2010 JKA AMERICAN FEDERATION
NATIONAL TOURNAMENT
November 13 – 14, 2010
New Orleans, Louisiana, USA
National Karate Tournament
National Senior Tournament
National Youth Tournament
National Collegiate Tournament
REGISTRATION PACKAGE
November 13 and 14, 2010
University of New Orleans
Health & P. E. Center
New Orleans, Louisiana
706-C Phosphor Avenue
Metairie, LA 70005
Phone 504-835-6825 Fax 504-835-6825
Email:
Contents
Table of Contents……………………………………………………………………………………………………………………………………1
General Information………………………………………………………………………………………………………………………………..2
Important Deadlines………………………………………………………………………………………………………………………………..3
Schedule of Events………………………………………………………………………………………………………………………………….4
Schedule of Events (continued)……………………………………………………………………………………………………………….5
Fees and Admission Fees………………………………………………………………………………………………………………….…….6
Competitor Checklist and Dan Exam Fees...... 7
Dan Exam Form...... 8
Selection of Judges Form...... 9
Participant's Medical Questionnaire……………………………………………………………………………………………………..10
Waiver / release Agreement...... 11
Adult Division - General Information...... 12
Adult Individual Black Belt Club Representative Seeding Form...... 13
Adult Individual Registration Form...... 14
Brown Belt Adult Individual Registration Form...... 15
Black Belt Adult Individual Registration Form...... 16
Adult Club Team Registration Form...... 17
Senior Division Qualifications and Rules...... 18
Senior Individual Registration Form...... 19
Brown Belts Senior Individual Registration Form...... 20
Black Belts Senior Individual Registration Form...... 21
Senior Team Kata Registration Form...... 22
Collegiate General Information...... 23
Collegiate Contest Rules...... 24
Collegiate Individual Registration Form...... 25
Collegiate Team Registration Form...... 26
Youth Division – General Information...... 27
Youth Division – Rules...... 28
Youth Individual Registration Form...... 29
Youth Team Registration Form - Kata Only...... 30
T-Shirt Order Form...... 31
Party Reservation Form...... 32
Program Advertising Form...... 33
2010 JKA/AF Karate Tournament
General Information
Event:JKA American Federation National Adult Tournament, National Senior Tournament, National Youth Tournament, National Collegiate Tournament
When:November 13 – 14, 2010
Where:University of New Orleans
Health & P. E. Center
New Orleans, Louisiana
For Tournament information:JKA American Federation
Phone 504-835-6825 Fax 504-835-6825
Email:
Make Payments to:JKA American Federation
Mail to:706-C Phosphor Ave.
Metairie, LA 70005
2010 JKA/AF Karate Tournament
Important Deadlines
Hotel Reservations: list and information to follow
Advertising Entries: Information to follow
Tournament Judges: Post Marked October 30, 2010
See enclosed judges selection form
Dan Examination Registrations:November 12, 2010
Must check in Friday November 6th, 2010 at JKA/AF Headquarter (706-C Phosphor Avenue, Metairie, LA 70005)
Tournament Registrations: Post marked October 30, 2010
All Participants must check in Friday November 6th, 2010 at JKA/AF Headquarter (706-C Phosphor Avenue, Metairie, LA 70005)
Who Can Participate
Tournament:
The Tournament is open to any JKA member in the United States, regardless of JKA organization.
(This is a National Tournament only. No members from outside the United States may participate)
Dan Examinations:
JKA/AF members (only)
2010 JKA/AF Karate Tournament
Schedule of Events
Friday, November 12, 2010
12:00 Noon tillCheck in for all competitors
JKA/AF Head quarter
706-C Phosphor Avenue, Metairie, LA 70005
Saturday, November 13, 2010
7:45 AMJUDGES MEETING
8:00 AMJKA American Federation Tournament Begins
Competition Eliminations and Finals Youth (up to 13 yrs)
Competition Eliminations – Collegiate, Senior and Adult Division
Time to be announcedParty location and map to follow
Sunday, November 14, 2010
9:00 AMDan exams
11:00 AMDoors Open
NoonOpening Ceremony
Demonstration
National Youth Final EventsBoys (14 – 15) Brown & Black Belts
Kata:3 finalist
Kumite2 finalist
Girls (14 – 15) Brown & Black Belts
Kata:3 finalist
Kumite2 finalist
Boys (16 – 17) Brown & Black Belts
Kata:3 finalist
Kumite2 finalist
Girls (16 – 17) Brown & Black Belts
Kata:3 finalist
Kumite2 finalist
Team
Kata: 3 finalists
2010 JKA/AF Karate Tournament
Schedule of Events (continued)
National Collegiate Final EventsWomen (Brown and Black Belt)
Kata:3 finalists
Kumite:2 finalists
Men (Brown and Black Belt)
Kata:3 finalists
Kumite: 2 finalists
Team
Kata:3 finalists
Kumite:2 finalists:
National Senior FinalWomen
Kata:3 finalists
Kumite:2 finalists:
Men
Kata:3 finalists
Kumite:2 finalists
Team
Kata: 3 finalists
JKA/AF National AdultWomen
Kata:3 finalists
Kumite:2 finalists:
Men
Kata:3 finalists
Kumite:2 finalists
Women’s Team
Kata: 3 finalists
Kumite:4 finalists
Men’s Team
Kata: 3 finalists
Kumite:4 finalists
Closing CeremoniesAwards Presentation and Closing ceremonies
2010 JKA/AF Karate Tournament
Fees and Admission Prices
JKA/AF Karate Championship fees:
Adult Division:Individual, Single Event$40
Individual, Both Events$50
Team$100
Senior Division:Individual, Single Event$40
Individual, Both Events$50
Team Kata$100
Youth Division:Individual, Single Event$30
Individual, Both Events$40
Team Kata$50
National Collegiate tournament fees:
Individual Single Event$30
Individual, Both Events$40
Team $50
REGISTRATIONS POSTMARKED AFTER OCTOBER 30TH, 2010 WILL BE ASSESSED A $l0 HANDLING FEE PER CONTESTANT.
