Saturday, October, 26, 2013

Transcription

1 Saturday, October, 26, 2013 The Events will consist of Judo Junior and Senior Kata, and Junior, Senior and Master Shiai, and No Gi Grappling. This tournament is open to all competitors who possess a valid Naitonal Governing Body Membership Card such as USJA, USJF, USA Judo or Foreign Federation membership card. Sanctioned By: Hosted By: Competition Site: Registration & Weigh In: United States Judo Association Judan Judo and The Training Compound Calvary Bible Chapel 3742 West Alexis Rd, Toledo, OH Calvary Bible Chapel Saturday, 10/26/2013 8:00-9:30 a.m. Tournament Directors: Gary Monto Julio Ramirez Contact information : Prior to Event Judan Judo JudanJudoToledo@bex.net Day of Event Gary Monto Julio Ramirez REGISTRATION, ENTRY FEES, TOURNAMENT CHECK-IN Pre-Remigration: Official Shiai and/or Grappling entry form(s), waiver(s) and Medical Consent (Minors only) must be fully completed and signed and sent no later than Saturday. 10/19/2013 (please do not send any entry packets after 10/19/2013) with the entry fees to: Judan Judo, PO Box , Oregon, OH Registration Fees: Shiai Only - $30.00 First Division No Gi Grappling Only - $30.00 First Division Both Shiai and Grappling - $50.00 * Kata - $15.00 per Team up to 2 Katas $10.00 Additional Divisions (Max 2 Division) $10.00 Additional Divisions * if doing both Shiai and Grappling both entry forms must be completed. $10.00 Any Additional Division $5.00 Additional Katas per Team Tournament Directors cannot guarantee multiple divisions for competitors

2 ALL ENTRY FEES ARE NON-REFUNDABLE JUDO SHIAI RULES The Maumee Bay Classic will be held in accordance with the Contest Rules, Organization Code, and Sporting Code of the International Judo Federation. These rules include, but are not limited to draw, weigh-in, length of contests, and competition procedures. The weigh-in is the only modification to the IJF rules for the event. Current International Judo Federation Rules as Modified: Division Rules 1. Junior Division 8 through 16 years of age a. Juvenile A (age 13 through 16) Shime Waza is allowed. NO Kansetsu Waza allowed b. Juvenile B (age 8 through 12) No Shime Waza or Kansetsu Waza allowed c. For Youth 10 and under there may be co-ed competition at the discretion of the tournament director. 2. Senior Division (age 13 and above) a. Kansetsu waza is allowed regardless of competitor s age. b. Minimum age to enter senior division is 13 years. Match Length: Junior, Novice and Master division are 3 minutes. Advanced are 5 Minutes Injury Rule: Pre 2003 Medical Rule will be used for Jr. Division s only. Decisions as to ether an athlete may continue if injured while on the mat, are to be resolved in accordance with IJF rules; such decisions occurring off the mat or not covered by the IJF rules, are to be made by the coach, athlete, and team doctor. If there is not a unanimous opinion among these three individuals, the athlete may not continue. Color Belts Required: Blue belts must be worn by the Blue Competitor and a White belt must be worn by the White Competitor. Blue and White Belts are not provided at tournament site, so please bring your own belts. Color Gis: Competitors if you only have one gi it must be white to compete and when you are on the blue side you must have a blue belt. Competitor without a white gi will have to forfeit all matches they are to fight on the white side or find a white gi to change into. NO EXCEPTIONS. Foot Wear: All competitors must bring and wear zoris or footwear when not on the mat Golden Score: The Golden Score will apply to ALL DIVSIONS. There will be Hantei when neither contestants score by the end of the overtime match period. For 6& 7 year olds the Golden Score Match times are one minute. Choking: If a competitor (age 13 to 16) fails to tap out when being choked and passes out they will forfeit all father matches in that division. Weigh-In: The weigh-in for the all Judo events will only take place on Saturday, 10/26/2013, 8:00-9:30 a.m. The athlete s measured weight will be used for the purposes of the draw, i.e., the athlete does not have to make their declared weight. This is a slight modification from the IJF rules but has been the standard practice for the Maumee Bay Classic Tournament.

