40thCUMBRIA OPEN : Penrith Leisure Centre: Sunday June 12th 2016

ENTRY FORM - PAGE 1 of 7

CONDITIONS OF ENTRY

  1. Closing date – Saturday 4th June 2016 (No entries on the day) No entry fee refunds.
  2. The latest WKF Rules will apply with certain modifications, see “Rules of the Day”
  3. All competitors must enter via club or association (excluding members of WUKF/WKC) and have a valid licence with relevant insurance covering accidents at this event. Individual entry is not permitted.

The representative signing the form below must be a person holding a responsible position in the club or association, i.e Chairman, Secretary, Instructor or Coach

Particulars of Entry

Club Name………………………………Style………………..Karate Governing Body Mem………..…….

Representative ………………………………… Position in Organisation ……………………………..

Address……………………………………………………………………………………………………………

Tel No: …………………….. Mobile: …………………….. Daytime Tel No: ………………………………

No of Pairs/Team Entries………………….. @ £16 (2) or £24 (3) per team = £

No of INDIVIDUAL KATA Entries………………..…………@ £12 per entry = £

No of INDIVIDUAL KUMITE Entries.……………..……...... @ £12 per entry = £

No of KICKMASTER Entries…………….……...... @ £6 per entry = £

FREE OF CHARGE - VETERANS KATA & KUMITE ………….Number of entries?

Total Entries enclosed £…………. Cheque payable to “Chojinkai Karate”

Or BANK TRANSFER: HSBC Sort Code, 40 16 22: Acc No, 41836188: Name, Chojinkai Karate

DECLARATION

I confirm that all the entrants have been advised of and will comply with the conditions of entry.

I have also advised all competitors of the risk of competition karate and they fully realise and accept these risks. I have checked and can confirm that they all have a valid licence and relevant insurance.

Signed……………………..……….…. Print Name……………..….……………..

REFEREES/JUDGES/TABLE OFFICIALS

Names of Officials Specify Role Qualification/Experience

…………………..…….. ………………. ……………………………….

A fee will be paid to National Governing Body Qualified Officials, from an allocated budget, determined from the number of entries fees received.

If you would like confirmation of receipt of your entry by Email - please supply.

PLEASE PRINT EMAIL CLEARLY: .

PLEASE SEND YOUR ENTRIES by POST or EMAIL, TOGETHER WITH YOUR CHEQUE PAYABLE TO “Chojinkai Karate” BY THE CLOSING DATE OF 4th JUNE 2015 to:-

Doug James, “Greenacres”, High Hesket, Carlisle, Cumbria, CA4 0HS.

Or BANK TRANSFER: HSBC Sort Code, 40 16 22: Acc No, 41836188: Name, Chojinkai Karate

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40th CUMBRIA OPEN : Penrith Leisure Centre: Sunday June 12th 2016

BOYS GIRLS KATA

BOYS/GIRLS KATA – 9th to 7th Kyu – Pinan/Heian 1,2 & 3 Kata Only

Both individuals WILL perform their Kata AT THE SAME TIME- CAN repeat Kata indefinitely

9 & Under / 10/12 years / 13/15 years
No / Name / Grade / No / Name / Grade / No / Name / Grade
1 / 1 / 1
2 / 2 / 2
3 / 3 / 3
4 / 4 / 4
5 / 5 / 5

BOYS/GIRLS KATA – 6th to 4th Kyu - anyPinan/Heian Kata

Both individuals WILL perform their Kata AT THE SAME TIME, can repeat, but not consecutively

9 & Under / 10/12 years / 13/15 years
No / Name / Grade / No / Name / Grade / No / Name / Grade
1 / 1 / 1
2 / 2 / 2
3 / 3 / 3
4 / 4 / 4
5 / 5 / 5

BOYS KATA – Black/Brown Belt – any Kata, free choice, no repeat

NOTE: Both individuals WILL perform their Kata on Tatami SEPERATELY

BOYS & GIRLS EVENT MAY BE AMALGAMATED IF LOW ENTRY IN EACH

9 & Under / 10/12 years / 13/15 years
No / Name / Grade / No / Name / Grade / No / Name / Grade
1 / 1 / 1
2 / 2 / 2
3 / 3 / 3
4 / 4 / 4
5 / 5 / 5

GIRLS KATA – Black/Brown Belt – any Kata, free choice, no repeat.