JKA/AF membership card may be purchased at the tournament for $50.
All JKA/AF collegiate contestants must show a current membership card or JKA passport and 2010 College ID.
Spectator Admission Prices: Competitors and Judges in uniform are free
$ 6 One Day Pass
$10 Two Day Pass
$ 4 Children (12 & Under)
2010 JKA/AF Karate Tournament
Competitor Checklist and Dan Exam Fees
COMPETITOR CHECKLIST
______Mouthpiece
______Gloves (padded all cotton)
______Current JKA/AF Card or JKA passport for JKA/AF members
______Current student ID card (2010)
______Standard White Gi
Dan Examination will take place on Sunday morning at 9 a.m. at the University of New Orleans.
DAN EXAMINATION FEES- payable to JKA/AF
Shodan$ 80.00
Nidan$100.00
Sandan$120.00
Yondan$150.00
DAN REGISTRATION FEES- payable to JKA/AF
Shodan$90.00
Nidan$120.00
Sandan$165.00
Yondan$200.00
Please make check or money orders payable to: JKA American Federation
Please send to:706-C Phosphor Ave.
Metairie, LA 70005
2010 JKA/AF Karate Tournament
Dan Exam Form
Please type or print clearly.
Name______
Date of Birth______/______/______
Gender M / F Rank (dan)______
Address ______
City ______State ______Zip ______Country ______
Telephone ( )______Fax ( )______E-Mail ______
Dojo ______
Dan rank you are testing for: ______
Signature______
Date______
List previous JKA Dan registration numbers (if applicable):
Rank / Registration Number / Date of Exam / Chief Instructor/Examiner’s nameShodan
Nidan
Sandan
*All Examinees must be members of the Japan Karate Association thru Affiliations officially recognized by the JAPAN KARATE ASSOCIATION and have a current JKA passport.
The Dan Registration Form must be signed by their Chief Instructor.
2010 JKA/AF Karate Tournament
Selection of Judges Form
Judges must meet the requirements as established by t he JKA/AF and the JKA. The Chief Instructor and/r tournament director will designate the Chief Judge and Arbitrator.
This is to confirm that the following persons wills serve as Judges at the 2010 JKA/AF National Karate Tournament and Collegiate Tournament.
Club:______
NameDan Rank Judge's Rank
(A, B, C, D or none)
1. ______
2. ______
3. ______
4. ______
5. ______
6. ______
Signature of Club Director:______
This information must be postmarked no later than October 24, 2010.
ALL JUDGES MUST SHOW VALID JKA QUALIFICATION CARD
2010 JKA/AF Karate Tournament
Waiver/release agreement
PARTICIPANT’S MEDICAL QUESTIONNAIRE:
To be completed by all adults and guardians of minors attending the JKAAF National Tournament 2010.
Name______Date of Birth______Sex______Rank______
Address______City ______State_____ Zip______
Organization______Country ______Dojo ______
Do you have a history of any of the following conditions? Please check either yes or no for each one.
