27 th Annual Georgia Games Boxing Championships Georgia s Grassroots Olympics

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Veronica Harper
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Online with credit card OR b) Mail-in with money

Female) Olympic-Style T-shirts for all participants

Olympic-style Gold, Silver, Bronze medals for each

Championships Georgia s Grassroots Olympics Georgia

1 July 15-16, W. Booth Rd. Marietta, GA Two Easy ways to Register: a) Online with credit card OR b) Mail-in with money order Junior Olympic, Novice, and Open (Male & Female) Olympic-Style T-shirts for all participants Earn points toward Scholastic Olympiad Olympic-style Gold, Silver, Bronze medals for each division 27 th Annual Georgia Games Boxing Championships Georgia s Grassroots Olympics Georgia Games P.O. Box 2043 Kennesaw, GA info@georgiagames.org State Games Program Participant

2 2017 Georgia Games Championships Boxing Information July 15-16, 2017 Date: Saturday-Sunday July 15-16, 2017 Site: Time: Weigh-in at 8:00am 10:00am on July 15 Saturday July 15: Competition begins at 4pm Sunday July 16: Competition begins at 2:00 p.m. Entry Fee: $20.00 (per athlete) *Out-of- State residents add $5.00 to entry fee* Divisions: Junior Olympic, Novice, and Open (Male and Female) Contact: Registration: Advanced Registration Deadline: July 7th To Register: 1. Online with credit card at OR 2. Mail-in with money order to P.O. Box 2043 Kennesaw, GA NO DAY OF REGISTRATION --EVENT FORMAT-- Rules: USA Boxing Senior rules will apply for Novice and Open boxers. USA Boxing Junior Olympic rules will apply for Junior Olympic Boxers. USA Boxing memberships are required for all divisions. Sports Olympiad: Points accumulated by competing will go directly towards winning your school a sports grant! 1 st, 2 nd, and 3 rd places for each division. See Georgia Games website for details. Awards: Medals will be presented to the champion and runners-up in each weight class. Pairings: Held immediately after weigh-ins. Buddy Davis, GABA President will administer the drawings in the presence of GABA Officials, Coaches and Managers. All teams are encouraged to have a representative present so as to classify the boxers and assist in draw, but no boxers please. Insurance: The USA Boxing insurance is a secondary insurance coverage, paying only after a boxer s personal insurance and carries a $ deductible as long as primary insurance is owned. If primary insurance is not owned, the deductible is $ It becomes primary insurance when a boxer has no other coverage. Should it be necessary to use this coverage, the boxer and/ or his team is responsible for the payment of deductible. Entry forms: Each boxer must complete entry form and sign waivers and releases. Boxers under the age of 18 must secure signatures of parents/guardian on both entry and treatment release forms. Participation Requirements: All competitors and non-athletes who participate must be registered with USA Boxing before they participate. NO EXCEPTIONS. There will be a registration at the weigh-ins. Please bring application, two (2) above the shoulders photos, birth certificate and appropriate cash amount. Non-athlete membership is $80.00/year; Athlete membership is $65.00/year. Existing passbooks may be renewed at weigh-ins. Each team is responsible for its own training, transportation, lodging, hand wraps, protective cup, fitted mouthpiece and headgear. All coaches and officials must be registered and certified by USA Boxing and must have written proof of both. : 1465 W. Booth Rd Ext Marietta, GA VENUE ADDRESS--

