OR TYPE ONLY! APPLICANT INFORMATION LAST NAME: FIRST NAME: TAEKWONDO DOJANG: KWANJANG/MASTER: DOJANG PHONE NO#: SEX: MALE FEMALE DAN# I am applying for VIP KWANJANG MASTER PASS INSTRUCTOR PASS COACH LIABILITY WAVER In consideration of your acceptance of my application, I do hereby, for myself, my heirs, executors and administrators waive, release and forever discharge any and all rights and claims for damages In consideration of your acceptance of my application, I do hereby, for myself, my heirs, executors and administrators waive, release and forever discharge any and all rights and claims for damages which I may have, or which may accrue to me, against us black belt., inc, and it s Tournament Organizing Committee, and all members of the championship, or their respective officers, agents, representatives, successors, and/or assigns, and against any competitor for any and all damages which may be sustained by me in connection with my association with or entry in the above athletic meet, and in connection with any medical services I may be provided in connection with such injury or illness. I understand that the competition rules are based on the rules of the WTF. I agree to all the tournament competition rules and understand that if I do not follow these rules, I knowingly forfeit all applicable registration fees. I further understand that any pictures taken of me in connection with U.S. JUNIOR TAEKWONDO CHAMPIONSHIP may be used by the Tournament Director for publicity or promotion without compensation. I hereby agree to all the terms and conditions of the liability waiver above.. I understand that in case of injury, only basic first aid will be made available on site, and that I am fully responsible for any and all resulting medical or other expenses. Signature of Applicant: Signature of Parent/Legal Guardian: (Signature of Parent or Legal Guardian required if applicant is under 18 old) *PLEASE MAKE SURE THAT ALL APPLICANTS FOR ALL TYPES OF APPLICATIONS FROM YOUR DOJANG SPELL YOUR SCHOOL NAME THE SAME. SOME SCHOOLS HAVE VERY SIMILAR NAMES WITH MASTERS HAVING THE SAME LAST NAMES. WE WANT TO MAKE SURE YOUR PASS GOES TO THE CORRECT SCHOOL.

10 2017 U.S. JUNIOR TAEKWONDO CHAMPIONSHIP Saturday, October 7, 2017 The Felix Event Center AZUSA PACIFIC UNIVERSITY For More Information: Application Deadline: September 30, 2017 Mailing Adderss: 1418 S. Azusa Ave. D2 West Covina, CA Pair (one male, one female) / Team (3 People) Authorized Poomsae Application Pair / Team Poomsae Competition Rules: Synchronized Movement ALL MEMBERS OF PAIR AND TEAM POOMSAE COMPETITION MUST ALSO PARTICIPATE IN THE INDIVIDUAL EVENTS Division of Age (* check the block with ) Junior (4 17) SeniorⅠ (18+) Color Belt Black Belt Color Belt Black Belt Athlete Name *Frist Name Last Name Birthday* Age* Gender* 1. M F 2. M F 3. M F C T.K.D. School (Dojang)* T.K.D. School Phone #* Kwan-Jang/Master s Name Division Rank Appointed Poomsae Color Belt *Required Poomsae: Taekuek 4 Jang Junior 4-17 *Required Poomsae: Taekuek 7 Black Belt *Option (Choose One Poomsae):Koryo, Keumkang, Taebaek Color Belt *Required Poomsae:Taekuek 6 Jang Senior 18 + *Required Poomsae: Taekuek 8 *Option (Choose One Poomsae) Black Belt Koryo, Keumkang, Taebaek, Pyongwon, Sipjin, Jitae, Chonkwon, Han Soo, Ilyeo **1st Place TROPHY and Medals, 2nd Place TROPHY and Medals, 3rd Place TROPHY and Medals PAYMENT INFORMATION Please check the event(s) you applying for: Pair (2 People)$150 Team (3 People) $300 Check Payment Type: School Check Payable to: JRTKD Money Order Cashier s Check Credit Card (Visa, Master,paypal) Total Amount Due: $ Credit Card# Expiration Date Security Code Print Name of Cardholder Zip Code Signature Release Of Claims Personal Injury and Assumption of Risk In consideration of your acceptance of my application, I do hereby, for myself, my heirs, executors and administrators waive, release and forever discharge any and all rights and claims for damages which I may have, or which may accrue to me, against us black belt., inc, and it s Tournament Organizing