Celita Schutz EAST COAST CHAMPIONSHIPS Judo Tournament Date: Sunday, June 11, 2017 Location: Monsignor Farrell High School 2900 Amboy Road, Staten Island, NY 10306 Online Registration is NOW Available! www.kokushikai.com Sanctioned By: USJA and USA JUDO Tournament Directors: Dave Goodwin sensei@bushidodojosi.com Celita Schutz celita@kokushikai.com www.bushidodojosi.com www.kokushikai.com 718-966-9566 Dojo 201-797-8988 Dojo Tournament Coordinator: Tamara Hemingway, tamarahemingway@gmail.com cell: 908-300-4242 Technical Advisor: Head Referee: Eligibility: Awards: Yoichiro Matsumura Charles Schweizer PJC-C (Vice Chairman: USJA RC) Any judoka, age 5 to adult, who has a CURRENT USA Judo, USJA or USJF Card or National Passport Card for foreign athletes. Judo players must present card at registration. A photocopy of your card/judo passport must be sent with your application. 1 st, 2 nd and 3 rd place Celita Schutz East Coast Championship medals 1 st, 2 nd and 3 rd place Overall Club Trophies Entry Fee & Deadline: Postmarked by May 31, 2017 and received by June 4, 2017: Early Bird Registration is $60 for 1st Division- $40 for Additional Division(s) Family Discounts Available Late Fee & Deadline: If received between June 5 and June 9, 2017: Late fee is $75 per competitor - $40 for Additional Division(s) Super Late Registration on June 10 or June 11 is $90 per competitor (no exceptions) Spectator Fee: Food: Tournament Schedule: 8:00 am Doors Open Weigh-ins: $5 per individual / $15 per family There will be food available for purchase on site. 8:00 am Doors open for Referee s and Volunteers only 8:30 am Referee and Volunteer/Technical Table Meeting 9:00 am Doors open for Competitors and Spectators 9:45 am Check-in and Walk-up Registration Ends for Cadets, IJF Seniors and Veterans 10:30 am Competition begins for Cadets, IJF Seniors and Veterans 12:00 pm Check-in and Walk-up Registration ends for Co-ed (5-6 yrs) and ALL Juniors (7-14 yrs) 1:00 pm (will not start before) Competition begins for Co-Ed (5-6 yrs) and ALL Juniors (7-14 yrs) Club Coach must certify player s weight on application. If there is a discrepancy, player s weight will be checked at the venue. Download Full Application : www.kokushikai.com or www.bushidojosi.com
Rules: 2017 IJF Rules will govern, except (1) no armlocks will be allowed in the 13-14 divisions (2) matside coaching will be allowed in all divisions and (3) players will be allowed to change gis to conform to the rules, without being penalized. Modified Double Elimination for all pools except 3 & 4 player pools will fight Round Robin. No chokes for 12 and under. No armbars for ANY novice categories. Current IJF medical rules (no examination except for blood or grave injury) will apply to all divisions. All female contestants are required to wear a plain white tee shirt or leotard to compete! All contestants, including juniors must bring at least one white gi. A player called to white side must wear a white gi, or forfeit- no exceptions. Blue judo gis are to be worn on blue side ONLY, but are not required. Players may bring their own blue belt to be worn instead. Tournament Director(s) reserve the right to make changes as needed. Match Times: Co-ed Juniors 5 and 6 yrs: 2 minutes/2 minute Golden Score Juniors 7-14. All Novice & Veterans: 3 minutes /3 minute Golden Score Cadet (15-16) and IJF (17-19): 4 minutes /Unlimited Golden Score Elite Seniors: 4 minutes/unlimited Golden Score Divisions: Boys and Girls 5-6 years old are placed in Co-Ed Round Robin pools of 3-4 players based on weight and rank. All 5-6 yrs old players will receive medals! Weights are in Kilograms Novice Jr. Boys 7-8 years old: 20, 23, 27, 32, 37, 37+ (Pounds 2.2 = Kilograms) Novice Jr. Boys 9-10 years old: 27, 31, 35, 39, 44, 50, 50+ Novice Jr. Boys 11-12 years old: 35, 42, 47, 53, 58, 58+ Novice Jr. Boys 13-14 years old: 42, 47, 52, 58, 65, 65+ Novice Cadet Male 15-16 years old: 55, 60, 66, 73, 81, 90, 90+ Novice IJF Male 17 19 years old: 55, 60, 66, 73, 81, 90, 90+ Novice Jr. Girls 7-8 years old: 20, 23, 27, 32, 32+ Novice Jr. Girls 9-10 years old: 27, 31, 35, 39, 43, 43+ Novice Jr. Girls 11-12 years old: 27, 32, 37, 42, 47, 47+ Novice Jr. Girls 13-14 years old: 44, 48, 52, 57, 63, 70, 70+ Novice Cadet Girls 13-14 years old: 44, 48, 52, 57, 63, 70, 70+ Novice IJF Girls 15-16 years old: 44, 48, 52, 57, 63, 70, 70+ Novice Senior Men: 65, 73, 81, 90, 100, 100+ Novice Senior Women: 58, 66, 74, 74+ Novice Veteran Men: Age 30-39 70, 81, 94, 94+ Age 40-49 70, 81, 94, 94+ Age 50+ 70, 81, 94, 94+ Novice Veteran Women: Age 30-44 58, 66, 74, 74+ Age 45+ 58, 66, 74, 74+ Jr. Boys 7-8 years old: 20, 23, 27, 32, 37, 37+ Jr. Boys 9-10 years old: 27, 31, 35, 39, 44, 50, 50+ Jr. Boys 11-12 years old: 35, 42, 47, 53, 58, 58+ Jr. Boys 13-14 years old: 42, 47, 52, 58, 65, 65+ Cadet. Male 15-16 years old: 55, 60, 66, 73, 81, 90, 90+ IJF Male 17 19 years old: 55, 60, 66, 73,81,90, 90+ Jr. Girls 7-8 years old: 20, 23, 27, 32, 32+ Jr. Girls 9-10 years old: 27, 31, 35, 39, 43, 43+ Jr. Girls 11-12 years old: 27, 32, 37, 42, 47, 47+ Jr. Girls 13-14 years old: 44, 48, 52, 57, 63, 70, 70+ Cadet Girls 15-16 years old: 44, 48, 52, 57, 63, 70, 70+ IJF Girls 15-16 years old: 44, 48, 52, 57, 63, 70, 70+ Senior Men Elite: 55, 60, 66, 73, 81, 90, 100, 100+ Senior Women Elite: 44, 48, 52, 57, 63, 70, 78, 78+ Brown and Black Belts Brown and Black Belts Veteran Men Age 30-39 70, 81, 94, +94 Age 40-49 70, 81, 94, +94 Age 50+ 70, 81, 94, +94 Veteran Women Age 30-44 58, 66, 74, 74+ Age 45+ 58, 66, 74, 74+ The Tournament Directors reserve the right to make any changes they deem necessary to insure the safety and fairness to all competitors.
Entry Form for Juniors 5-14, Cadet (15-16), IJF (17-19) and Jr. Novice US FUNDS ONLY Fee is Per Entry, Per Division No Exceptions Standard Registration Postmarked by June 1st Late Registration Received between June 6th and June 10th 1 st Division 2 nd Division 1 st Division 2 nd Division $60 $40 $75 $40 Note: The Special Family Plan 1 st Division for 2nd & 3rd child is $40.00, 4th child free - is only available for Standard Registration and must be postmarked by May 31, 2017. All applications must be received by June 9 th. Super Late Registration on JUNE 10 or JUNE 11 is $90 (NO EXCEPTIONS) Make all checks payable (US Funds Only) to Kokushikai Inc and mail to: Celita Schutz ECC Online Registration is NOW Available! 24-28 Fair Lawn Ave. www.kokushikai.com Fair Lawn, NJ 07410 NO PHONE ENTRIES. NO FAX ENTRIES. NO EMAIL ENTRIES. NO REFUNDS. All athletes competing in two categories must fill out two forms Contestant s Last Name First Name Date of Birth: Address: City: State Zip Tel. # Judo Club: Rank: Card # (USA JUDO, USJA,USJF) Exp Date Age: Sex: Foreign Athlete Judo Passport # USA Citizen Yes No Email Division - Please check Division: (2.2 pounds = 1kg) All athletes competing in two divisions must fill out two forms Co-Ed Boys and Girls: 5-6 Weight (kgs only) Novice Jr. Boys (White/Yellow): 7-8 9-10 11-12 13-14 15-16 17-19 Weight (kgs only) Junior Boys (): 7-8 9-10 11-12 13-14 Cadet 15-16 IJF 17-19 Weight (kgs only) Novice Jr. Girls (White/Yellow): 7-8 9-10 11-12 13-14 15-16 17-19 Weight (kgs only) Junior Girls (All Ranks): 7-8 9-10 11-12 13-14 Cadet 15-16 IJF 17-19 Weight (kgs only) If player is uncontested in this division I authorize player to (check one): Move up next weight within same age group Move up age group within same weight Accept uncontested medal I certify that all of the above information is correct. Signature: (Contestant 18 years or older or Parent/Guardian) Instructor/Coach Certificate Regarding Contestants Weight I,, a judo instructor, who has been awarded the Judo rank of Name of Instructor Shodan or higher, recognized by under the auspices of the USJI, USJF, USJA or Judo Canada, hereby certify that, is at the weight declared of in the above Entry Form. Name of contestant Contestant s weight in kilograms (Divide pounds by 2.2) I understand that if this player is not at the declared weight on the day of the tournament he/she may be removed from competition and not allowed to participate. Judo Instructor (print) Signature of Judo Instructor