If you answer yes to any, please explain:
Yes No
______Heart murmur
______Hypertension
______Recent infection
______Bone fracture in the past six months
______Concussion or severe head injury in the past six months
______Seizures
______Eye injury
______Severe bone bruises requiring padding
______Kidney injury
______Allergy to medication (list all):
______Are you currently taking any medications? If yes please specify ______
______Other:______
______Date ______
Signature of Participant (Parent or Guardian if under 18 years of age)
WAIVER/RELEASE AGREEMENT: Event: the JKAAF National Tournament 2010. I understand that there are risks and dangers inherent in martial arts training and in participating in and/or receiving instruction at the EVENT. I understand and agree that by signing this Waiver/Release, I am assuming full responsibility for any and all risk of personal injury or death or for property damage suffered by me while participating in and/or receiving instruction at the EVENT. I expressly acknowledge that my participation in the EVENT may subject me to personal injury or bodily harm and I assume any and all risks of that participation. I also understand that in order to be allowed to participate
in and/or receive instruction at the EVENT, I must give up my rights to hold the JKA American Federation and its affiliates, All South Karate Federation , University of New Orleans, and any and all other clubs, schools, instructors, members, judges, officials, representatives and all other participants (collectively the “Releasees”) liable for any injury or damage which I may suffer while participating in and/or receiving instruction at the EVENT.
I also understand and agree that by signing the Waiver/Release, I acknowledge that I am solely responsible for having or obtaining all insurance coverage which may be necessary or desirable in connection with my participation in and/or receipt of instruction at the EVENT and for any travel to and from the EVENT and in all lodging or any other activities which may be related directly, indirectly or incidentally to the foregoing. I further understand and agree that any fees or costs required for necessary or requested medical attention shall be my sole responsibility and that I shall not seek indemnification or contribution from any Releasee in connection therewith. I also understand that the Releasees shall not be responsible for any incidental, consequential or exemplary damages of any kind even if they are notified of the possibility of such in advance. I also understand and agree that any damage to any lodging sites or the tournament site that I cause is my full responsibility. In no case are said damages the responsibility of any of the Releasees. I further understand and agree that as consideration for my participation in the EVENT, the JKA American Federation and /or its designees shall have the right to use my name, image or likeness in the promotion of the EVENT or in any publication relating to the EVENT (or similar Events) and in any broadcast or rebroadcast transmission of the EVENT without any additional consideration to me for the use of my said name, image, audio/sound or likeness.
I understand and agree that this Waiver/Release will have the effect of releasing, discharging, waiving and forever relinquishing any and all actions or causes of action that I may have or have had, whether past, present or future, whether known or unknown, and whether anticipated or unanticipated by me, arising out of my participation in and/or receipt of instruction at the EVENT. Knowing this, and in consideration of being permitted to participate in and/or receive instruction at the EVENT, I hereby release and agree to indemnify
and hold harmless the above-named Releasees individually and their entities, and their officers, agents, principals, partners, shareholders, directors and employees from any and all liability or costs, including attorney fees, associated with or arising from my participation in and/or receipt of instruction at the EVENT. I further understand and agree that this Waiver/Release will be binding on my spouse, my heirs, my personal representative, my assigns, my children, any guardian ad litem and me for said children.
I understand that if I am signing this Waiver/Release on behalf of my minor child, that I will be giving up the same rights for said minor as I would be giving up if I signed this document on my own behalf. I acknowledge that I have read this Waiver/Release Agreement and that I understand the words and language in it.
Print Name______Date______
Sign Name______Witness______
Contestants Medical Questionnaire
THIS FORM IS FOR MINOR PARTICIPANTS AND MUST BE FILLED OUT BY PARENT OR LEGAL GUARDIAN. PLEASE PRINT CLEARLY. ALL INFORMATION MUST BE SUPPLIED.
EMERGENCY CONTACT AND MEDICAL INFORMATION:
Name of Parent/Legal Guardian: ______
Address:______City______State______Zip______
Telephone ______(day) ______(night) Child’s Name:______
Any recent or present condition or injury: ______
My child is allergic to the following medications: ______
My child routinely takes the following medication: ______
Her/his last tetanus immunization was: ______
CONSENT FOR EMERGENCY TREATMENT:
Date: _____/_____ /_____
I hereby give permission to the Emergency Department at any hospital chosen or designated by the JKA American Federation to treat my son/daughter (name of minor):
Last Name ______First Name ______
while we are away. I understand this permission covers the average emergency such as strain, sprain, cut, bruise, scrape, bump, skin rash such as impetigo, poison oak or ivy, bites such as bee stings and snake bites, allergic reactions, foreign bodies in the eye or skin, upset stomach, diarrhea, pink eye, minor burns, sunburn, suspected minor fractures, minor concussions, fevers, diagnostic x-rays, suturing, and the like. I give permission for my child to receive a tetanus booster (if needed). This permission is valid for 6 months only. I also understand that in cases of major significance such as a fracture, appendicitis, or any illness or injury requiring admission that additional consents will be necessary for treatment and that the hospital will make every attempt to reach me. I can be reached at the above address.
Authorization is hereby given to release to:
______
(insurance company) (policy number)
any information needed to complete hospitalization claims.
