Confederación Dominicana de Judo (CONDOJUDO)

USA Traditional Kodokan Judo

2015 USA Traditional Kodokan Judo National & US Open Judo Championships Conducted by USA Traditional Kodokan Judo (USA-TKJ)   Friday June 5, 2015 Mandatory Check-In, Uniform Inspection, Weigh-In and Late Registration Saturday June 6, 2015  Competition Day, USA-TKJ National & US Open Championships Sanctioned by the following International Organizations & Programs: World Judo Federation (WJF), Panamerican Judo Union (PJU),  International Traditional Kodokan Judo (ITKJ) and Martial Arts International Federation (MAIF) Event Schedule: Friday, June 5, 2015 (Check-In, Weigh-in & Late Registration) NOTE: This is a "MANDATORY CHECK-IN” for All Competitors in All Divisions. Referee Course: 3:00- 6:00 PM - International Traditional Kodokan Judo Coaching Course: 3:00 - 5:00 PM - International Traditional Kodokan Judo Saturday, June 6, 2015 USA National & US Open Championships Competition Day    SPECTATOR FEE: Adults: $5.00 and Children Ages 5-12: $3.00 Hotel Reservations:  Courtyard Marriott, Courtyard Akron Stow  Address: 4047 Bridgewater Parkway - Stow, Ohio 44224 USA Phone For Reservations: 330-945-9722 When making Your Hotel Reservation mention "Judo Competition” for Special Discount Rate.      Event Date: June 5, 2015 2:00pm - June 6, 2015 6:00pm Registration Deadline: June 4, 2015 11:00pm [Eastern Time] Venue: Hickey Karate Center: 4540 Stow Road Stow, Ohio 44224 USA,   First Name Last Name Address Address (line 2) City State Zip Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongoCook IslandsCosta RicaCote D'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaeroe IslandsFalkland IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadaloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHrvatskaHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKoreaKuwaitKyrgyz RepublicLaoLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSt. HelenaSt. Kitts and NevisSt. LuciaSt. Pierre and MiquelonSt. Vincent and the GrenadinesSudanSurinameSvalbard & Jan Mayen IslandsSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUS Virgin IslandsUzbekistanVanuatuVenezuelaVietnamWallis and Futuna IslandsWestern SaharaYemenYugoslaviaZambiaZimbabwe Home Phone Email Gender     Male  Female  Judo School / Club Name Instructor Name Age Category*     Cadet (6-14 years)  Junior (15-20 years)  Senior (21+years)  I want to compete in the USA-TKJ National Championships.  JUDO SHIAI  JUDO KATA  JUDO SELF- DEFENSE  NOTE:  Registering for the US Open International Judo Championships at the same time as registering for the USA-TKJ National Championships will give a $20 credit on entry fees. I also want to compete in the US Open International Judo Championships.  JUDO SHIAI  JUDO KATA  JUDO SELF- DEFENSE  NOTE: All Competitors and Officials must be "current members” of the USA Traditional Kodokan Judo or of an Affiliate National Organization.  USA-TKJ Membership will be available at the "check-In” table on Friday at the Hickey Karate Center, 4540 Stow Road - Stow, Ohio 44224 USA. Phone: 330-388-3115 * You must be able to verify your identity and age (i.e. passport, driver's license, permit, parent/guardian, etc.). COMPETITION RULES & DIVISIONS Competition Rules:  ITKJ Competition Rules Note: An ALL WHITE Judo Uniform is required for USA Traditional Kodokan Judo NationalChampionships. This Judo Competition will follow International Traditional Kodokan Judo (ITKJ) Competition Rules of the MAIF. Competition Divisions: "Cadet” Judo (Ages 6 - 14 Years) Divisions. Exact ages, skill levels and weight classes will be determined actual based on entries. Each competitor is also required to have both Red and Blue colored belts. Specific color of belt will be announced by the referee. "Junior” (Ages 15 - 20 Years) Divisions. Exact ages, skills levels and weight classes will be determined based on actual entries. Each competitor is also required to have both Red and Blue colored belts. Specific color of belt will be announced by the referee. "Senior” (Ages 21 Years & Up) Divisions. Exact ages, skills levels and weight classes will be determined based on actual entries. Each competitor is also required to have both