3 GAPPLING RULES The Maumee Bay Classic Grappling Tournament will be an open tournament, so it doesn t matter if you re Brazilian Jiu- Jitsu, Judo, Wrestling, Submission Wrestling, Submission Grappling, Karate with a Jujitsu Component, Sambo or an independently trained person. We accept all competitors. And because ranks in different martial arts are different, we are now going to try to make this as fair as we can for everyone. 1. You first compete in your experience level and your weight class. This is a single elimination match. 2. You then can compete in your experience level with no restrictions on weight. This is also a single elimination match. 3. Lastly, you can compete in a full open match with no restrictions on weight or level of experience. This is also a single elimination match. You have the chance to potentially win 3 Gold Medals. Masters ages 36+ Adult ages Juniors ages Kids ages 8 15 Divisions Age Divisions Juniors, Seniors, Masters, Adult Women Light Weight: 130 lbs & under Middle Weight: to 160 lbs Light Heavy Weight: to 190 lbs Heavy Weight: to 230 lbs Super Heavy: & Up Kids Light: 60 lbs & under Kids Middle: 60.1 to 80 lbs Kids Heavy: 80.1 to 110 lbs Kids Heavy+: and Up Kids Boys & Girls Competitions & Levels When you register for Gi and/or No-Gi, you will have 3 matches that you are able to compete in. This will give you the ability to place in multiple competitions. This applies for Gi, No-Gi, Mens, Women, and Kids. Please also note to select your experience level wisely. Since this is an open tournament, you will be competing with grappling specialists. Competition By Levels (Gi) Beginner 1 Year or Less Training Intermediate Over 1 Year to 3 Years Advanced Over 3 Years Competition By Levels (No-Gi) Beginner 1 Year or Less Training Intermediate Over 1 Year to 3 Years Intermediate Advanced Over 3 Years to 6 Years Advanced Over 6 years of training (BJJ Brown Belt or Black Belt.) Open Competition With No Weight Or Level Restriction Scoring & Time Scoring & Time Limits Points: Takedowns 2 Points Sweeps & Reversals 2 Points Knee on the stomach 2 Points Passing the half/full guard 3 Points Mount 4 Points Back Mount with hooks 4 Points Victory By: Submission Points Referees decision Time Limits: Adult Gi & No-Gi Beginner 5 min Intermediate 6 min Advanced 7 min Juniors Gi & No-Gi Beginner 4 min Intermediate 5 min Kids Gi & No-Gi All Levels 3 min ***Women are allowed to compete in all men s competition matches.***

4 Maumee Bay Classic Rules Continued Equipment No Wrestling Shoes Cups and Athletic Supporters are allowed Knee Pads allowed as long as they are cloth only and have no metal or flexible plastic All types of Gi s are allowed as long as it complies with Judo and/or Brazilian Jiu-Jitsu Gi Regulations found and All women are required to wear a t-shirt under their Gi. Grappling Shorts and Gym Shorts are allowed as long as there are no pockets, zippers, buttons, snaps or metal or plastic of any type. Must be elastic, string tied or Velcro sealed. Rash Guards and stay dry shirts are allowed for Gi and No-Gi. No sweat pants, sweat shirts, jeans or any other clothing that is not described here are allowed to be worn during the competition. Gi Jiu-Jitsu: Illegal Techniques Children (ages 14 & under) and Teen (ages 16 17) Gi Competitors No attacks below the waist are permitted (ankle locks, knee bars, toe holds, heel hooks etc.). No wrist locks are permitted. No neck cranks or cervical locks are permitted. No scissors takedowns are permitted. No bicep or calf crunches are permitted. No slamming from the guard or to escape submission. No squeezing the legs around an opponent s torso (from guard) as a submission. No Boston Crab techniques are permitted. Note: Pulling the head down on triangle chokes and guillotines is permitted. Gi Ezekiel chokes are permitted in Jiu-Jitsu competition. Beginners Adult, Masters, Seniors Gi Jiu-Jitsu Competitors Straight ankle locks to the outside are permitted (cannot turn the ankle lock towards the other leg). The inside leg is permitted to cross over the opponents leg. Example 50 / 50 guard is a legal position to execute a straight ankle lock. However, if the outside leg crosses over the opponent s leg in any manner, the result will be an immediate Disqualification (even if the opponent does not tap due to the ankle lock. No knee bars, toe holds, heel hooks, etc. are permitted. No wrist locks are permitted. No neck cranks or cervical locks are permitted. No scissors takedowns are permitted. No bicep or calf crunches are permitted. No slamming from the guard or to escape submission. Intermediate Adult, Masters Senior Gi Jiu-Jitsu Competitors The same rules apply to Intermediate as the Beginners with one exception: Intermediate are permitted to apply wrist locks. Intermediate-Advanced and Advanced Belts Adult, Masters, Senior Gi Jiu-Jitsu Competitors Straight ankle locks to the outside, toe holds and knee bars are permitted (No heel hooks are permitted). Wrist locks are permitted. 4 P a g e

