ALABAMA OPEN KARATE TOURNAMENT & USA KARATE NATIONAL QUALIFIER BIRMINGHAM, ALABAMA APRIL 20, 2013 USA Karate Kumite Referee Course Friday, April 19 & Saturday, April 20 Alabama Open National Qualifier Saturday, April 20 Welcome Letter Tournament Flyer Entry Form for Athletes Referee/Judges Kumite Course Flyer & Entry Form Area Hotels
Alabama Open Karate Tournament USA Karate National Qualifier Saturday, April 20, 2013 Shades Mountain Christian School Gym 2290 Old Tyler Road, Birmingham, AL 35226 www.smcs.org Dear Athletes, Parents, and Instructors: I am proud to invite you to the 2013 Alabama Open on Saturday, April 20, 2013. The Alabama Open grows each year as it continues to draw quality competitors from all over the South Eastern United States. This regional tournament qualifies athletes to compete at the USA Karate National Championships and US Team Trials, held this year in Greeneville, SC on July 12-15. We will also be hosting a Kumite Referee Course led by Mr. Cleve Baxter of the World Karate-Do Federation and Pan American Karate-Do Federation Referee Commissions and the USA Karate Referee Committee. USA Karate is the National Governing Body for Sport Karate within the United States, as recognized by the United States Olympic Committee. The Official USA Karate Team is chosen for both adults and juniors at the National Championships each year. This team represents the United States in all international championships. The national championships have divisions for all ages and skill levels. Even if you do not plan to attend the National Championships, the Alabama Open is an excellent event which provides athletes with indispensable competition experience and allows competitors, officials, and volunteers to meet new people and gain knowledge within the world of Karate-do. Your support is what makes the Alabama Open a successful and quality event in the sport of Karate. I look forward to seeing you at the Alabama Open! Sincerely, Keith MacConkey Alabama Open Tournament Director USA Martial Arts www.usamartialarts.com 205-822-1671 alo@usamartialarts.com
LOCATION: SHADES MOUNTAIN CHRISTIAN SCHOOL GYM 2290 OLD TYLER ROAD HOOVER, AL 35226 COMPETITOR COST: $55.00 FOR 1 OR 2 EVENTS (INCLUDES REQUIRED 1-DAY USA KARATE MEMBERSHIP) $50.00 FOR 2013 USA KARATE MEMBERS $5 PER ADDITIONAL EVENT SATURDAY, APRIL 20, 2013 DOORS OPEN AT 9:00 A. M. (OPENING CEREMONIES BEGIN AT 10:00 A.M.) HOSTED BY: USA MARTIAL ARTS KEITH MACCONKEY THIS IS A PRE-REGISTRATION ONLY EVENT REGISTRATION BY APRIL 13 IS REQUIRED REGISTER ONLINE AT TOURNAMENTINABOX.COM OR SEND REGISTRATION FORM & ENTRY FEE TO: USA Martial Arts 645 Shades Crest Road Hoover, AL 35226 MAILED REGISTRATION MUST BE POSTMARKED BY APRIL 13 USA KARATE KUMITE REFEREE COURSE FRIDAY, APRIL 19 & SATURDAY, APRIL 20 FRI (6:00PM-9:00PM) STUDY OF RULES & WRITTEN TESTS SAT (8:30AM START) PRACTICAL TRAINING & EVALUATION KUMITE COURSE: $ 99 MONITOR FOR $ 49 OPEN TO PARENTS & ATHLETES MR. CLEVE BAXTER WILL INSTRUCT ON THE 2013 RULES OF COMPETITION SPECTATOR FEE: $5.00 (UNDER 4 & OVER 65 FREE) COMPETITION EVENTS: KOBUDO (WEAPONS FORM) IAIDO (SWORD FORM) KATA (EMPTY HAND FORM) KUMITE (SPARRING) FOR MORE INFORMATION, CONTACT KEITH MACCONKEY AT 205-822-1671 OR VIA E-MAIL: ALO@USAMARTIALARTS.COM DOCUMENTS ARE AVAILABLE AT WWW.TOURNAMENTINABOX.COM OR WWW.USAMARTIALARTS.COM PLEASE MAKE CHECKS OR MONEY ORDERS PAYABLE TO: USA MARTIAL ARTS