NOTE: Both individuals WILL perform their Kata on Tatami SEPERATELY

BOYS & GIRLS EVENT MAY BE AMALGAMATED IF LOW ENTRY IN EACH

9 & Under / 10/12 years / 13/15 years
No / Name / Grade / No / Name / Grade / No / Name / Grade
1 / 1 / 1
2 / 2 / 2
3 / 3 / 3
4 / 4 / 4
5 / 5 / 5

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40th CUMBRIA OPEN : Penrith Leisure Centre: Sunday June 12th 2016

PAIRS KATA – mixed/same sex

Two Competitors – If more than one team denote A, B or C

Boys/Girls Pairs Kata – Name of Team ……………………………

9 & under– 9th to 4th Kyu – Any Pinan/Heian Kata, can repeat, but not consecutively

if a high entry - both pairs will perform their Kata on Tatami at same time

Boys/Girls Pairs Kata – Name of Team ……………………………

9 & under– Brown/Black Belt - Free choice of Kata, can repeat, but not consecutively

Boys/Girls Pairs Kata – Name of Team ……………………………

10/12 years– 9th to 4th Kyu – Any Pinan/Heian Kata, can repeat, but not consecutively

if a high entry - both pairs will perform their Kata on Tatami at same time

Boys/Girls Pairs Kata – Name of Team ……………………………

10/12 years– Brown/Black Belt - Free choice of Kata, can repeat, but not consecutively

Boys/Girls/Cadet Pairs Kata – Name of Team ……….………………………

13/15 years– 9th to 4th Kyu – Any Pinan/Heian Kata, can repeat, but not consecutively

if a high entry - both pairs will perform their Kata on Tatami at same time

Boys/Girls/Cadet Pairs Kata – Name of Team ……….………………………

13/15 years – Brown/Black Belt - Free choice of Kata, can repeat, but not consecutively

3 TEAM KATA - mixed/same sex

Three Competitors – If more than one team denote A, B or C

Boys/Girls Kata – Name of Team ……………………………

9 & under– 9th to 4th Kyu – Any Pinan/Heian Kata, can repeat, but not consecutively

Boys/Girls Kata – Name of Team ……………………………

9 & under– Brown/Black Belt - Free choice of Kata, can repeat, but not consecutively

Boys/Girls Kata – Name of Team ……………………………

10/12 years– 9th to 4th Kyu – Any Pinan/Heian Kata, can repeat, but not consecutively

Boys/Girls Kata – Name of Team ……………………………

10/12 years– Brown/Black Belt - Free choice of Kata, can repeat, but not consecutively

Boys/Girls/Cadet Kata – Name of Team ……….………………………

13/15 years– 9th to 4th Kyu – Any Pinan/Heian Kata, can repeat, but not consecutively

Boys/Girls/Cadet Kata – Name of Team ……….………………………

13/15 years – Brown/Black Belt - Free choice of Kata, can repeat, but not consecutively

KICKMASTER KUMITE – 6 to 7 yrs

6/7 yrs – BOYS
OPEN GRADE / 6/7 yrs – GIRLS
OPEN GRADE
No / Name / No / Name / No / Name / No / Name
1 / 4 / 1 / 4
2 / 5 / 2 / 5
3 / 6 / 3 / 6

KICKMASTER KUMITE – 8/9 yrs plus 9 & under

8/9 years BOYS
9th to 4th Kyu / 8/9 years GIRLS
9th to 4th Kyu / 9 yrs & under BOYS & GIRLS
Brown/Black
No / Name / Grade / No / Name / Grade / No / Name / Grade
1 / 1 / 1
2 / 2 / 2
3 / 3 / 3

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40th CUMBRIA OPEN : Penrith Leisure Centre: Sunday June 12th 2016

GIRLS KUMITE 6/7 Years GIRLS KUMITE 8/9 Years

(These categories may be split further, if a large varience in Height/ Weight etc)

6/7 yrs –
OPEN GRADE / 8/9 years
9th to 6th Kyu / 8/9 years
5th Kyu & above
No / Name / Grade / No / Name / Grade / No / Name / Grade
1 / 1 / 1
2 / 2 / 2
3 / 3 / 3
4 / 4 / 4
5 / 5 / 5

GIRLS KUMITE 10 to 11 Years – Under 38 Kilo

9th to 4th Kyu / Brown/Black
No / Name / Grade / No / Name / Grade
1 / 1
2 / 2
3 / 3
4 / 4
5 / 5

GIRLS KUMITE 10 to 11 Years – 38 Kilo & Above

9th to 4th Kyu / Brown/Black
No / Name / Grade / No / Name / Grade
1 / 1
2 / 2
3 / 3
4 / 4
5 / 5

GIRLS KUMITE 12 to 13 Years – Under 43 Kilo

9th to 4th Kyu / Brown/Black
No / Name / Grade / No / Name / Grade
1 / 1
2 / 2
3 / 3
4 / 4
5 / 5

GIRLS KUMITE 12 to 13 Years – 43 Kilo & Above

9th to 4th Kyu / Brown/Black
No / Name / Grade / No / Name / Grade
1 / 1
2 / 2
3 / 3
4 / 4
5 / 5

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40th CUMBRIA OPEN : Penrith Leisure Centre: Sunday June 12th 2016

BOYS KUMITE 6/7 Years BOYS KUMITE 8/9 Years

(These categories may be split further, if a large varience in Height/ Weight etc)

6/7 yrs –
OPEN GRADE / 8/9 years
9th to 6th Kyu / 8/9 years
5th Kyu & above
No / Name / Grade / No / Name / Grade / No / Name / Grade
1 / 1 / 1
2 / 2 / 2
3 / 3 / 3
4 / 4 / 4
5 / 5 / 5