3 Sport Event Information: Division: (please check) Male Female Open Novice Jr. Olympic JO Bantam JO Junior JO Intermediate JO Senior Georgia Games Official Individual Athlete Form & Waiver Scholastic Olympiad All GHSA rules apply in order to be eligible Participant Non-participant School Name Non-participant High School Passbook #: (REQUIRED) Weight Class: (REQUIRED) _ Club Name: (REQUIRED) Coaches Name: (REQUIRED) Coaches Phone: (REQUIRED) Account Summary: Entry Fee per player ($20) =_ Out of State Fee per player ($5) =_ Donations =_ Total = Athlete Information: Last Name First Name Middle Initial Street Address/Apt # City/Town County State Zip Phone Numbers: _ Daytime Evening Cell Phone Address: Date of Birth: (M/D/Y) Sex: T-Shirt Size (Youth: YS, YM, YL or Adult: -AS, AM, AL, AXL, AXXL): EMERGENCY CONTACT INFORMATION: Last Name First Name Phone: AGREEMENT, RELEASE AND WAIVER OF LIABILITY In consideration of being permitted to participate in or assisting others in participation in the Georgia Games Championships ( Championships )/District Sports Festivals, and related events and activities, on behalf of myself, or a minor child or ward, heir, next of kin, personal representative, successor or assign; (1) I ACKNOWLEDGE, UNDERSTAND AND DECLARE THAT: (a) To the best of my knowledge, I am in GOOD PHYSICAL CONDITION and have no disease or injury that would be aggravated by participating in activities related to the Championships; (b) Participating or assisting other in participating in the Championships may involve RISK OF INJURY TO ME, INCLUDING DEATH, LOSS OR DAMAGE TO ME OR MY PROPERTY, or other consequences, which might result not only from my own actions, in actions or negligence but also the actions, in actions or negligence of others, the rules play, or the conditions of the premises or of any equipment used; (c) There may be OTHER RISKS not known or not reasonably foreseeable; and Understanding All of the Above, (2) I ASSUME ALL OF THE ABOVE RISKS AND RELEASE, WAIVE, DISCHARGE, HOLD HARMLESS, INDEMNIFY AND COVENANT NOT TO SUE: (a) The State of Georgia or any of its agencies, District Sports Festivals, the Georgia State Games Commission, the Georgia Sports Foundations, its Commissioners, its Board of Directors, its employees, agents, volunteers, coaches, trainers, or officials affiliated with their programs; (b) Any affiliated subsidiary, successor, organization, or related companies or businesses, other participants, participating or sponsoring municipalities, governmental agencies, international organizations, agencies, sponsors, or advertisers, the respective administrators, officers, directors, agents, representatives, employees, or volunteers of such entities or organizations; (c) The National Congress of State Games (NCSG), the United States Olympic Committee (USOC) and/or their respective representatives, officers, directors, employees, agents, successors and assigns; (d) Owners, lessors and lessees of premises used to conduct the Games FROM ANY AND ALL LIABILITY FOR INJURY, INCLUDING DEATH, LOSS OR DAMAGE TO PERSON OR PROPERTY, OR ANY OTHER CONSEQUENCE in connection with entry in or arising out of participation in, performance in or lack of performance in, including travel en route to and from the Championships. (3) I AGREE THAT: (a) Prior to participating as an athlete, I, or in the case of a minor, a parent or guardian, will INSPECT the facilities and equipment to be used, and If I believe same to be unsafe, I will immediately REPORT such condition(s) to the athletic coach, supervisor or official connected with the Championships of same and either DECLINE TO PARTICIPATE or ASSUME THE RISK of participating; (b) I will ALLOW my PHOTOGRAPH, PICTURE or LIKENESS and/or VOICE to APPEAR in any official documentary, promotional (including and all advertisements), television, radio or film coverage of the Championships, WITHOUT COMPENSATION. (4) I CONSENT TO: (a) ALL EMERGENCY MEDICAL TREATMENT as may be deemed appropriate under existing circumstances by medical personnel or personnel associated with the Championships. I HAVE READ THIS FORM IN ITS ENTIRITY AND HAVE PROVIDED TRUTHFUL INFORMATION. Name of Athlete (print) Signature of Athlete (if at least 18 years of age) Date Name of Parent/Legal Guardian if Athlete is a minor (print) Signature of Parent/Guardian, Individually and in the capacity Date as Parent/Legal Guardian if Athlete is under 18 years of age.

