Campionato Open Veneto Di Taekwon-Do ITF

Comitato Veneto Taekwon-Do

III Campionato Open Veneto di Taekwon-Do ITF

Entry Form Society

Society

Name of Society / Society n.
Filled by Organization
Responsible
City – State – ZIP code
Cell. / Only for real emergency

Umpires

Surname Name / Degree / Surname Name / Degree

Iscrizioni

Juniores female / nr. / X 15,00 € / =
Juniores male / nr. / X 15,00 € / =
Seniores female / nr. / X 15,00 € / =
Seniores male / nr. / X 15,00 € / =
Total to pay:

With the present one I declare that all juniores competitors (14, 15, 16 and 17 years old) and all the seniores competitors (18 years old and over) listed below, have the requirements demanded from the Regulations of the Contest and are suitable, from the medical, insurance and fiscal point of view, to participate to the competition. Consequently Taekwon-Do Veneto Committee and the Competition Organizing Committee will be out of every responsibility concerning the organization and the development of the competition.

I am conscious that the Taekwon-Do Veneto Committee and the Competition Organizing Committee, declines every responsibility on eventual damages to things or persons also coming from lack of the necessary medical controls of competitors.

The responsible of the Society ______

Please send the Entry Form modules within Saturday 19 may 2007 to:

Mr. Omar Carli

Posta / Fax / e-mail
Omar Carli
Via Gatta 110/A
30174 Zelarino (Venezia – Italy) / +39.041.53.16.508 /

Entry Form Juniores

Juniores Female

n. / Surname Name / Belt/Degree / Patterns / Sparring
White / Yellow / Green / Blue / Red / Black
Degree / Yes / No / -55 kg / +55 kg
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

Juniores Male

n. / Surname Name / Belt/Degree / Patterns / Sparring
White / Yellow / Green / Blue / Red / Black
Degree / Yes / No / -62 kg / -70 kg / + 70 kg
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

Please send modules within Saturday 19 may 2007

Entry Form Seniores

Seniores Female

n. / Surname Name / Belt/Degree / Patterns / Sparring
White / Yellow / Green / Blue / Red / Black
Degree / Yes / No / -60 kg / +60 kg
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

Seniores Male

n. / Surname Name / Belt/Degree / Patterns / Sparring
White / Yellow / Green / Blue / Red / Black
Degree / Yes / No / -70 kg / -80 kg / + 80 kg
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

Please send modules within Saturday 19 may 2007

Presidenza
Maestro Alessandro Boscari / via Magenta, 8 35141 Padova tel. 049.87.25.070
Cell. 335.59.45.960
Segreteria
Maestro Omar Carli / via Gatta, 110/A 30174 Zelarino – VE tel. 041.54.60.026
Cell. 338.80.44.722