5 Maumee Bay Classic Biceps and calf crunches are permitted. No neck cranks or cervical locks are permitted. No scissors takedowns are permitted. No slamming from the guard or to escape submission. No-Gi Submission Wrestling: Illegal Techniques All Adult Divisions (Male and Female, Adult, Masters, Seniors) The Training Compound Challenge (TTC Challenge) is open to athletes from all forms or grappling, and discriminates against none. All submission holds are legal. Neck cranks and all leg locks including inside heel hooks, outside heel hooks, and knee slices are permitted. Bicep slices and wrist locks are permitted. No scissors takedowns are permitted, unless a hand is first placed on the mat. No slamming from the guard or to escape submission. No slamming is allowed in takedowns. In determining whether or not a takedown was a slam, referees will consider whether the intention was to hurt the opponent. Submissions must be applied in order to get a submission, and not in order to injure the joint. No strikes of any kind are allowed to any part of the body or head, by any part of the body or head. No clutching of the windpipe is permitted. No pressure of any type is allowed to the eyes. Explicitly, no fingers, chin, palm heel, etc are allowed to press on the eye. No pressure of any type is allowed to the groin, unless it is an inevitable and unintended result of a legitimate technique. No pushing palm or elbow directly into nose. No striking of any kind including: shoulder, head-butts, punches, elbows, knees, kicks etc. No fish Hooking is permitted. No biting is permitted. A player defending against a rear naked choke. No spiking an opponent on his/her head. No Small Joint Manipulation is permitted. No pulling a thumb or less than three fingers is permitted. No pulling hair. No pinching, twisting of skin. No putting a finger into any orifice. No Interference by a corner with any official or fighter. No attacking an opponent in any of these circumstances: o Before the fight has started o After the fight has ended o During a rest period between rounds o When an opponent is being looked at by the medic or any other official No spitting while on the mat is permitted. No swearing is allowed by a player in the arena. Throwing an opponent off the mat. No unsportsmanlike conduct. Hygiene Rule: All competitors must wear a clean competition uniform (gi, shorts, shirt, etc.). If a referee feels this criteria has not been met they will not allow the competitor to compete. At a minimum a groin protector, mouthpiece, and shorts with a drawstring must be worn, no pockets on the shorts. Excessive taping of hands, wrists and feet are not allowed. Knee braces cannot have a solid portion that could result in injury. No stalling is permitted. No going out of bounds to avoid a submission. It is not possible to restart players in a near submission position, so referees are directed to allow the contest to continue if the out of bounds was inadvertent. Purposefully exiting the ring to avoid a submission will results in disqualification. 5 P a g e

6 Maumee Bay Classic No going out of bounds to avoid a takedown. Purposefully going out of bounds to avoid a takedown will result in the player initiating the takedown receiving two points. In addition to all forbidden techniques above for adults, the further restrictions below also apply to children. Kids and Teens No-Gi Competitors No neck cranks or cervical locks are permitted. Pulling the head down on triangle chokes is allowed. Guillotines are permitted. Many other techniques including Ezekiel chokes and Scarf Hold can be done in such a way that the neck is cranked; this is not permitted. If the Exekiel Choke, Scarf Hold, etc is done in such a way that the neck is not cranked, then it is permitted. No mata leo (rear naked) is allowed from Mount. It is allowed from Back Mount. No squeezing the legs around an opponent s torso (from guard, back, or side) as a submission. No twisting leg locks are permitted. Explicitly, all heel hooks and toes holds are forbidden. In the case of a straight ankle lock, there can be no rolling or reaping. The players outside leg cannot come across past the hip. No wrist locks, not calf crush, no bicep slice. No scissor takedown is permitted, whether a hand is on the ground or not. WHAT FORMS TO FILL OUT Judo Shiai: JUDO SHIAI ENTRY FORM (page 7) JUDO WARNING / WAIVER FORM (page 8) MEDICAL RELEASE if competitor is under 18 (page 12) Grappling (no gi): GRAPPLING ENTRY FORM (page 9) GRAPPLING WARNING / WAIVER FORM (page 10) MEDICAL RELEASE if competitor is under 18 (page 12) Judo Kata: JUDO KATA TEAM ENTRY FORM (page 11) JUDO WARNING FORM (page 8) MEDICAL RELEASE if competitor is under 18 (page 12) Any incomplete packet will be marked as incomplete and competitor will not be allowed to compete until packet is completed. If you are mailing in your packet make sure you have included all the necessary forms. 6 P a g e