4 WAIVER/WARNING IN CONSIDERATION OF YOUR ACCEPTING THIS ENTRY, I HEREBY, FOR MYSELF, MY HEIRS, EXECUTORS, ADMINISTRATORS AND ASSIGNS WAIVE AND RELEASE ANY AND ALL RIGHTS TO ANY CLAIM FOR DAMAGES I MAY OR MIGHT HAVE AGAINST, GEORGIA GAMES CHAMPIONSHIPS, DISTRICT SPORTS FESTIVAL AND RELATED EVENTS AND ACTIVITIES, UNITED STATES BOXING, INC., GOLDEN GLOVES, ANY SANCTIONING LOCAL BOXING COMMITTEES OF USA BOXING, GOLDEN GLOVES AND ALL SPONSORS AND VENUE OWNERS, OR THE OFFICERS, SUB-COMMITTEES OF USA BOXING, GOLDEN GLOVES AND ALL INTITIES, OR ANY INJURY OR DAMAGE SUFFERED BY ME DURING MY PARTICIPATION IN, AND/OR ARISING FROM TRAVELING TO AND/OR RETURNING FROM THE TOURNAMENT. I AGREE TO ABIDE BY THE RULES OF UNITED STATES AMATEUR BOXING AND GOLDEN GLOVES. I FULLY UNDERSTAND THAT I ASSUME ALL RESPONSIBILITY FOR ANY INJURY OR DAMAGE THAT I MAY INCUR IN THESE BOXING BOUTS. I UNDERSTAND AND AGREE THAT MEDICAL OR OTHER SERVICES RENDERED TO ME BY OR AT THE INSISTANCE OF ANY OF THE NAMED PARTIES IS NOT AN ADMISSION OF LIABILITY TO PROVIDE OR CONTINUE TO PROVIDE ANY SUCH SERVICES AND IS NOT A WAIVER BY ANY OF SAID PARTIES OF ANY RIGHT OR RIGHTS HEREUNDER. I CERTIFY THAT I HAVE NO INJURIES TO MY HANDS, NEITHER FRACTURES NOR BROKEN BONES, WITHIN THREE MONTHS PRECEDING THE DATES OF THIS ENTRY FORM, AND KNOW OF NO OTHER INJURIES TO THE HEAD, CONCUSSION, FAINTING SPELLS AND WILL NOTIFY BOXING OFFICIALS IMMEDIATELY SHOULD ANY OF THESE INJURIES AND CONDITIONS BE EXPERIENCED IN THE FUTURE. IN ADDITION, I ALSO UNDERSTAND AND APPRECIATE THAT PARTICIPATION IN SPORT CARRIES A RISK TO ME OF SERIOUS INJURY, INCLUDING PERMANENT PARALYSIS OR DEATH. I VOLUNTARILY AND KNOWINGLY RECOGNIZE, ACCEPT AND ASSUME THIS RISK. FEMALE BOXERS ONLY: I FURTHER CERTIFY THAT I AM NOT PREGNANT, OR HAVE ANY PAINFUL; PELVIC DISCOMFORT SUCH AS SYMPOTOMATIC ENDOMETRIOSIS OR OTHER CAUSES, ABNORMAL VAGINAL BLEEDING OF UNDETERMINED CAUSES (ETIOLOGY), RECENT (SECONDARY AMENORRHEAL, RECENTLY DEVELOPED BREAST DYSFUNCTION PREVIOUSLY NOT PRESENT OR SURGICAL BREAST IMPLANTS, AND HAVE READ SECTION (4) OF USA BOXING S OFFICIAL RULES PERTAINING TO MY PRESENT PHYSICAL CONDITION. SIGNED PARTICIPANTS FULL NAME DATE *SIGNED PARENT (S) OR GUARDIAN (S) DATE SIGNED BOXER S COACH (OR OTHER WITNESS) *REQUIRED IF ENTRANT IS UNDER LEGAL AGE (18 YEARS). DATE