BOYS KUMITE 10 to 11 Years – Under 40 Kilo

9th to 4th Kyu / Brown/Black
No / Name / Grade / No / Name / Grade
1 / 1
2 / 2
3 / 3
4 / 4
5 / 5

BOYS KUMITE 10 to 11 Years – 40 Kilo & Above

9th to 4th Kyu / Brown/Black
No / Name / Grade / No / Name / Grade
1 / 1
2 / 2
3 / 3
4 / 4
5 / 5

BOYS KUMITE 12 to 13 Years – Under 45 Kilo

9th to 4th Kyu / Brown/Black
No / Name / Grade / No / Name / Grade
1 / 1
2 / 2
3 / 3
4 / 4
5 / 5

BOYS KUMITE 12 to 13 Years – 45 Kilo & Above

9th to 4th Kyu / Brown/Black
No / Name / Grade / No / Name / Grade
1 / 1
2 / 2
3 / 3
4 / 4
5 / 5

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40th CUMBRIA OPEN : Penrith Leisure Centre: Sunday June 12th 2016

GIRLS CADET KUMITE 14 to 15 Years – Under 53 Kilo

9th to 4th Kyu / Brown/Black
No / Name / Grade / No / Name / Grade
1 / 1
2 / 2
3 / 3

GIRLS CADET KUMITE 14 to 15 Years – 53 Kilo & Over

9th to 4th Kyu / Brown/Black
No / Name / Grade / No / Name / Grade
1 / 1
2 / 2
3 / 3

BOYS CADET KUMITE 14 to 15 Years – Under 58 Kilo

9th to 4th Kyu / Brown/Black
No / Name / Grade / No / Name / Grade
1 / 1
2 / 2
3 / 3

BOYS CADET KUMITE 14 to 15 Years – 58 Kilo & Over

9th to 4th Kyu / Brown/Black
No / Name / Grade / No / Name / Grade
1 / 1
2 / 2
3 / 3

BOYS TEAM KUMITE

Three Competitors – If more than one team denote A, B or C

Boys Team Kumite – Name of Team ……….………………………

9 Years & under – Any Grade – Open Weight

Boys Team Kumite – Name of Team ……….………………………

10 to 11 Years – Any Grade – Open Weight

Boys Team Kumite – Name of Team ……….………………………

12 to 13 Years – Any Grade – Open Weight

Boys Cadet Team Kumite – Name of Team ……….………………………

14 to 15 Years – Any Grade – Open Weight

GIRLS TEAM KUMITE

Three Competitors – If more than one team denote A, B or C

Girls Team Kumite – Name of Team ……….………………………

9 Years & under – Any Grade – Open Weight

Girls Team Kumite – Name of Team ……….………………………

10 to 11 Years – Any Grade – Open Weight

Girls Team Kumite – Name of Team ……….………………………

12 to 13 Years – Any Grade – Open Weight

Girls Cadet Team Kumite – Name of Team ……….………………………

14 to 15 Years – Any Grade – Open Weight

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40th CUMBRIA OPEN : Penrith Leisure Centre: Sunday June 12th 2016

KATA EVENTS - 16 Years and Above

MALE/FEMALE
9TH to 4TH KYU / MALE/FEMALE
BLACK/BROWN
Will be separate M/F if large entry / VETERANS
Male/Female
35 & Over
No / Name / Grade / No / Name / Grade / No / Name / Grade
1 / 1 / 1
2 / 2 / 2
3 / 3 / 3

16 years & above - Pairs Kata – Name of Team ….…………………………….…………

16 years & above - 3 Team Kata – Name of Team …………………………………..………

Two or Three Competitors – All Male/ All Female or Mixed Male/Female- Open Grade

Free choice of Kata, can repeat, but not consecutively - If more than one team denote A, B or C

JUNIOR KUMITE – 16/17 years only

JUNIORMALE KUMITE
16/17 yrs Open Grade/WT / JUNIORFEMALEKUMITE 16/17yrs Open Grade/WT
No / Name / Grade / No / Name / Grade
1 / 1
2 / 2
3 / 3

FEMALE KUMITE - 18 Years plus& Veterans

FEMALE KUMITE – 18+
OPEN GRADE / FEMALE KUMITE
VETERANS35yrs & Over
Will separate - if bigwt variation
No / Name / Grade / No / Name / Grade
1 / 1
2 / 2
3 / 3

MALE KUMITE - 18 Years and Above + Veterans

9th to 4th KYU
Open Weight / Brown/BlackWill separate – if bigwt variation / Male Veterans
Will separate – if bigwt variation
No / Name / Grade / No / Name / Grade / No / Name / Grade
1 / 1 / 1
2 / 2 / 2
3 / 3 / 3

Male Open Senior Team Kumite – Name of Team.……………

Female Open Senior Team Kumite– Name of Team..…………..

16 Years and Above – Any Grade – Note: Contact rules as 18 yrs plus

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