I n d i a n a A A U Tae Kwon Do State Championships May 4, 2013 Noblesville, Indiana

Transcription

1 I n d i a n a A A U Tae Kwon Do State Championships May 4, 2013 Noblesville, Indiana DATE: May 4, 2013 TIME: LOCATION: HOST: Doors Open at 8:30am, Coaches/Officials Meeting at 9:30am Competition Begins at 10:00am Hamilton County 4-H and Convention Center, 2003 Pleasant St. Noblesville, IN,, Director ENTRY FEE &DEADLINE: REGISTRATION PRICE, IF RECEIVED BY APRIL 20, 2013 = $55.00 for 2 Events, $65 for 3 Events Received between April 21 and April 27, $70 for 2 Events, $80 for 3 Events. Received between April 28 and May 2, $90 for 2 Events, $100 for 3 Events. Registrations received after May 2 or the day of tournament, $100 for 2 Events, $120 for 3 Events Team Forms - $65 per Team of 3 Black Belts, IF RECEIVED BY APRIL 20, 2013 REGISTRATIONS RECEIVED AFTER MAY 2, 2013 WILL BE AT THE DAY OF TOURNAMENT PRICES *$50 FEE WILL BE CHARGED FOR ANY REGISTRATION CHANGES AFTER MAY 2* AGE GROUPS: Junior Ages 5-17 Senior Ages Executive Ages Ultra Ages 43 and older This event is sanctioned by the Amateur Athletic Union of the U. S., Inc. All participants must have a current AAU membership. AAU membership is not included as part of the entry fee to this event. AAU membership must be obtained before the competition begins. Participants are encouraged to visit the AAU web site to obtain their membership. FOR MORE INFORMATION: This Event is an Official Qualifier for the 2013 AAU National Taekwondo Championships, Ft. Lauderdale, FL, July 1 July 6, and the AAU Junior Olympic Games, Detroit, MI July 26-28

2 ~Athlete Registration Form~ Mail Completed Form Along with Payment (Money Order NO Checks) to:, 939 Conner Street, REGISTRATION PRICE, IF RECEIVED BY APRIL 20, 2013 = $55.00 for 2 Events, $65 for 3 Events Received between April 21 and April 27, $70 for 2 Events, $80 for 3 Events. Received between April 28 and May 2, $90 for 2 Events, $100 for 3 Events. Registrations received after May 2 or the day of tournament, $100 for 2 Events, $120 for 3 Events REGISTRATIONS RECEIVED AFTER MAY 2, 2013 WILL BE AT THE DAY OF TOURNAMENT PRICES *$50 FEE WILL BE CHARGED FOR ANY REGISTRATION CHANGES AFTER MAY 2* Street Address: City: State: Zip Code: Phone Number: Address: Age: (As of 8/31/2013) Weight: Male/Female: Rank: TaeKwonDo School: Instructor: Please Specify Geup or Dan Rank Not Just Belt Color: Birth (mm/dd/yyyy) Phone Number: *Your 2013 AAU Membership Number: *Please note: This application will be rejected without your 2013 AAU membership number. You may register online at to receive your 2013 AAU membership number. Please have your 2013 card or a copy of your 2013 card available at the door. Please mark the level of competition you are entering (You may compete at ONLY ONE level of competition): Junior (5-17) Senior (18-32) Executive (33-42) Ultra (43-Up) *Please mark the events you are entering and fill out your name, age, rank and school on the event slips below for your events: Individual Forms: Olympic Sparring: Point Sparring: Center,, all coaches, officials, individually or collectively, from all liability, including claims at law or in equity for any injury, fatal or otherwise, Competitor s Signature INDIVIDUAL FORMS OLYMPIC SPARRING POINT SPARRING Name Name Name Age Age Age Rank Rank Rank School School School

3 ~Officials Registration Form~ Mail Completed Form to:, 939 Conner Street, Last Name: First Name: M.I: Street Address: City: State: Zip Code: Phone Number: Address: Your Current Rank: Referee Level: TaeKwonDo School: Birth (mm/dd/yyyy) Instructor: Phone Number: *Your 2013 AAU Membership Number: *Please note: This application will be rejected without your 2013 AAU membership number. You may register online at to receive your 2013 AAU membership number. Please have your 2013 card or a copy of your 2013 card available at the door. Center,, all coaches, officials, individually or collectively, from all liability, including claims at law or in equity for any injury, fatal or otherwise, Official s Signature

4 ~Coach Registration Form~ Mail Completed Form and a copy of your 2013 coaches card along with payment (Money Order NO Checks) to:, 939 Conner Street, As coaches and officials are vital to the success of any tournament, we would like to invite our coaches to Registrations received before April 27, 2013, $10 Coaches Pass Registrations received between April 28 and May 2, $20 Coaches Pass Registrations received after May 2, $30 Coaches Pass Late registrations for coaches will be accepted at the door at $30 Last Name: First Name: M.I: Street Address: City: State: Zip Code: Phone Number: Age: (As of August 31, 2013) Rank: TaeKwonDo School: Instructor: Address: Birth (mm/dd/yyyy) Phone Number: *Your 2013 AAU Membership Number: *Please note: This application will be rejected without your 2013 AAU membership number. You may register online at to receive your 2013 AAU membership number. Please have your 2013 card or a copy of your 2013 card available at the door. **Your 2013 AAU Coaches Number: ** You must complete the online Coaches clinic for 2013 to coach at this event. You may take the Online Coaches Clinic at Center,, all coaches, officials, individually or collectively, from all liability, including claims at law or in equity for any injury, fatal or otherwise, Coach s Signature

5 ~Team Form Registration Form~ Mail Completed Form Along with Payment (Money Order NO Checks) to:, 939 Conner Street, REGISTRATION PRICE IF RECEIVED BY APRIL 20, 2013, $65 Received between April 21 and April 27, $80 Received between April 28 and May 2, $100 Team Contact Information: TaeKwonDo School: Instructor: Age Division: (Check One) 5-17 Black Belt 18 & Up Black Belt Sex: (Check One) Male Female Mixed Team Member #1: Team Member #2: Team Member #3: *Please note: This application will be rejected without all three team member s 2013 AAU membership number. You may register online at to receive your 2013 AAU membership number. Please have your 2013 card or a copy of your 2013 card available at the door. injury which may result from activities in which I engage at the 2013 AAU Indiana TaeKwonDo District Championship, including supervised and unsupervised activities, that I for myself, my heirs, administrators and assigns, do hereby release the Amateur Athletic Union, Hamilton County Convention Center,, all coaches, officials, individually or collectively, from all liability, including claims at law or in equity for any injury, fatal or otherwise, mental or emotional damages, which may result directly or indirectly from my traveling to, participating in, or returning from said tournament or related functions. I understand that TaeKwonDo is a contact sport with a risk of serious injury to me, or my children who may enter said tournament. I also assume all risk of my personal property at the tournament premises if lost or stolen. I also understand there are absolutely no refunds. I have read and Team Member 1 Signature Team Member 2 Signature Team Member 3 Signature