Finally, I understand in cases of acute emergency when hospital personnel have attempted to notify me and are unable to reach me, that this permission form will suffice for treatment until such time as I am able to be reached. While we are away, (name of minor):
Last Name ______First Name ______
is under care of: JKA American Federation
This form is for minor participants and must be filled out by Parent or Legal Guardian. Please print clearly. All information must be supplied.
JKA American Federation/ All South Karate Federation PARENTAL CONSENT FORM:
First Aid
I hereby give permission for JKA American Federation / All South Karate Federation (hereinafter “JKAAF/ASKF) doctor
or nurse to administer minor first aid and/or seek emergency medical care for my son/daughter (name of minor):
Last Name ______First Name ______
during his/her stay at the JKA American Federation National Tournament 2010 being held at University of New Orleans, New Orleans, Louisiana, November 7 - 8, 2010. I understand that this permission covers the average emergency such as, but not limited to, strains, sprains, cuts, bruises, scrapes, bumps, skin rashes, minor bites, allergic reactions, upset stomach, diarrhea, minor burns, suspected minor fractures, fevers, and other similar occurrences. This permission is valid only for the duration of the JKAAF/ASKF event or activity described above.
Emergency Care
In the event that my child needs emergency medical care, as determined by the JKAAF/ASKF doctor/nurse, supervisory staff or administrators, I hereby give permission for said child to be treated in the emergency room and by the medical professionals of the hospital or medical center nearest to or most easily accessible to the JKAAF/ASKF event or activity described above. This permission includes, but is not limited to, fractures, snake bites, allergic reactions, minor concussions, contusions, lacerations, foreign bodies in the eyes or skin, fevers, diagnostic x-rays, suturing, minor burns, etc. I also give permission for my child to receive a tetanus booster (if needed). I understand that in cases of major significance, such as a fracture, appendicitis, or any illness or injury, which would require admission to a hospital, more consents will be necessary for treatment. If such a situation should arise, I further understand that the JKAAF/ASKF doctor/nurse, supervisory staff and/or administrators, and the hospital will make every attempt to reach me. I hereby release THE CAMP (JKA American Federation National Tournament2010, JKAAF/ASKF and University of New Orleans from any and all liabilities due to personal injury, bodily harm, or lost or stolen articles.
______
Signature of Parent/Legal Guardian
Adult Division - General Information
The National Karate Championships open to ALL JKA Members Only. Competitors must be at least 18 years old to compete in the adult division. JKA/AF competitors must present a current membership card or JKA passport or buy one at the tournament for $50.
Please Note
In kumite matches, mouthpiece and padded all cotton gloves are required for all contestants regardless of rank. No contestant will be permitted to compete without both. Only safety glasses will be permitted to be worn during kumite events. Absolutely no jewelry of any type will be permitted to be worn by competitors or officials (with the exception of the JKA tiepin for officials) (male or female).
Nationals Adult lndividual Events
All individuals will compete in separate events.
Club Eliminations; each club of the JKA/AF may recommend a seeding of up to 4 competitors from its club in the following events: Women's Kata, Men's Kata, Women's Kumite, and Men's Kumite. Selection of the final seeding will be decided by the Chief Instructor and/or tournament director according to regional and other considerations.
Four finalists from each individual event will compete in the finals on Sunday November 8, 2010.
Any member of the JKA, who wishes to compete, may do so simply by filling out the appropriate forms and meeting the deadlines for registration.
There are no limits to the number of contestants from one club.
Nationals Adult and Senior Team Events
JKA rules will apply for all events
Team Kata: Each JKA/AF club may send one men's team and one women's team, and one senior team.
Kata teams will compete in the preliminaries on Saturday November 7, 2010. The top three men's Teams, top three women's teams and top three senior teams will advance to the finals Sunday afternoon.
Team Kumite: Each men's team will consist of three members and one alternate. Each women’s team
will consist of three members and one alternate. Each JKA/AF club may send up to two men's and up to two women's kumite team.
Kumite teams will compete in the preliminaries on Saturday November 8, 2010. The top two teams will advance to the finals on Sunday November 8, 2010.
2010 JKA/AF Karate Tournament
Adult Individual Black Belt Club Representative Seeding Form
Categories as follows:
Women's Kata (4) Women's Kumite {4) Men's Kata (4) Men's Kumite {4)
All contestants must pre-register, and all registrations must be postmarked by October 24, 2010.
Contestants must be at least 18 years of age. JKA/AF contestants must present a current membership card or JKA passport at check-in.
Registration fees are non-refundable. A single event is $40 or both events are $50 per contestant.
Club:______
Club Director’s Signature:______
Men's Kumite: NameRank
1. (top seed) ______
2. ______