7 JUDO SHIAI ENTRY FORM Complete Form and Mail With Entry Fee To: Judan Judo, P.O. Box , Oregon, OH FOR USE BY TOURNAMENT STAFF ONLY Date Received Amount Received $ Received By: Payment Method Cash Money Order Check # ENTRY FEES Shiai Registration Fees Max 2 Divisions Amount Paid $30.00 Shiai $10.00 Additional Division $ COMPETITOR INFORMATION Name (Last) Address (First) City State Country Zip Code Date of Birth: (Mo) (Day) (Year) (Age) (Sex) Parent(s)/Legal Guardian(s) Club Name Instructor Name Club Phone: Judo Rank USJA # USJI # USJF # Foreign # Expiration Date: I Need to Purchase a Membership Card USJA USJF DIVISIONS Male Female JUNIOR DIVISIONS Youth (5-10 may be co-ed) Juvenile B (8-12) Juvenile A (13-16) SENIOR DIVISIONS Novice Brown Belt Black Belt MASTER DIVISIONS Novice Brown Belt Black Belt CERTIFICATE REGARDING NON-BLACK BELT CONTESTANTS I, (name of Instructor), a judo black belt and instructor who has been awarded the rank of Shodan or higher hereby certifies that although not having been awarded the rank of Shodan or higher, is of sufficient aptitude and skill in Judo to compete in this event. Signature of Instructor TOURNAMENT DIRECTORS RESERVE THE RIGHT TO CHANGE DIVISIONS DEPENDING ON NUMBER OF ENTRIES FOR MORE THAN 1 DIVISION PLEASE COPY THIS PAGE FOR EACH DIVISION. Date 7 P a g e

8 JUDO WARNING! WAIVER AND RELEASE OF LIABILITY AND AGREEMENT TO PARTICIPATE In consideration of being permitted to participate in any way, including travel to and from the Maumee Bay Classic, in any Judo tournament, practice, clinic and related events and activities ( Activity ) of United States Judo Associations, Inc., Calvary Bible Chapel (3742 West Alexis Rd, Toledo, OH 43623), Judan Judo of Toledo Inc., and the Maumee Bay Classic Staff and Volunteers. I agree: 1. I understand the nature of Judo activities and believe I am qualified to participate in such Activity. I also understand the rules governing the sport of Judo. 2. I further acknowledge that prior to participating, I will inspect the mats, equipment, facilities, competition pools or division, and the elimination or scoring system to be used, and if I believe anything is unsafe or beyond my capability, I will immediately advise my coach, supervisor, and/or a tournament official of such conditions and refuse to participate. 3. I acknowledge and fully understand that I will be engaging in a contact sport that might result in serious injury, illness or disease, including permanent disability or death, and sever social and economic losses due not only to my own actions, inactions or negligence, but also to the actions, inactions or negligence of others, the rules of the sport of Judo, or conditions of the premises or of any equipment used. Further, I acknowledge that there may be other risks not known to me or not reasonably foreseeable at this time. 4. Knowing the risks involved in the sport of Judo, I assume all such risks and accept personal responsibility for the damages following such injury, illness, disease, permanent disability, or death. 5. I hereby release, waive, discharge and agree not to sue the United States Judo Associations, Inc., Calvary Bible Chapel, Judan Judo of Toledo Inc., together with their affiliated clubs, their respective administrators, directors, officers, agent, coaches and other employees or volunteers of the organization, event officials, medical personnel, other participants, their parents, legal guardians, supervisors and coaches, sponsoring agencies, sponsors, advertisers, and if applicable, owners, lessors, and lessees of premises used in conducting the event, all of whom are hereinafter referred to as Releasees, from any and all litigation expenses, attorney fees, losses, liability, damage or cost on account of injury, illness, disease, including permanent disability and death or damage to property, caused or alleged to be caused in whole or in part by the negligent acts or omissions of the Releasees or otherwise the to the fullest extent permitted by law I HAVE READ THE ABOVE WARNING, WAIVER, AND RELEASE, AND UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND KNOWING THIS, SIGNED IT VOLUNTARILY AND WITHOUT ANY INDUCEMENT OR ASSUANCE OF ANY NATURE. I AGREE TO PARTICIPATE KNOWING THE RISKS AND CONDITIONS INVOLVED AND DO SO ENTIRELY OF MY OWN FREE WILL. I AFFIRM THAT I AM AT LEAST 18 YEARS OF AGE, OR, IF I AM UNDER 18 YEARS OF AGE, I HAVE OBTAINED THE REQUIRED CONSENT OF MY PARENT/LEGAL GUARDIAN AS EVIDENCE BY THEIR SIGNATURE BELOW. I INTEND THIS TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABLITY TO THE GREATEST EXPENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THAT THE BALANCE, NOTWITHSTANDING SHALL CONTINUE IN FULL FORCE AND EFFECT. Participant s Printed Name Participant s Signature Date. FOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE (UNDER AGE OF 18 AT TIME OF REGISTRATION) This is to certify that 1, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release, as provided above, of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child's involvement or participation including litigation expenses, attorney fees, loss, liability, damage or cost which may incur as the result of the minor child s participation in these programs as provided above, even if arising from their negligence, to the fullest extent permitted by law. I have instructed the underlined participant as to the above warnings and conditions and their ramifications. Parent/Legal Guardian Printed Name Parent/Legal Guardian s Signature Date 8 P a g e

