4 th KIDS KARATE DO TOURNAMENT

Transcription

1 KATY SHOTOKAN KARATE-DO ASSOCITION Main Dojo: FM1093 Suite C1 Richmond Texas th KIDS KARATE DO TOURNAMENT Date: December 06, 2014 Tournament Location: Information: Best Kids Academy Gym (South Mason Rd across ALDI mart) Royal Montreal Dr. Katy, TX Sensei Tavakoli: Main Dojo: FM1093 Suite C1 Richmond, Texas katyshotokan@gmail.com

2 4 th Annual Katy Shotokan Karate-Do Association General Information Date: Saturday December 06, 2014 Time: Registration/Warm-up:1:30PM-2:00PM Tournament start: 2:00 PM -5:00 PM Location: Best Kids Academy Gym (South Mason Rd across ALDI mart) Royal Montreal Dr. Katy, TX Events: Individual/ Team Shotokan Karate-Do KATA (form) KUMITE (sparring) Registration Fees: Two events for individuals (Kata/Kumite) One event for Teams By December 2, 2014 Kata/Kumite: $45.00 One event: $45.00 After December 2, 2014 Kata/Kumite: $55.00 One event: $55.00 Payments to: Sensei SIAMAK TAVAKOLI Events rules: Shotokan Karate-Do International Federation USA (SKIF USA) Competitor attire: White clean Karate-Do uniform (No rolled sleeves) Protective equipment: Mouthpiece is required for all Kumite competitors. Groin protection is required for all males. *No Shin-guards protection allowed. Categories: Beginners (10, 9, 8, 7 Kyu) 0-1 yrs. training Intermediate (6, 5, 4 Kyu) 1-2 years of training Advanced (3, 2, 1 Kyu and Dan) 3-4 yrs. training Age Divisions Individual 6 & Under Individual/Team events for boys/girls will compete together. Information: Sensei Tavakoli: katyshotokan@gmail.com 2

3 4 th Katy Shotokan Karate-Do Association Location: Best Kids Academy Gym Royal Montreal Dr. Katy, TX NAME: AGE: M F BELT KYU/ RANK: Length of Training: < 1 YR 1-2YRS 3-4YRS 4YRS+ PHONE: ADDRESS: CITY: STATE: ZIP: Dojo name Instructor s name: DOJO/SCHOOL ADDRESS: CHECK ( ) OR X THE DIVISION AND EVENTS YOU ARE ENTERING. 6 & UNDER DIVISIONS BEGINNER (10, 9, 8, 7 kyu) 0-1 yrs INTERMEDIATE (6, 5, 4 kyu) 1 2 yrs ADVANCED (3, 2, 1 kyu/ Dan) 2 3 yrs TEAM KUMITE KATA Team Name Kumite Team Name 1 2 Events (until 12/02/14) $45.00 KATA KUMITE BOTH 1 2 Events late payment $55.00 $60.00 TEAM KUMITE $

4 4 th Katy Shotokan Karate-Do Association Location: Best Kids Academy Gym Royal Montreal Dr. Katy, TX TEAM NAME: TEAM MEMBERS: 1. BELT / RANK: 2. BELT / RANK: 3. BELT / RANK: DOJO/SCHOOL NAME: DOJO INSTRUCTOR(S) NAME(S): $65.00 per team TEAM KUMITE TEAM NAME: TEAM MEMBERS: 1. BELT / RANK: 2. BELT / RANK: 3. BELT / RANK: 4. BELT / RANK: 5. BELT / RANK: DOJO/SCHOOL NAME: DOJO INSTRUCTOR(S) NAME(S): TEAM KUMITE $65.00 per team 4

5 ASSUMPTION OF RISK, HOLD HARMLESS, WAIVER & RELEASE FORM KATY SHOTOKAN KARATE ASSOC. KARATE-DO TOURNAMENT APPLICANT'S AGREEMENT OF ASSUMPTION OF RISK, TO HOLD HARMLESS, AND WAIVER & RELEASE OF LIABILITY I understand that karate is a martial art, that there are risks and dangers inherent in karate competition, that serious accidents do occur, and that participants may sustain serious personal injuries, including mortal injury, and/or property damage. Knowing the risks and dangers involved, nevertheless: I assume any and all risk of personal injury, death or property damage that I may sustain, incur, or cause, that is directly or indirectly related to my participation in the Tournament. I agree to hold harmless all of the individuals or entities who through negligence or carelessness might be or become liable to me, or liable to another party because of my fault, for any and all damages directly or indirectly related to my participation. I waive, release and discharge, in advance, any and all liability, claims, causes of action and possible causes of action whatsoever, for any and all losses, damages and injuries, including but not limited to damages for death, personal injury and property damage, that I may have or that may subsequently accrue to me, my heirs or assigns, directly or indirectly related to my participation in the Tournament. This agreement shall apply in favor of all individuals and entities who might otherwise be or become liable to me, including but not limited to the Katy Shotokan Karate-Do Assoc., their instructors, assistant instructors, officers, directors, members, volunteers, visitors, leasers of the premises, staff, agents and employees; and all promoters, organizers, directors and officials of, and other participants in, the Tournament. This agreement is binding on me, my heirs and assigns. This agreement shall be construed to give the fullest effect allowed by law (as now or hereafter in force, whichever allows the greatest effect) to my undertakings and agreements herein. If the Participant is not at least 18 years of age, this agreement is signed by a parent of the Participant, on behalf of the Participant and on the parent's individual behalf. Signature of Participant Date of Birth Printed Name of Participant Signature of Parent Printed Name of Parent Date Signed: /, 2014 (MO) / (DAY) 5