KOHBUKAN-SISU JUDO & JIU JITSU CLUB Of Guelph Fourteenth Annual Shiai SATURDAY,JANUARY 26, 2013

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1 KOHBUKAN-SISU JUDO & JIU JITSU CLUB Of Guelph Fourteenth Annual Shiai SATURDAY,JANUARY 26, 2013 SANCTIONING This is a Judo Ontario Sanctioned shiai and is pointable. LOCATION: University of Guelph Athletic Centre Guelph, Ontario COMPETITION & SHIAI Kata Individual START TIMES Kata: Opening ceremonies: Shiai: 8:00 AM Immediately following the kata competition or 9:50 AM whichever is later. 10:00 AM Rules & General Notes: Current NSO and PSO rules will apply. Weight Divisions as per JUDO CANADA TOURNAMENT STANDARDS & SANCTION POLICY,2011 PLEASE UNDERSTAND! The YEAR you were BORN determines the division you will fight in. 1. The Tournament Director, with the approval of the Chief Official, reserves the right to delete, combine, add or alter any category or division if necessary for the successful running of this shiai. 2. Competitors are allowed 5 minutes (U9 U13) or10 minutes (U15+) rest period between bouts. 3. ONE coach per athlete is allowed to coach mat side. Coaches must vacate the area when their athlete s match is over. 4. All players must have at least 1 white gi. 5. Blue judogis are allowed on the BLUE SIDE ONLY. Two players wearing blue judogis will not be allowed to compete against each other. 6. Judokas coming with a white gi only should also bring both a white and a blue sash of an appropriate size. 7. Fair Play rules will apply to U9 and U Made up divisions, where necessary, will follow Judo Ontario sanction policy with regard to age and weight limits. DRAW SYSTEM SplitDraw will determine the draws at this tournament. Double elimination for 6 or more in a pool Round Robin for 5 or fewer in a pool. Tournament Directors David Robb/Lorina Mahoney Judo Ontario Appointed Chief Referee Tom Kasprzyk Judo Ontario Appointed Chief Official Gavin Blake Chief Medical Officer Wayland Pulkinnen REGISTRATION: PLEASE PRE REGISTER!!!!!!! IT SAVES YOU MONEY AND US TIME. IF YOU ARE UNSURE ABOUT ATTENDING PRE REGISTER AND PAY AT THE DOOR. IT WILL STILL SAVE YOU MONEY. REFEREES & OFFICIALS REFEREES, PLEASE REGISTER WITH THE CHIEF REFEREE BY 9:30 AM Officials, please register in the Officials Room by 9:30 AM AGE GROUPINGS U U U U U U SENIORS 1997 OR EARLIER MASTERS 1983 OR EARLIER Please direct all enquiries to: drobb1012@rogers.com