Alabama Open USA Karate National Qualifier Saturday, April 20, 2013 Male Female As of April 20, 2013: Age: Years of Training Beginner (Under 1 Year) Novice (1 to 2 Years) Intermediate (2 to 3 Years) Advanced (3 Years & Up) Division(s) Entering In: REGISTRATION BY APRIL 13 IS REQUIRED Kata (Form) Kumite (Sparring) Tournament Fee: 1 or 2 Events $55 $5 Per Additional Event *2013 USA Karate Members Receive a $5 Discount on Tournament Fees Iaido (Sword Form) * Members Must Provide 2013 USA Karate Membership # Here: Kobudo (Weapons Form) Check as applicable: Bo Kama Nunchaku Sai Tonfa Personal Check (or Money Order) should be made payable to: USA Martial Arts Name: Date of Birth: Address: Phone #: City: State: Zip: E-Mail Address: Karate Rank: Provide your KYU grade/rank (belt colors differ from school to school) or specific Dan level. Instructor s Name: Style: Martial Arts School: Address: Adult & Minor Amateur Athletic Waiver and Release of Liability In consideration of being allowed to participate in any way in the USA Martial Arts Bluff Park Inc. athletics/sports, and related events and activities, the undersigned: 1. Agrees that prior to participating, they (Parent or Guardian, if under 18) will inspect the facility and equipment to be used, and if the participant and/or Parent/Guardian, believes anything is unsafe, they will immediately advise their coach or supervisor or USA Martial Arts Bluff Park Inc. tournament personnel of such condition(s) and refuse to participate. 2. Acknowledge and fully understand that each participant will be engaging in activities that involve risk of serious injury, including permanent disability and death, and severe social and economic losses which might result not only from their own actions, inactions, or negligence of others, the rules of play, or the condition of the premises or of any equipment used. Further, that there may be other risks not known to us or not reasonably foreseeable at this time. Assume all the foregoing risks and accept personal responsibility for the damages following such injury, permanent disability or death. 3. Release, waive, discharge, and covenant not to sue USA Martial Arts Bluff Park Inc., Event Venue, City and County of the Event, its officers, its affiliated clubs, regional sports organizations, their respective administrators, directors, agents, coaches and other employees of the organization, other participants, sponsoring agencies, sponsors, advertisers, and if applicable owners and lessees of premises used to conduct the event, all of which are hereinafter referred to as releasees from any and all liability to each of the undersigned, his or her heirs and next of kin for any and all claims, demands, losses or damages on account of injury including death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the releasee or otherwise. 4. All entries are final, no refunds will be given. I fully understand that any medical treatment given will be of a first aid type treatment only. I consent that any pictures furnished by me or any pictures taken of me in connection with the Tournament can be used for publicity, promotion or television showing now or in the future, and I waived compensation in regard thereto. All participation in any event or class in this Tournament is by permission only. The Director or his authorized agent(s) reserve the right to refuse entry to any person, school, team or club. 5. PLEASE NOTE: All athletes must be covered by health or medical insurance in order to compete. 6. Statement of Health. By my (and/or Parent s/guardian s signature) below I confirm that I am in sound health and there is no reason why I cannot participate in this championship and/or event. The undersigned has read the above waiver and release, understand that they have given up substantial rights by signing it and sign it voluntarily. Signature of Contestant Signature of Parent/Guardian Date REGISTRATION BY APRIL 13, 2013 IS REQUIRED Register Online at TournamentInABox.com Or Mail Registration Form & Entry Fee to: USA Martial Arts 645 Shades Crest Road Birmingham, AL 35226 All contestants must be 2013 USA Karate registered athletes to qualify for nationals. Parents, Guardians and those of legal age should apprise themselves of the USA Karate rules and regulations at www.usankf.org prior to registration.