Entry Form for Seniors and Novice Seniors US FUNDS ONLY Fee is Per Entry, Per Division No Exceptions Standard Registration Postmarked by June 1st Late Registration Received between June 6th and June 10th 1 st Division 2 nd Division 1 st Division 2 nd Division $60 $40 $75 $40 Note: The Special Family Plan 1 st Division for 2nd & 3rd child is $40.00, 4th child free - is only available for Standard Registration and must be postmarked by May 31, 2017. All applications must be received by June 9 th. Super Late Registration on JUNE 10 or JUNE 11 is $90 (NO EXCEPTIONS) Make all checks payable (US Funds Only) to Kokushikai Inc and mail to: Celita Schutz ECC Online Registration is NOW Available! 24-28 Fair Lawn Ave. www.kokushikai.com Fair Lawn, NJ 07410 NO PHONE ENTRIES. NO FAX ENTRIES. NO EMAIL ENTRIES. NO REFUNDS. All athletes competing in two categories must fill out two forms Contestant s Last Name First Name Date of Birth: Address: City: State Zip Tel. # Judo Club: Rank: Card # (USA JUDO, USJA,USJF) Exp Date Age: Sex: Foreign Athlete Judo Passport # USA Citizen Yes No Email Division - Please check Division: (2.2 pounds = 1kg) All athletes competing in two divisions must fill out two forms Senior Novice Women () Weight Class weight in kgs only Senior Women Elite (Brown and Black Belts) Weight Class weight in kgs only Senior Novice Men () Weight Class weight in kgs only Senior Men Elite (Brown and Black Belts) Weight Class weight in kgs only If player is uncontested in this division I authorize player to (check one): Move up next weight within same age group Move up age group within same weight Accept uncontested medal I certify that all of the above information is correct. Signature: (Contestant 18 years or older or Parent/Guardian) Instructor/Coach Certificate Regarding Contestants Weight I,, a judo instructor, who has been awarded the Judo rank of Name of Instructor Shodan or higher, recognized by under the auspices of the USJI, USJF, USJA or Judo Canada, hereby certify that, is at the weight declared of in the above Entry Form. Name of contestant Contestant s weight in kilograms (Divide pounds by 2.2) I understand that if this player is not at the declared weight on the day of the tournament he/she may be removed from competition and not allowed to participate. Judo Instructor (print) Signature of Judo Instructor
Entry Form for Veterans and Novice Veterans US FUNDS ONLY Fee is Per Entry, Per Division No Exceptions Standard Registration Postmarked by June 1st Late Registration Received between June 6th and June 10th 1 st Division 2 nd Division 1 st Division 2 nd Division $60 $40 $75 $40 Note: The Special Family Plan 1 st Division for 2nd & 3rd child is $40.00, 4th child free - is only available for Standard Registration and must be postmarked by May 31, 2017. All applications must be received by June 9 th. Super Late Registration on JUNE 10 or JUNE 11 is $90 (NO EXCEPTIONS) Make all checks payable (US Funds Only) to Kokushikai Inc and mail to: Celita Schutz ECC Online Registration is NOW Available! 