Red and Blue colored belts. Specific color of belt will be announced by the referee. Note: Championships Director reserves authority to adjust and/or combine divisions to provide forcompetition. Championships Medals will be presented for divisions that are actually competed. Weight Class For Shiai - Men & Boys     Men Select One  Senior - 69kg/136 lbs  Senior - 77kg/152 lbs  Senior - 85kg/170 lbs  Senior - 94kg/206 lbs  Senior - 94+kg/206+ lbs  Junior - 62kg/136 lbs  Junior - 69kg/152 lbs  Junior - 77kg/170 lbs  Junior - 85kg/187 lbs  Junior - 94kg/206 lbs  Junior -94+kg/206+ lbs  Cadets -46kg/101 lbs  Cadets -50kg/110 lbs  Cadets -55kg/121 lbs  Cadets -60kg/132 lbs  Cadets -66kg/145 lbs  Cadets -73kg/161 lbs  Cadets -81kg/178 lbs  Cadets 81+kg/178+ lbs  Weight Class For Shiai - Women & Girls     Women Select One  Senior - 55kg/121 lbs  Senior - 62kg/137 lbs  Senior - 70kg/154 lbs  Senior - 70+kg/154+ lbs  Junior - 49kg/108 lbs  Junior - 55kg/121 lbs  Junior - 62kg/137 lbs  Junior - 70kg/154 lbs  Junior - 70+kg/154+ lbs  Cadets -40kg/88 lbs  Cadets -44kg/97 lbs  Cadets -48kg/105 lbs  Cadets -52kg/115 lbs  Cadets -63kg/139 lbs  Cadets -63+kg/139+ lbs  Judo Kata Selection - Select all that apply  Nage no Kata  Katame no Kata  Kodokan Goshin Jutsu Kata  Kime no Kata  Ju no Kata  Itsutsu no Kata  Koshiki no Kata  Note: Championships Director reserves authority to adjust and/or combine divisions to provide forcompetition. Championships Medals will be presented for divisions that are actually competed. I want to compete in the USJJF National Ju-Jitsu Championships  Ju-Jitsu Self-Defense (DUO)  Ju-Jitsu Self-Defense (Free Form)  Ju-Jitsu Kata  Ju-Jitsu Kumite System  Ju-Jitsu Grappling Gi  Ju-Jitsu Grappling No Gi  Ju-Jitsu Kobudo  Waiver and Release of Liability In consideration of being allowed to participate in any way in the USA Traditional Kodokan Judo National & US Open Championships, a USA Traditional Kodokan Judo (USA-TKJ) athletics/sports program, and related events and activities, the undersigned: I agree that prior to participating, they will inspect the facilities and equipment to be used, and if the athlete believes anything is unsafe, he or she will immediately advise their coach or supervisor or USA-TKJ personnel of such condition(s) and refuses to participate. I 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 but the 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. I assume all the foregoing risks and accept personal responsibility for the damages following such injury,permanent disability or death. I release, waive, discharge and covenant notto sue the Bill Adam's Martial Arts & Fitness Center, USATraditional Kodokan Judo (USA-TKJ), United States Ju-Jitsu Federation (USJJF), and United States Martial Arts Federation (USMAF) their affiliated clubs, regional sports organizations,their respective administrators, directors, agents, consultants, 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. I authorize, and agree to hold harmless, whatever medical personnel that may be present at the tournament to take any action necessary, should I become injured. I further understand that tickets will be sold to spectators to watch the tournament; that news media and others might cover the tournament and that it may also be videotaped or otherwise shown to audiences around the world. I hereby consent to having my likeness shown, publicized, commented and/or reported on; and I do not expect to, and in fact waive any compensation I might otherwise be entitled to as a result thereof. I represent that I am in good health; that I am not presently, nor will I participate while under the influence of any drug or medication; that no one affiliated with this tournament has encouraged me to enter or made any representations regarding my fitness or ability to participate; that I have read and understood every provision of this release; and that I am legally competent to and freely enter into this waiver, release and assumption of risk agreement. Furthermore, if the competitor is a minor, I hereby certify that I am Parent or legal guardian of the above named minor; that I have read and understood every provision of this release; and that I am legally