9 NO-GI GRAPPLING ENTRY FORM Complete Form and Mail With Entry Fee To: Judan Judo, P.O. Box , Oregon, OH FOR USE BY TOURNAMENT STAFF ONLY Date Received Amount Received $ Received By: Payment Method Cash Money Order Check # GRAPPLING FEES # of Divisions Amount Paid $30.00 First Division $10.00 Additional Division $ $10 Insurance (only if you do not have a National Governing Body Membership Card) $ COMPETITOR INFORMATION Name (Last) (First) Address City State Country Zip Code Date of Birth: (Mo) (Day) (Year) (Age) (Sex) Parent(s)/Legal Guardian(s) Phone: Club Name Club Instructor Name Judo Rank USJA # USJI # USJF # Other # Expiration Date: I Need to Purchase a Membership Card USJA USJF DIVISIONS (Please check one) Kid Male (8-15) Junior Male (16-17) Adult Male (18-35) Master Male (36+) Kid Female (8-15) Junior Female (16-17) Adult Female (18-35) Master Female (36+) Competition By Level Gi (See Grappling Rules for details) Beginner Intermediate Advanced Competition By Level No Gi (See Grappling Rules for details) Beginner Intermediate Intermediate Advance Advance Open Competition With No Weigh or Level Restrictions TOURNAMENT DIRECTORS RESERVE THE RIGHT TO CHANGE DIVSIONS DEPENDING ON THE NUMBER OF ENTRIES. CERTIFICATE REGARDING NON-BLACK BELT CONTESTANTS I, (name of Instructor), a black belt and instructor who has been awarded the rank of 1 st Degree Black Belt or higher hereby certifies that although not having been awarded the rank of black belt is of sufficient aptitude and skill in Grappling to compete in this event. Signature of Instructor FOR MORE THAN 1 DIVISION PLEASE COPY THIS PAGE FOR EACH DIVISION. Date 9 P a g e