24-28 Fair Lawn Ave. www.kokushikai.com Fair Lawn, NJ 07410 NO PHONE ENTRIES. NO FAX ENTRIES. NO EMAIL ENTRIES. NO REFUNDS. All athletes competing in two categories must fill out two forms Contestant s Last Name First Name Date of Birth: Address: City: State Zip Tel. # Judo Club: Rank: Card # (USA JUDO, USJA,USJF) Exp Date Age: Sex: Foreign Athlete Judo Passport # USA Citizen Yes No Email Division - Please check Division: (2.2 pounds = 1kg) All athletes competing in two divisions must fill out two forms Veteran Novice Women (): Age Group: 30 34 45 and over Weight kgs only Veteran Women (All Ranks): Age Group: 30 34 45 and over Weight in kgs only Veteran Novice Men (): Age Group: 30 39 40 49 50 and over Weight kgs only Veteran Men (All Ranks): Age Group: 30 39 40 49 50 and over Weight kgs only If player is uncontested in this division I authorize player to (check one): Move up next weight within same age group Move up age group within same weight Accept uncontested medal I certify that all of the above information is correct. Signature: (Contestant 18 years or older or Parent/Guardian Instructor/Coach Certificate Regarding Contestants Weight I,, a judo instructor, who has been awarded the Judo rank of Name of Instructor Shodan or higher, recognized by under the auspices of the USJI, USJF, USJA or Judo Canada, hereby certify that, is at the weight declared of in the above Entry Form. Name of contestant Contestant s weight in kilograms (Divide pounds by 2.2) I understand that if this player is not at the declared weight on the day of the tournament he/she may be removed from competition and not allowed to participate. Judo Instructor (print) Signature of Judo Instructor
Certificate Regarding Non-Black belt Contestants I,, a judo instructor, who has been awarded the Judo rank of Name of Instructor Shodan or higher, recognized by under the auspices of the USJI, USJF, USJA or Judo Canada, hereby certify that, although not having been awarded the Judo rank of Shodan or Name of contestant higher, is of sufficient aptitude and skill in Judo to compete in these Championships. Judo Instructor (print) Rank Signature of Judo Instructor 2017 Celita Schutz East Coast Championship Credit Card Charge Request If you wish to use your Credit Card for Entry Fee, please complete the following information and enclose with your application form(s): Name: Billing Address Associated with Credit Card: Telephone #: Credit Card (circle one): MasterCard VISA Credit Card # / / / Credit Card Expiration Date CVV Code: (Month) (Year) Name of athlete if different from card holder: Name as it appears on Credit Card (please print): Amount authorized to charge: $ Signature: Date:
WARNING! WAIVER AND RELEASE OF LIABILITY AND AGREEMENT TO PARTICIPATE (Including Limited Co-Ed Competition for Age 8 and Under for USJI Sanction) In consideration of being permitted to participate in any way, including travel to and from, in any Judo tournament, practice, clinic, and related events and activities ( Activity ) of the USA Judo/United States Judo, Inc., United States Judo Association, Inc., United States Judo Federation, Inc., Hudson Judo Yudanshakai, Monsignor Farrell High School, Kokushiaki Judo Academy, Bushido Dojo of Staten Island, any Medical & Emergency Services Company and Individuals, 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 divisions, 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 severe 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 covenant not to sue the USA Judo/United States Judo, Inc., United States Judo Association, Inc., United States Judo Federation, Inc., Hudson Judo Yudanshakai, Monsignor Farrell High School, Kokushiaki Judo Academy, Bushido Dojo of Staten Island, any Medical & Emergency Services Company and Individuals, together with their affiliated clubs, their respective administrators, directors, officers, agents, 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, loss, liability, damage or costs 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 to the fullest extent permitted by law. I HAVE READ THE ABOVE WARNING, WAIVER, AND RELEASE, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND KNOWING THIS, SIGN IT VOLUNTARILY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE. CONSISTENT WITH THE BY-LAWS OF USJF, THIS TOURNAMENT MAY INCLUDE CO-ED COMPETITION FOR AGES 10 AND UNDER IN COMPARABLE AGE/WEIGHT DIVISIONS WHERE THERE IS AN INSUFFICIENT NUMBER OF GIRLS FOR NON-CO-ED AGE/WEIGHT DIVISIONS. I HAVE READ AND UNDERSTAND THE TOURNAMENT ANNOUNCEMENT CONCERNING THESE SPECIAL DIVISIONS. 