2 ENTRY FEES*: SHIAI REFEREE TOTAL PRE REGISTRATION & PRE PAYMENT*: U9, U11, U13 (ONE DIVISION ONLY) $35.00 $3.50 $38.50 Up to, and including Jan 21., 2013 U15, U18, U21, SENIORS & MASTERS $45.00 $4.50 $49.50 *If entry sent by , payment must come by Jan. 21, 2013 FAMILY RATE: $ $10.00 $ PRE REGISTRATION & PAYMENT ON SITE: (Pre registration up to, and including Jan. 21, 2013) REGISTRATION & PAYMENT ON SITE: Jan. 26, 2013 U9, U11, U13 (ONE DIVISION ONLY) $45.00 $4.50 $49.50 U15, U18, U21, SENIORS & MASTERS $55.00 $5.50 $60.50 FAMILY RATE: $ $12.00 $ U9, U11, U13 (ONE DIVISION ONLY) $55.00 $5.50 $60.50 U15, U18, U21, SENIORS & MASTERS $65.00 $6.50 $72.50 NO FAMILY RATE FOR LATE REGISTRATIONS *A JUDO ONTARIO BOARD APPROVED SURCHARGE OF 10% IS ADDED INTO THE ENTRY FEE. THIS SURCHARGE WILL GO DIRECTLY TO THE REFEREEING COMMITTEE. PLEASE NOTE: THERE WILL BE NO JUDO ONTARIO REGISTRATION ON SITE! YOU MUST HAVE REGISTERED WITH JUDO ONTARIO PRIOR TO THE SHIAI! YOU MUST BRING PROOF OF CURRENT JUDO ONTARIO MEMBERSHIP OR MEMBERSHIP IN A JUDO CANADA RECOGNIZED ORGANIZATION REGISTRATION: All registration forms must be completed in full. Waivers must be signed. MAIL ENTRY FORMS TO: E MAIL ENTRY FORMS TO: KOHBUKAN SISU JUDO SHIAI drobb1012@rogers.com C/O Dave Robb 15 Carnaby Cres. MAKE CHEQUES PAYABLE TO: Guelph, ON THE KOHBUKAN JUDO CLUB N1G 2R6 (Please pay in Canadian funds) Registration Notes: All participants must be members of Judo Ontario or of a Judo Canada recognized organization. Current membership books/cards must be presented on site.. You CANNOT register at the door with Judo Ontario. A Birth Certificate MAY BE REQUESTED UPON REGISTRATION. KATA COMPETITION: REGISTER ON SITE FEES: per team 1ST KATA $33.00 NAGE NO KATA Mixed teams allowed SUBSEQUENT KATAS EACH $11.00 GOSHIN JUTSU JU NO KATA Weigh In, Kata & Team Registration Times: KATA Registration 7:30 AM 8:00 AM U9, U11, U13 8:00 AM 9:00 AM U15, U18 9:00 AM 10:00 AM U21, Seniors & Masters Divisions 10:00 AM 11:00 AM Awards: 1 st, 2 nd, and 3 rd place medals

3 Kohbukan-Sisu Annual Shiai 2013 A Judo Ontario Sanctioned Tournament Name Please print Date of birth dd/mm/yyyy Division Please circle one U9* Born Gender M F U11* Born Belt colour U13* Born U15 Born Address U18 Born U21 Born Senior Born 1997 or earlier Masters Born 1983 or earlier Phone # Kata Name of Kata Tori Uke Kata: Separate entry forms for each kata, please. J.O. # Weight. To be filled in by weigh-in official only. J.C. # Kgs Home Club Dojoshu/ Instructor As dojoshu/instructor of the above named competitor holding a rank below shodan, I hereby certify that he/she has attained the necessary age, rank and skill level to compete in this tournament. Official division Signature of weigh-in official Signature of dojoshu/instructor * All competitors (except Masters) may compete in one division only.

4 Release Form for Minors (Competitors under 18 years of age) NOTE: This is a legal document which must be properly completed and signed, in order for your entry to be accepted. The content of this document affects your rights as a Judo Ontario member. If you do not understand it, we recommend you obtain legal advice before signing. RELEASE, INDEMNITY, WARRANTY, AND ASSUMPTION OF RISK IN CONSIDERATION OF the acceptance of the entry of (hereinafter referred to as "the said child") to compete in and /or being permitted to participate in THE KOHBUKAN-SISU ANNUAL SHIAI (hereinafter referred to as "this shiai"), I/We for myself/ourselves and for and on behalf of the said child hereby release, remise and forever discharge, and agree to indemnify and save harmless The Ontario Judo Black Belt Association, THE KOHBUKAN-SISU JUDO CLUB, the organizers of this shiai, their respective officers, executives, directors, officials, agents, servants and representatives (hereinafter referred to as "the Releases") from and against all claims, actions, costs, expenses and demands in respect of death, injury, loss or damage to the person or property of the said child, or myself/ourselves, howsoever caused, arising out of or in connection with the said child competing or participating in this shiai and notwithstanding that the same may have been caused by, contributed to or occasioned by the negligence, breach of contract, breach of a common duty of care as an occupier of premises, or otherwise, of or by the Releases or any of them. I/We agree for myself/ourselves and for and on behalf of the said child to assume all risks, both known and unknown, and all consequences thereof, arising out of or in connection with the said child competing or participating in this shiai and to adhere to all rules, regulations and conditions of this shiai. I/WE CERTIFY THAT: 1. the said child is in good physical condition and has no injury within the last 60 days (e.g. concussion, sprain), disease or disability nor has he/she injected or ingested anything that would impair his/her performance or physical condition or increase the likelihood of injury in competing or participating in this shiai. 2. No physician, nurse, therapist, trainer, coach, manager or other person has advised me/us not to allow the said child to compete or participate in a body contact sport or in this shiai. 3. 1/we am/are familiar with the sport of judo and the nature of a judo contest. I/We am/are aware that there is a high risk of injury by the very nature of the sport. 4. We are the father and mother of the said child or the Guardian(s) of the said child and the only person(s) entitled to act for and on behalf of the said child. 5. This Release Form authorizes the Shiai Director, after consultation with me, to permit a change in either age or weight categories or both as permitted by Judo Canada s Tournament Policy: Standards & Sanctions. (Initialled) 6. We are aware of the code of conduct governing this sport and agree to comply. We understand that disciplinary action will be used if there is a violation of the code of conduct. THIS DOCUMENT SHALL BE BINDING UPON THE SAID CHILD, MYSELF/OURSELVES, THE HEIRS, EXECUTORS, ADMINISTRATORS, ASSIGNS, AND PERSONAL REPRESENTATIVES OF EACH OF US AND THE SAID CHILD. I/we have read this document and I/we understand it fully. PARENT/GUARDIAN PARENT/GUARDIAN DATE: SIGNED: PRINT NAME / RELATIONSHIP PRINT NAME / RELATIONSHIP