10 GRAPPLING WARNING! GRAPPLING WAIVER AND RELEASE OF LIABILITY AND AGREEMENT TO PARTICIPATE In consideration of being permitted to participate in any way, including travel to and from the Maumee Bay Classic, and related events and activities ( Activity ) of United States Judo Associations, Inc., Calvary Bible Chapel, Judan Judo and The Training Compound, and the Maumee Bay Classic Staff and Volunteers, I agree: 6. I understand the nature of Grappling activities and believe I am qualified to participate in such Activity. I also understand the rules governing the sport of Grappling. 7. I further acknowledge that prior to participating, I will inspect the mats, equipment, facilities, competition pools or division, and the elimination or scoring system to be used, and if I believe anything is unsafe or beyond my capability, I will immediately advise my coach, supervisor, and/or a tournament official of such conditions and refuse to participate. 8. I acknowledge and fully understand that I will be engaging in a contact sport that might result in serious injury, illness or disease, including permanent disability or death, and sever social and economic losses due not only to my own actions, inactions or negligence, but also to the actions, inactions or negligence of others, the rules of the sport of Grappling, or conditions of the premises or of any equipment used. Further, I acknowledge that there may be other risks not known to me or not reasonably foreseeable at this time. 9. Knowing the risks involved in the sport of Grappling, I assume all such risks and accept personal responsibility for the damages following such injury, illness, disease, permanent disability, or death. 10. I hereby release, waive, discharge and agree not to sue the United States Judo Associations, Inc., Calvary Bible Chapel, Judan Judo and The Training Compound, together with their affiliated clubs, their respective administrators, directors, officers, agent, coaches and other employees or volunteers of the organization, event officials, medical personnel, other participants, their parents, legal guardians, supervisors and coaches, sponsoring agencies, sponsors, advertisers, and if applicable, owners, lessors, and lessees of premises used in conducting the event, all of whom are hereinafter referred to as Releasees, from any and all litigation expenses, attorney fees, losses, liability, damage or cost on account of injury, illness, disease, including permanent disability and death or damage to property, caused or alleged to be caused in whole or in part by the negligent acts or omissions of the Releasees or otherwise the to the fullest extent permitted by law I HAVE READ THE ABOVE WARNING, WAIVER, AND RELEASE, AND UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND KNOWING THIS, SIGNED IT VOLUNTARILY AND WITHOUT ANY INDUCEMENT OR ASSUANCE OF ANY NATURE. I AGREE TO PARTICIPATE KNOWING THE RISKS AND CONDITIONS INVOLVED AND DO SO ENTIRELY OF MY OWN FREE WILL. I AFFIRM THAT I AM AT LEAST 18 YEARS OF AGE, OR, IF I AM UNDER 18 YEARS OF AGE, I HAVE OBTAINED THE REQUIRED CONSENT OF MY PARENT/LEGAL GUARDIAN AS EVIDENCE BY THEIR SIGNATURE BELOW. I INTEND THIS TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABLITY TO THE GREATEST EXPENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THAT THE BALANCE, NOTWITHSTANDING SHALL CONTINUE IN FULL FORCE AND EFFECT. Participant s Printed Name Participant s Signature Date. FOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE (UNDER AGE OF 18 AT TIME OF REGISTRATION) This is to certify that 1, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release, as provided above, of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child's involvement or participation including litigation expenses, attorney fees, loss, liability, damage or cost which may incur as the result of the minor child s participation in these programs as provided above, even if arising from their negligence, to the fullest extent permitted by law. I have instructed the underlined participant as to the above warnings and conditions and their ramifications. Parent/Legal Guardian Printed Name Parent/Legal Guardian s Signature Date 10 P a g e

11 JUDO KATA TEAM ENTRY FORM Complete and Mail With Entry Fee To: Judan Judo, P.O. Box , Oregon, OH FOR USE BY TOURNAMENT STAFF ONLY Date Received Amount Received $ Received By: Payment Method Cash Money Order Check # KATA TEAM ENTRY FEES Kata Cost (Two Katas) Additional Katas # of Katas Amount Paid $15.00 Per Team $5.00 per Kata $ Please fill out Per Team, One form for each Kata entered. Each KATA partner must fill out a separate Waiver and Medical form Nage No Kata Katame No Kata Ju No Kata Kime No Kata Itsusu No Kata Goshin Jitsu No Kata DIVISIONS: Junior Male Team Junior Female Team Junior Mixed Team Senior Male Team Senior Female Team Senior Mixed Team Tori's Name (Last): (First): Address: City: State: Country: Zip: Date of Birth: (Mo) (Day) (Year) (Age) (Sex) Judo Rank Instructor s Name Club Name Club Address City State Country Zip USJA # USJI # USJF # Foreign # Daytime Phone Evening Phone Parent(s)/Legal Guardian(s) Uki s Name (Last): (First): Address: City: State: Country: Zip: Date of Birth: (Mo) (Day) (Year) (Age) (Sex) Judo Rank Instructor s Name Club Name Club Address City State Country Zip USJA # USJI # USJF # Foreign # Daytime Phone Evening Phone Parent(s)/Legal Guardian(s) 11 P a g e