competent to and freely enter into this waiver, release and assumption of risk agreement on behalf of the minor and myself. USA Traditional Kodokan Judo (hereinafter 'Organizer') hereby expressly reserves the right to change, modify or otherwise edit information contained upon the competitor's registration form, including but not limited to: the competitor's school's name and affiliation and/or the competitor's name and/or nickname. Organizer likewise expressly reserves the right to add or remove a competitor from a division for any reason whatsoever with or without cause. The head coach of a school's competition team shall be granted the right to change a competitor's registration information up until one (1) day prior to the deadline for registration. Such changes are limited to:competitor's name/nickname, school affiliation and those members of the school that will be competing in the competition divisions. Absolutely no changes, regardless of the reason requested therefore shall be permitted beyond the time period stated in this paragraph. Field Type I have read the above Release and Waiver statement and:  I accept  Review Your Payment Information: Registration Fee: $45.00 Promotional Code:   Payment Method: Credit Card     Credit Card Holder First Name: Credit Card Holder Last Name: Credit Card Number: Credit Card Expiration:   01 - January  02 - February  03 - March  04 - April  05 - May  06 - June  07 - July  08 - August  09 - September  10 - October  11 - November  12 - December   /   2015  2016  2017  2018  2019  2020  2021  2022  2023  2024  2025  Credit Card Security Code:   Billing Information: First Name: Last Name: Address: City: State/Province: Zip/Postal: Country: AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongoCook IslandsCosta RicaCote D'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaeroe IslandsFalkland IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadaloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHrvatskaHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKoreaKuwaitKyrgyz RepublicLaoLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSt. HelenaSt. Kitts and NevisSt. LuciaSt. Pierre and MiquelonSt. Vincent and the GrenadinesSudanSurinameSvalbard & Jan Mayen IslandsSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUS Virgin IslandsUzbekistanVanuatuVenezuelaVietnamWallis and Futuna IslandsWestern SaharaYemenYugoslaviaZambiaZimbabwe Phone: Email: Billing and Payment Billing and payment processing for Businesses' events is performed by Member Solutions, Inc. ("MSI"), and this contract is specifically assigned to MSI for all such purposes. Customer knowingly and irrevocably authorizes MSI to charge electronically Customer's bank account and/or credit card for any and all amounts due for Customer's, and anyone registering under Customer's, attendance and participation in the Event. The phrase "8882448044 ONLINE REG FEE" will appear on your bank or credit card statement. Any returned payment will be assessed a $25.00 fee. Any unsuccessful electronic transaction is subject to a $10.00 processing fee. MSI is not responsible for any bank fees incurred by Customer. MSI has the sole right to resubmit returned or declined items (plus applicable fees) without prior notice. BILLING INQUIRIES -- 888-244-8044 or by mail to PO Box 297, Hatboro, PA 19040. Applicant Agreement I represent that I am the person who appears on the application above. I acknowledge and agree to the statements, terms and conditions above, as well as any applicable terms and conditions for this registration, and that by typing my name below and completing this registration form, I am electronically signing the document, which will have the same legal effect as the execution of the document by a written signature and shall be valid evidence of my intent and agreement to be bound. Applicant Signature Please enter your full name in the space below. Please click the button below to finalize your registration. Registration inquiries: For further details or questions - Contact: Mr. Bruce R. Bethers, Championships Director Email: natlhq.usatkj@gmail.com or brucebethers@gmail.com National Office: 775-851-8875 Cell: 775-813-1195 = required field