Committee, and all members of the championship, or their respective officers, agents, representatives, successors, and/or assigns, and against any competitor for any and all damages which may be sustained by me in connection with my association with or entry in the above athletic meet, and in connection with any medical services I may be provided in connection with such injury or illness. I understand that the competition rules are based on the rules of the WTF. I agree to all the tournament competition rules and understand that if I do not follow these rules, I knowingly forfeit all applicable registration fees. I further understand that any pictures taken of me in connection with U.S. JUNIOR TAEKWONDO CHAMPIONSHIP may be used by the Tournament Director for publicity or promotion without compensation. I hereby agree to all the terms and conditions of the liability waiver above.. I understand that in case of injury, only basic first aid will be made available on site, and that I am fully responsible for any and all resulting medical or other expenses. Note: THIS RELEASE, CONSENT AND ASSUMPTION OF RISK HAVE IMPORTANT LEGAL CONSEQUENCES. IF UNDER 18, THIS DOCUMENT MUST BE EXECUTED BY PARENT OR LEGAL GUARDIAN. *PLEASE MAKE SURE THAT ALL APPLICANTS FOR ALL TYPES OF APPLICATIONS FROM YOUR DOJANG SPELL YOUR SCHOOL NAME THE SAME. SOME SCHOOLS HAVE VERY SIMILAR NAMES WITH MASTERS HAVING THE SAME LAST NAMES. WE WANT TO MAKE SURE YOUR PASS GOES TO THE CORRECT SCHOOL. Signature of Applicant/Signature of Parent/Legal Guardian: (Signature of Parent or Legal Guardian required if applicant is under 18 old)

11 2017 U.S. JUNIOR TAEKWONDO CHAMPIONSHIP Saturday, October 7, 2017 The Felix Event Center AZUSA PACIFIC UNIVERSITY For More Information: Application Deadline: September 30, 2017 Mailing Adderss: 1418 S. Azusa Ave. D2 West Covina, CA (Taekwondojang) Club Poomsae Team Application EACH TEAM MUST BE COMPRISED OF EXACTLY: 10 MEMBERS ALL MEMBERS OF T CLUB POOMSAE TEAM COMPETITION MUST ALSO PARTICIPATE IN THE INDIVIDUAL EVENTS Division of Age (* check the block with ): Sinior and Junior All Ages! ALL AGES, All Belts (Junior & Senior) Last Name First Name Birthday* Age* Gender* 1. M F 2. M F 3. M F 4. M F 5. M F 6. M F 7. M F 8. M F 9. M F 10. M F C T.K.D. School (Dojang)* T.K.D. School Phone #* Division All Ages & Belts Appointed Poomsae *Option (Choose One Poomsae) *Required Poomsae: Taekuek 4 Jang, Taekuek 7 Jang **1st Place $1,500 & TROPHY, 2nd Place $700 & TROPHY, 3rd Place $500 & TROPHY Club Poomsae Team Competition Rules: Synchronized Movement PAYMENT INFORMATION Please check the event(s) you applying for: Club Poomsae Team (10 People) $350 Check Payment Type School Check Payable to: JRTKD Money Order Cashier s Check Credit Card (Visa, Master, Paypal) Total Amount Due: $ Credit Card# Expiration Date Security Code Print Name of Cardholder Zip Code Signature Release Of Claims Personal Injury and Assumption of Risk In consideration of your acceptance of my application, I do hereby, for myself, my heirs, executors and administrators waive, release and forever discharge any and all rights and claims for damages which I may have, or which may accrue to me, against us black belt., inc, and it s Tournament Organizing Committee, and all members of the championship, or their respective officers, agents, representatives, successors, and/or assigns, and against any competitor for any and all damages which may be sustained by me in connection with my association with or entry in the above athletic meet, and in connection with any medical services I may be provided in connection with such injury or illness. I understand that the competition rules are based on the rules of the WTF. I agree to all the tournament competition rules and understand that if I do not follow these rules, I knowingly forfeit all applicable registration fees. I further understand that any pictures taken of me in connection with U.S. JUNIOR TAEKWONDO CHAMPIONSHIP may be used by the Tournament Director for publicity or promotion without compensation. I