12 MEDICAL RELEASE AND CONSENT TO THE TREATMENT OF A MINOR EMERGENCY MEDICAL NOTICE Contestant s Name (Last): (First): Address: City: State: Country: Zip: Date of Birth: (Mo) (Day) (Year) (Age) (Sex) Daytime Phone Evening Phone Parent(s)/Legal Guardian(s) In emergency, parent(s)/guardian(s) can be reached at ( ) 1, (we), the undersigned parent(s)/guardian(s) of a minor, do hereby authorize the UNITED STATES JUDO ASSOCIATION, ITS TOURNAMENT DIRECTOR, REFEREE DIRECTOR, AND ANY AND ALL ORGANIZERS, PROMOTERS, OFFICERS, STAFF, REFEREES, TOURNAMENT WORKERS AND VOLUNTEERS OF Maumee Bay Classic, hereafter referred to as the "Maumee Bay Classic," as agent(s) for the undersigned to consent to any x-ray examination, anesthetic, medical or surgical diagnosis, or treatment and hospital care which is deemed advisable by, and is to be rendered under the general or special supervision of any physician and surgeon, licensed under the provisions of the Medical Practice Act on the medical staff of a licensed hospital, whether such diagnosis or treatment is rendered at the office of said physician or at said hospital. PLEASE INITIAL It is understood that this authorization is given in advance of any specific diagnosis, treatment of hospital care being required, but is given to provide authority and power on the part of our aforesaid agent(s) to give specific consent to any and all such diagnosis, treatment or hospital care which the aforementioned physician, in the exercise of his best judgment, may deem advisable. PLEASE INITIAL This authorization is given pursuant to provisions of the Ohio Revised Code and shall remain in effect until10/27/2013, unless sooner revoked in writing and delivered to said agent(s). PLEASE INITIAL It is understood that the parent(s)/guardian(s) of are responsible for all costs that may be be incurred as a result of the diagnosis, treatment or hospital care while traveling to or competing in the Maumee Bay Classic. It is also understood that the Maumee Bay Classic/agent(s) will contact the parent(s)/guardian(s) at the first opportunity available, but will have the welfare of the injured minor as a first priority. In the event that the parent(s)/guardian(s) are unable to make decisions concerning the need for medical diagnosis, treatment or hospital care, either a Maumee Bay Classic official or, in the event of a life or death threatening situation, a proper authority (police, fire, rescue, medical, etc.) will be authorized to give consent for diagnosis, treatment or hospital care. PLEASE INITIAL The undersigned has carefully read and voluntarily signed the MEDICAL RELEASE AND CONSENT TO THE TREATMENT OF A MINOR form, and further agrees that no oral representations, statements, or inducements apart from the foregoing written have been made; and that the undersigned understands that this contract constitutes a MEDICAL RELEASE AND CONSENT TO THE TREATMENT OF A MINOR. PLEASE INITIAL Signature of Participant: Date: If the Participant is under the age of 18 years, the signature of a Parent or Guardian is also required Signature of Guardian: Date: 12 P a g e

13 Directions Calvary Bible Chapel, 3742 West Alexis Rd, Toledo, OH TRAVELING NORTH I-75: North I-75 to Exit 204 (left) to West I-475 to Exit 18A turn Right onto Monroe St.; travel ½ mile to Secor Rd Turn Right; go about 2.5 miles and Turn Left onto Alexis Rd.; travel about ½ mile to Venue on the Right TRAVELING NORTH I-475 / I-23: North I-475 / 1-23 to Exit 234; Bear left onto Acres Rd.; Turn Right on Alexis Rd.; Travel about 3 miles to Venue located on the Left. TRAVELING SOUTH I-75: South 1-75 to Exit 210; turn Right on Alexis Rd; Travel about 7 miles to Venue located on the Right. TRAVELING SOUTH I-23: South 1-23 to Exit 234; turn right on Monroe St; just past the overpass turn Left on Alexis Rd.; Travel about 3 miles to Venue located on the Left. 13 P a g e

14 Booster Club Concessions The Booster Club of Judan Judo of Toledo will be running the concession stand at the tournament. All proceeds go to the Judo Club to help the children in the Judo Program. Concession stand will be open at 8 a.m. Menu Items Breakfast: Breakfast Bars Doughnuts Fruit Coffee Lunch and Snacks: Pizza Hot Dogs Nachos Pop Corn Assorted Candy and Snacks Water, Power Aid and Pop 14 P a g e