5 Release form for Adults (Competitors 18 yrs old and older) NOTE: This is a legal document which must be properly completed and signed, in order for your entry to be accepted. The content of this document affects your rights as a Judo Ontario member. If you do not understand it, we recommend you obtain legal advice before signing. RELEASE, INDEMNITY, WARRANTY, AND ASSUMPTION OF RISK IN CONSIDERATION OF the acceptance of my entry to compete in and/or my being permitted to participate in THE KOHBUKAN- SISU ANNUAL SHIAI (hereinafter referred to as "this shiai"), I hereby release, remise and forever discharge, and agree to indemnify and save harmless The Ontario Judo Black Belt Association, THE KOHBUKAN-SISU JUDO CLUB, the organizers of this shiai, their respective officers, executives, directors, officials, agents, servants and representatives (hereinafter referred to as "the Releases") from and against all claims, actions, costs, expenses and demands in respect of death, injury, loss or damage to my person or property, howsoever caused, arising out to or in connection with my competing or participating in this shiai and notwithstanding that the same may have been caused by, contributed to or occasioned by the negligence, breach of contract, breach of a common duty of care as an occupier of premises, or otherwise, of or by the Releases or any of them. I agree to assume all risks, both known and unknown, and all consequences thereof, arising out of or in connection with my competing or participating in this shiai. I agree to adhere to all rules, regulations and conditions of this shiai. I CERTIFY THAT: 1. I am in good physical condition and I have no injury within the last 60 days (e.g. concussion sprain), disease or disability nor have I injected or ingested anything that would impair my performance or physical condition or increase the likelihood of injury in competing or participating in this shiai. 2. No physician, nurse, therapist, trainer, coach, manager or other person has advised me not to compete or participate in a body contact sport or in this shiai. 3. I am familiar with the sport of judo and the nature of a judo contest. I am aware that there is a high risk of injury by the very nature of the sport. 4. This Release Form authorizes the Shiai Director, after consultation with me, to permit a change in either age or weight categories or both as permitted by Judo Canada s Tournament Policy: Standards & Sanctions. (Initialled) 5. I am aware of the code of conduct governing this sport and agree to comply. I understand that disciplinary action will be used if there is a violation of the code of conduct. THIS DOCUMENT SHALL BE BINDING UPON ME, MY HEIRS, EXECUTORS, ADMINISTRATORS, ASSIGNS AND PERSONAL REPRESENTATIVES. I have read this document and I understand it fully. DATE:.. SIGNED:..

6 DIRECTIONS TO THE KOHBUKAN-SISU ANNUAL SHIAI