hereby agree to all the terms and conditions of the liability waiver above.. I understand that in case of injury, only basic first aid will be made available on site, and that I am fully responsible for any and all resulting medical or other expenses. Note: THIS RELEASE, CONSENT AND ASSUMPTION OF RISK HAVE IMPORTANT LEGAL CONSEQUENCES. IF UNDER 18, THIS DOCUMENT MUST BE EXECUTED BY PARENT OR LEGAL GUARDIAN. *PLEASE MAKE SURE THAT ALL APPLICANTS FOR ALL TYPES OF APPLICATIONS FROM YOUR DOJANG SPELL YOUR SCHOOL NAME THE SAME. SOME SCHOOLS HAVE VERY SIMILAR NAMES WITH MASTERS HAVING THE SAME LAST NAMES. WE WANT TO MAKE SURE YOUR PASS GOES TO THE CORRECT SCHOOL. Signature of Applicant/Signature of Parent/Legal Guardian: (Signature of Parent or Legal Guardian required if applicant is under 18 old)

12 2017 U.S. JUNIOR TAEKWONDO CHAMPIONSHIP Saturday, October 7, 2017 The Felix Event Center AZUSA PACIFIC UNIVERSITY For More Information: Application Deadline: September 30, 2017 Mailing Adderss: 1418 S. Azusa Ave. D2 West Covina, CA Individual Sports Poomsae Application Authorized Poomsae are those approved by the World Taekwondo Federation: Taeguek 1-8 Jang and black belt Poomsae: Koryo, Keumgang, Taebaek, etc. Black belts must demonstrate a form that corresponds with their rank Division of Age: Black Belt Age 12 & Over Only DIVISION COMPULSORY POOMSAE PRELIMINARIES SEMI-FINAL FINAL Cadet (12-14) Taegeuk 3,4,5,6,7,8 Jang Koryo, Keumgang Taegeuk 7 Taegeuk 5 Taegeuk 7 & Keumgang Junior (15-17) Taegeuk 4,5,6,7,8 Jang Koryo, Keumgang, Taebaek Taegeuk 6 Taegeuk 8 Taegeuk 6 & Taebaek Under 30 (18-30) Taegeuk 4,5,6,7,8 Jang Koryo, Keumgang, Koryo Taegeuk 6 Koryo & Keumgang Under 40 (31-40) Taebaek, Pyongwon, Shpjin Koryo Taegeuk 6 Koryo & Keumgang Under 50 (41-50) Taegeuk 8 Jang Koryo, Keumgang,Taebaek, Pyongwon, Shpjin, Jitae, Chonkwon Keumgang Koryo Keumgang & Taebaek Under 60 (51-60) Taegeuk 8 Jang Koryo Keumgang Koryo & Shpjin Under 65 (61-65) Koryo, Keumgang,Taebaek, Pyongwon, Shpjin, Jitae, Koryo Keumgang Koryo & Shpjin Over 65 (66+) Chonkwon, Hansu Koryo Keumgang Koryo & Shpjin **1st Place TROPHY and Medals, 2nd Place TROPHY and Medals, 3rd Place TROPHY and Medals Athlete Name* Last Name First Name Phone No.* Birthday* Age* Gender* M F T.K.D. School (Dojang)* PAYMENT INFORMATION SPORT POOMSAE Check Payment Type: School Check Payable to: JRTKD Black Belt Age 12 & Over Only Money Order Cashier s Check T.K.D. School Phone #* Credit Card (Visa, Master,paypal) 1 EVENT $135 2 EVENTS (Add $25) Sparring Total Amount Due: $ Credit Card# Expiration Date Security Code Print Name of Cardholder Zip Code Signature Release Of Claims Personal Injury and Assumption of Risk In consideration of your acceptance of my application, I do hereby, for myself, my heirs, executors and administrators waive, release and forever discharge any and all rights and claims for damages which I may have, or which may accrue to me, against us black belt., inc, and it s Tournament Organizing Committee, and all members of the championship, or their respective officers, agents, representatives, successors, and/or assigns, and against any competitor for any and all damages which may be sustained by me in connection with my association with or entry in the above athletic meet, and in connection with any medical services I may be provided in connection with such injury or illness. I understand that the competition rules are based on the rules of the WTF. I agree to all the tournament competition rules and understand that if I do not follow these rules, I knowingly forfeit all applicable registration fees. I further understand that any pictures taken of me in connection with U.S. JUNIOR TAEKWONDO CHAMPIONSHIP may be used by the Tournament Director for publicity or promotion without compensation. I hereby agree to all the terms and conditions of the liability waiver above.. I understand that in case of injury, only basic first aid will be made available on site, and that I am fully responsible for any and all resulting medical or other expenses. Note: THIS RELEASE, CONSENT AND ASSUMPTION OF RISK HAVE IMPORTANT LEGAL CONSEQUENCES. IF UNDER 18, THIS DOCUMENT MUST BE EXECUTED BY PARENT OR LEGAL GUARDIAN. *PLEASE MAKE SURE THAT ALL APPLICANTS FOR ALL TYPES OF APPLICATIONS FROM YOUR DOJANG SPELL YOUR SCHOOL NAME THE SAME. SOME SCHOOLS HAVE VERY SIMILAR NAMES WITH MASTERS HAVING THE SAME LAST NAMES. WE WANT TO MAKE SURE YOUR PASS GOES TO THE CORRECT SCHOOL. Signature of Applicant/Signature of Parent/Legal Guardian: (Signature of Parent or Legal Guardian required if applicant is under 18 old)