USA KARATE KUMITE REFEREE COURSE Sanctioned by USA Karate National Governing Body for Sport Karate Member United States Olympic Committee Hosted by USA Martial Arts www.usamartialarts.com Friday & Saturday April 19 & 20, 2013 Shades Mountain Christian School Gym 2290 Old Tyler Road Hoover, AL 35226 April 19, 6:00 PM 9:00 PM (Study of Rules & Written Test) April 20, 8:30 AM 9:45 AM (Practical) (Evaluations Conducted During Tournament) Course Conducted by: Mr. Cleve Baxter USA Karate Referee Committee Member Pan-American Karate-Do Federation Referee Commission Member World Karate-Do Federation Referee Commission Member The Kumite Course is designed for: Instructors, Black Belts, & Advanced Students interested in obtaining or upgrading a referee license Coaches, Competitors, or Parents who want to understand the rules. NOTE: USA Karate membership must be up to date to obtain or upgrade licensing. Membership fees can be paid during course attendance. Cost Information: Kumite Course & Test: $99.00 (Required to obtain license or upgrade) USA Karate Passport: $10.00 (Required for 1 st time licenses) Monitor Only for $49.00 (Open to Athletes & Parents) Upgrading? Remember your passport! Questions? E-mail: alo@usamartialarts.com
OFFICIAL'S NUMBER (For Office Use Only) USA Karate COURSE ENTRY FORM If purchasing a USA Karate Passport, Please staple 2 pictures of yourself in this box before returning application and fee. USA Karate Membership No.: New or Upgrade KUMITE License Fee: $99.00 Monitoring Fee: $49.00 Referee Passport: $10.00 Name: Birth Date: USA Karate Grade: Address: Phone #: Sex: Age: City: State: Zip: E-Mail: CERTIFICATION RECORD RANK DATE STYLE RANK DATE USA Karate, Federation, System sanctioned rank 1st Dan 2nd Dan 3rd Dan 4th Dan 5th Dan 6th Dan 7th Dan 8th Dan USA KARATE REFEREE QUALIFICATIONS: KUMITE: KATA: DATE: RED WKF PASSPORT: Place of Issue: PLACE: Date: In Lieu of an official passport, please list all national and internationally sanctioned seminars attended with two photos attached. DATE LOCATION INSTRUCTOR QUALIFICATION ACHIEVED PERSONAL CERTIFICATION I hereby certify that the above facts are true and accurate and that I fully understand that any certification of recognition given to me may be withdrawn in the event of misrepresentation or fraud. Personal Signature: Date: Written Exam: (DO NOT WRITE IN THIS BOX - FOR OFFICIAL USE ONLY) Examiner's Comments (if any): Passed As:
ALABAMA OPEN NATIONAL QUALIFIER SATURDAY, APRIL 20, 2013 Shades Mountain Christian School Gym 2290 Old Tyler Road - Hoover, AL 35226 AREA HOTELS BEST WESTERN PLUS Carlton Suites 140 State Farm Pkwy, Birmingham, AL 35209 Phone: 205-940-9990 Fax: 205-940-9930 Web Site: www.book.bestwestern.com Located 5 miles north of the tournament site along Lakeshore Parkway in Homewood in the Wildwood Shopping Center. Embassy Suites Birmingham Hoover 2960 John Hawkins Parkway, Hoover, AL 35244 Phone: 205-985-9994 Fax: 205-985-9997 Web Site: www.embassysuites3.hilton.com Located less than 10 miles south of the tournament site on Hwy 150 (John Hawkins Pkwy) in Hoover, near the Riverchase Galleria Mall and the Patton Creek Shopping Center. Courtyard by Marriott Hoover 1824 Montgomery Highway South, Hoover, AL 35244 Phone: 205-988-5000 Web Site: www.marriott.com Located less than 10 miles south of the tournament site on Hwy 31 (Montgomery Hwy) in Hoover, near the Riverchase Galleria Mall and the Patton Creek Shopping Center. ADDITIONAL INFORMATION The tournament will be held in the gymnasium of Shades Mountain Christian School, located in the incorporated city of HOOVER which is south of the city of Birmingham. The cities of Hoover, Homewood, Mountain Brook, and Vestavia Hills are all subdivisions of Birmingham located around Shades Mountain. The tournament site is in a historical area of Hoover on Shades Mountain known as Bluff Park zip code 35226. The hotels listed above are some of those nearest the tournament site and are located in or near Hoover or Homewood. Should you have any questions, please do not hesitate to call us at (205) 822-1671. USA Martial Arts Bluff Park 645 Shades Crest Road Hoover, AL 35226 Contact: Keith MacConkey (205) 822-1671 Email: alo@usamartialarts.com