5 2017 Georgia Games Championships Boxing Information July 15-16, 2017 Georgia State Games Developed to promote grassroots amateur sports and an improved quality of life, the Georgia State Games attracts athletes from a variety of backgrounds, ages and skill levels. Each year the Georgia Games continues to develop programs that fit the athletic and lifestyle needs of the Georgia public. As a member of the National Congress of State Games (NCSG), which is a community based, multi-sport member of the United States Olympic Committee (USOC), the Georgia Games is committed to enhance and promote participation in amateur sports. Advance to Regionals or Nationals REGIONALS - Southeast Sports Festival Athletes and teams that participate in the Georgia Games Championships will be eligible to compete against participants from AL, AR, FL, GA, KY, LA, MS, NC, TN, & WV. The Olympic Style Sports Festival will be rotated around the southeast. The Sports Festival currently includes 8-10 sports. Go to for details and entry forms. NATIONALS - Every two years, 40 State Games come together as one to participate in a national competition, the State Games of America. All medal winners from State Games programs are eligible to compete. For more information, visit Sports Olympiad Competition Statewide competition between schools in all divisions. Earn points based on four criteria for your school. Points will be totaled for individuals in each sport and given to respective school. Top three schools in each division receive grants. About the Georgia Games Championships The Georgia Games Championships is a sports festival created for Georgia s amateur athletes. Patterned after the Summer Olympics, the 2015 Championships will consist of 40 sports providing Georgia s amateur athletes, of all ages and skill levels, a meaningful opportunity to participate in a true amateur sport competition. Who Can Compete All residents of Georgia who have lived in the state for at least 30 days prior to the date of competition for their sport are eligible if they meet the requirements specified by that sport. Georgia residents attending school or serving in the military in other states are also eligible. Residents of South Carolina and Tennessee are invited to participate as well. How To Enter - Online with credit card at OR Mail-in with money order to P.O. Box 2043 Kennesaw, GA NO DAY OF REGISTRATION Refund Policy REFUNDS WILL BE GIVEN UNDER THE FOLOWING CIRCUMSTANCES ONLY: Entry received after maximum numbers of teams or individuals are bracketed. Insufficient number of teams or individuals entered. Entry received from a non-qualified athlete. Insurance Insurance is the responsibility of each participant. In some instances, the National Governing Body (NGB), which sanctions an event, may have secondary coverage. Medical aid will be available in the event of an emergency, injury or illness. Preparation for competition, such as taping, will not be provided. Governing Body Registration/Membership NGB registration requirements vary between sports. Please check your sport event information for details. Number of Sports Entered - You may enter as many sports as you wish, as long as the events are not held at conflicting times. It is the athlete s responsibility to make sure there are no schedule conflicts in the sports he/she enters. Awards All participants will receive an official Georgia Games Championships commemorative T-shirt. Gold, silver and bronze medals will be awarded to the first three places. With the inclusion of out-of-state athletes, no Georgian will be displaced for a medal. See your Event Director with any questions regarding this information. The Georgia Games Sportsmanship Award will be presented to the male and female in each sport who best exemplifies the positive attributes of a model competitor. Additionally, one male and one female athlete from the pool of Sportsmanship Award winners will be nominated for the State Games Athlete of the Year Award. Organizers The Georgia State Games Commission and the Georgia Games staff, assisted by thousands of volunteers, carry out the various tasks associated with the execution of the Georgia Games Championships. For More Information Contact the Georgia Games: P.O. Box 2043 Kennesaw, GA 30156

Georgia Games Scholastic Sports Olympiad Fundamental Principle: To provide a fun, competitive atmosphere where the Olympic Ideals of the founder of the modern day Olympics, Pierre De Coubertin s, A

6 Georgia Games Scholastic Sports Olympiad Fundamental Principle: To provide a fun, competitive atmosphere where the Olympic Ideals of the founder of the modern day Olympics, Pierre De Coubertin s, A Celebration of Life through Sports is a positive attribute that should be encouraged across all youths, all skill levels, all ethnicities and all geographic areas of the state. What is the Scholastic Sports Olympiad? It s a statewide scholastic sports and fitness competition! Ask yourself: Is your school the most athletic and physical fitness oriented & spirited? How can you help your school claim bragging rights for ALL sports and not just a few? Earn your school points via: 1) final standings, 2) participation points, 3) sportsmanship points & 4) distance traveled. Schools win the right for a sports development grants by placing 1 st, 2 nd or 3 rd in their classification. Over 40 sports being offered! Archery Diving Rugby-HS Tae Kwon Do Badminton Equestrian Shooting-BB Gun Tennis-USTA Baseball Golf Shooting-Air Rifle Tennis-HS Basketball-Boy s In-Line Skating Shooting-Shot Gun Track & Field Basketball-Girl s Judo Soccer-Boy s Ultimate Frisbee Billiards Lacrosse-Boy s Soccer-Girl s Volleyball-Indoor BMX Cycling Lacrosse-Girl s Softball Volleyball-Outdoor Bowling Racquetball Swimming-Open Water Weightlifting-Olympic Boxing Road Race: 5K & 10K 1K, 3K, & 5K Weightlifting-Power Cycling-Criterium Roller Hockey Swimming-Youth Wrestling-Folk, Free/Greco & Road Race Rowing Table Tennis Categories 1A through 5A High Schools and Middle Schools each have their own division. Eligible Participants: Anyone who attends and competes from your school can earn points towards the Olympiad! Every athlete receives a Sports Festival t-shirt just for competing! Individuals and teams receive Gold, Silver or Bronze medals for winning their respective sports, divisions or events. Thousands of medals are up for grabs! The majority of the events are in the summer. Visit our website for complete details on scoring, schedules and more! Supported by: GHSA, GISA, GACA, GADA, GA State Board of Education Remember, you do not have to be the best to earn points for your school. You just have to compete!

--SPORT SPECIFIC INFORMATION--

2017 Georgia Games Championships Archery-900 Round Information July 7, 2018 Date: July 7, 2018 --SPORT SPECIFIC INFORMATION-- Site: Time: Entry Fee: Cobb County Practice 8:00am Competition 9:00am Adult