13 Early Registration Available! Make Checks Payable to: JRTKD Individual (Poomsae, Sparring) Competitor Application Poomsae Age Division (* Check the block ) 4-5 JuniorⅠ JuniorⅡ Cadet JuniorⅢ Junior SeniorⅠ SeniorⅡ SeniorⅢ Athlete Name* First Name Last Name Phone No.* Birth day* Age* Gender* M F T.K.D. School (Dojang)* T.K.D. School Phone #* DIVISION INFORMATION ( All Ages, All Belts) Competitor s Belt TAEGEUK/PALGUE # Black Belt 1ST Dan (Koryo) Black Belt 2ND Dan (Keumkang) Black Belt 3RD Dan (TaeBaek) Black Belt 4TH Dan (Pyongwon) Black Belt 5TH Dan (Sipjin) Black Belt 6TH Dan (Jitae) Black Belt 7TH Dan (Chonkwon) Black Belt 8TH Dan (Han soo) Black Belt 9TH Dan (Ilyeo) Please check the event(s) you are applying for: POOMSAE KYOROOGI SPARRING ( All Ages, All Belts) Included Senior Division ( 4-17 Only, All Belts) $115 One Event Two Events (Add $20) **Please Apply to your Master/Dojang We Accept application by school Divisions (Sparring, Poomsae, Etc.) Early Registration Fee Early Registration Deadline Final Registration Final Registration Deadline One Event $ September 23, 2017 $ F September 30, 2017 Two Events +$20.00 September , $20.00 e September 30, 2017 *After deadline: ALL LATE tournament registrations must 2017 be processed at the door. e ($150 CASH ONLY) PAYMENT INFORMATION Check Payment Type School Check Payable to: JRTKD Credit Card (Visa, Master ONLY) Cash Only (At the Door) Credit Card# Expiration Date Security Code Print Name of Cardholder Zip Code Signature Release Of Claims Personal Injury and Assumption of Risk In consideration of your acceptance of my application, I do hereby, for myself, my heirs, executors and administrators waive, release and forever discharge any and all rights and claims for damages which I may have, or which may accrue to me, against us black belt., inc, and it s Tournament Organizing Committee, and all members of the championship, or their respective officers, agents, representatives, successors, and/or assigns, and against any competitor for any and all damages which may be sustained by me in connection with my association with or entry in the above athletic meet, and in connection with any medical services I may be provided in connection with such injury or illness. I understand that the competition rules are based on the rules of the WTF. I agree to all the tournament competition rules and understand that if I do not follow these rules, I knowingly forfeit all applicable registration fees. I further understand that any pictures taken of me in connection with U.S. JUNIOR TAEKWONDO CHAMPIONSHIP may be used by the Tournament Director for publicity or promotion without compensation. I hereby agree to all the terms and conditions of the liability waiver above.. I understand that in case of injury, only basic first aid will be made available on site, and that I am fully responsible for any and all resulting medical or other expenses. Note: THIS RELEASE, CONSENT AND ASSUMPTION OF RISK HAVE IMPORTANT LEGAL CONSEQUENCES. IF UNDER 18, THIS DOCUMENT MUST BE EXECUTED BY PARENT OR LEGAL GUARDIAN. *PLEASE MAKE SURE THAT ALL APPLICANTS FOR ALL TYPES OF APPLICATIONS FROM YOUR DOJANG SPELL YOUR SCHOOL NAME THE SAME. SOME SCHOOLS HAVE VERY SIMILAR NAMES WITH MASTERS HAVING THE SAME LAST NAMES. WE WANT TO MAKE SURE YOUR PASS GOES TO THE CORRECT SCHOOL. Signature of Applicant/Signature of Parent/Legal Guardian: (Signature of Parent or Legal Guardian required if applicant is under 18 old)

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