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 EVIDENCED BY THEIR SIGNATURE BELOW. I INTEND THIS TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT 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 Participant s Signature Date FOR PARENTS/LEGAL GUARDIANS OF PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT TIME OF REGISTRATION) This is to certify that I, as parent/legal 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 costs 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 minor participant as to the above warnings and conditions and their ramifications. Parent/Legal Guardian Parent/Legal Guardian s Signature Date
CSECC ENTRY REQUIREMENTS CHECKLIST To assure that the requirements for participation in the Celita Schutz East Coast Championship have been fulfilled, the following forms must be completed and sent to the address printed at the bottom of this page. Official Entry Form(s) and appropriate fees Copy of current USA JUDO, USJA or USJF membership card. Certificate Regarding Contestant s Weight signed by Contestant s Coach/Instructor Certificate for Non-Black Belt Contestants Signed Warning, Waiver, Release of Liability and Agreement to Participate Contestants & Parent/Guardian Signatures wherever requested on all documents Proof of Age: Copy of birth certificate, passport, or driver s license. Send Application and Payment To: 2017 Celita Schutz ECC 24-28 Fair Lawn Ave. Fair Lawn, NJ 07410 Checks should be made to: Kokushikai Inc.
Driving Directions to Monsignor Farrell High School: 2900 Amboy Road, Staten Island, NY 10306 From the NJ Turnpike: Take exit 13 (Elizabeth) to Goethals Bridge: Take the Staten Island Expressway (I278) Eastbound to Exit 12 (Todt Hill Rd.) At Stoplight turn right onto Slosson Avenue, Continue on Slosson Avenue/Todt Hill Road to end. Turn right onto Richmond Road. Continue on Richmond Road approximately 1.1 miles, take the fork to the left onto Amboy Road, Proceed on Amboy Road to 2900. Venue will be on left. From Brooklyn/Verrazano Bridge: Take the Staten Island Expressway Westbound to exit 12 (Todt Hill Road) Turn Left onto Slosson Ave. Proceed as above. From the Garden State Parkway: Take exit 127 for NJ 440 towards I-287N, follow signs for NJ 440 N / Perth Amboy. Keep left at the fork and merge onto NJ 440 N. Continue on NJ 440 North to the Outerbridge Crossing. Take the Korean War Veterans Highway 8.2 miles to end. Proceed to Arthur Kill Road. Make Right turn on Arthur Kill road. At next traffic light turn right onto Richmond Avenue. Continue Approximately 2 miles on Richmond Avenue to Amboy Road. Turn Left on Amboy Road. Continue on Amboy road 2.8 miles to venue on Left Public Transportation to Monsignor Farrell High School: Ferry: Take Staten Island Ferry to Staten Island Rapid Transit. Take SIRT to the Oakwood Station. Venue is directly behind the train station. NYC Transit Bus from Staten Island Ferry ramp D, take bus S55 to venue. Tournament Main Hotel (Limited Number of Blocked Rooms: ask for East Coast Championship Rate of $159) Hampton Inn 1120 South Ave Staten Island, NY 10314 718-477-2400 Other Area Hotels Comfort Inn Hilton Garden Inn 310 Wild Ave 1100 South Ave Staten Island, NY 10314 Staten Island, NY 1-314 718 3708555 718-477-2400 Tournament Area Airports: (LGA) La Guardia Airport, NYC (JFK) John F. Kennedy Airport, NYC (EWR) Newark Airport, NJ