ikd 2018 world cup registration forms · the following is a list of the eligible categories for the...
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IKD 2018 WORLD CUP
REGISTRATION FORMS
Registration Deadline: June 30, 2018.
2
TOURNAMENT CATEGORIES
The following is a list of the eligible categories for the IKD 2018 World Cup. Please note all participants must be ranked IKD black or brown belt.
Individual Kata, Male and Female – 8-10, 11-13, 14-16, 17-19, 20-39, 40-49, 50+
Individual Kumite, Male and Female – 8-10, 11-13, 14-16, 17-19, 20-39, 40-49, 50+
Team Kata, Male and Female – 8-11, 12-15, 16-19, 20-39, 40-49, 50+
Team Bunkai, Male and Female – 8-11, 12-15, 16-19, 20-39, 40-49, 50+
Team Enbu, Male and Female – 8-11, 12-15, 16-19, 20-39, 40-49, 50+
Team Kumite, Male and Female – 20-39, 40-49
Registration Deadline: June 30, 2018.
3
IKD 2018 World Cup Participants Medical Questionnaire
To be completed by all adults and guardians of minors attending IKD 2018 World Cup.
Name: _________________________Date of Birth: ___________Sex: _______Rank: _________Dojo: ________________ Address: ___________________________City:___________Province:________PostalCode:________Country: _________
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)
Print Name:____________________________________________ Date: ____________________________ Sign Name: ____________________________________________ Witness: __________________________
THIS FORM IS FOR MINOR PARTICIPANTS AND MUST BE FILLED OUT BY PARENTS OR LEGAL GUARDIANS. PLEASE PRINT CLEARLY. ALL INFORMATION MUST BE SUPPLIED.
EMERGENCY CONTACT AND MEDICAL INFORMATON:
Names of Parent/Legal Guardian: ______________________________________________________________________ Address: ___________________________City: _____________ Province: _______Postal Code: ______Country:_______ 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: __________________________________________________________________
4
Dan Examination and Registration Fees:
1. Shodan exam $ 80 registration $60 2. Nidan exam $100 registration $70 3. Sandan exam $120 registration $100 4. Yondan exam $150 registration $150 5. Godan exam $200 registration $200 6. Rokudan exam $250 registration $250 7. Shichidan exam $300 registration $300 8. Hachidan exam $300 registration $300
Caribbean Dan Examination and Registration Fees:
9. Shodan exam $ 60 registration $60 10. Nidan exam $ 70 registration $70 11. Sandan exam $ 80 registration $100 12. Yondan exam $100 registration $150 13. Godan exam $150 registration $200 14. Rokudan exam $200 registration $250 15. Shichidan exam $300 registration $300 16. Hachidan exam $300 registration $300
Examination for Instructor’s qualification and annual License Fees:
a) D class examination $40 annual license $40 b) C class examination $40 annual license $40 c) B class examination $40 annual license $60 d) A class examination $40 annual license $60
Examination for Examiner’s qualification and annual License Fees:
a) D class examination $40 annual license $80 b) C class examination $40 annual license $80 c) B class examination $40 annual license $100 d) A class examination $40 annual license $100
Examination for Judge’s qualification and annual License Fees:
a) D class examination $40 annual license $20 b) C class examination $40 annual license $20 c) B class examination $40 annual license $20
d) A class examination $40 annual license $20
Amount Enclosed:
$
5
IKD Dan Registration and Examination Form For purposes of clarity all information must be typewritten. Handwritten forms will be returned.
Please list my rank in the register of the IKD. I promise to uphold the honour and standards of IKD
Part
Kihon – Arm
Major Kata Name
Major Kata Mark
Major Kata Bunkai or Enbu
Kumite – Attack
A Part
Kihon – Leg
Minor Kata Name
Minor Kata Mark
Minor Kata Bunkai
_ Kumite – Defence
or Self Defense
B
C Written Research
A: 90% B: 80% C: 70% D: 60%
Research Presentation
Other Kata/bunkai:
Attendance:
A B C
Pass:
_________ Dan
Re-exam:
_______Mo./______Yr.
No Pass:
Regular Rank Recommended Honorary
Authorized Examiner: _______________________Exam Date: _______________Place:_____________
Name Address
Telephone
Registering for
Date of Exam (dd/mm/yy)
Photo
Examiner Instructor
Dojo Name Region/Country Date of Birth (dd/mm/yy) Sex
( Occupation
Last School or College Degree
7th Dan
1st Dan
Date of Exam Registration No. Date of Exam Registration No.
2nd Dan
3rd Dan
4th Dan
5th Dan
6th Dan
Student's Signature
Present Age: ______ FOR EXAMINER’S USE ONLY
Instructor’s signature
Zip CodecC
8th Dan
6
IKD INSTRUCTOR, EXAMINER, JUDGE REGISTRATION AND EXAMINATION RECORD
For purposes of clarity all information must be typewritten. Handwritten forms will be returned.
Present Instructor Level: Present Examiner Level: Present Judge Level:
Circle Level (s) Testing for:
Instructor Examiner Judge
8A/7A 8A/7A 8A/7A/6A
6B 6B 5B/4B
5C 5C 3C
4D/3D 4D/3D 2D
2E (18+) 1E (18+)
1E (16+) 1E (16+)
Please list my qualification(s) in the IKD Register. I promise to uphold IKD standards and honours.
For Examiner’s Use Only
Instructor Written Exam Mark %
Examiner Written Exam Mark %
Judge Written Exam Mark %
Instructor Teaching Exam Mark
Examiner Evaluation Exam Mark
Gestures
Favourite Advanced Kata
Favourite Advanced Kata
Judge Evaluation
Kata Bunkai of Choice
Secondary Advanced Kata
Referee Evaluation
Instructor Rank Awarded: 8A, 7A, 6B, 5C, 4D, 3D, 2E, 1E
Examiner Rank Awarded: 8A, 7A, 6B, 5C, 4D, 3D
Judge Rank Awarded: 8A, 7A, 6A, 5B, 4B, 3C, 2D,1E
Authorized Examiner: ____________________ Exam Date: ____________Place: _______________
Signature: Date:
Name :
Address :
Dan Rank :
Tel:
Organisation :
Country :
Date of Birth:
Gender: M / F
Degree:
Occupation:
Education :
Email:
Date Obtained : Reg. No :
Photo
Registration Deadline: June 30, 2018.
7
Tournament Judges Registration Please note: Judges shall be selected from A kyu and B kyu as per IKD World Cup Rules listed in your Passport on page 13.
Basically, one judge per region/country shall be assigned to each ring in the interest of fairness. However, in cases where countries do not have judges representing them, two other judges per region/country may be assigned per
ring. All judges shall be selected at the end of the judges’ seminar.
Organization/Country: _________________________________________________________________
Name Dan Rank Judge’s Level
1
2
3
4
5
6
7
8
9
10
SELECTION OF JUDGES
Judges must meet the requirements as established by the International Karate Daigaku (IKD)
The Chief Judge shall designate the Ring Officials.
Judge’s Uniform o Haori o Whistle with black lanyard
Registration Deadline: June 30, 2018.
8
Official Representative, Manager and Coaches Registration (To be completed by Organization/Country Representative)
Organization/Country: _________________________________________________________________
NAME POSITION
1 Official Representative
2 Manager
3 Coach
4 Coach
5 Coach
6 Coach
7 Coach
Registration Deadline: June 30, 2018.
9
Contestant Registration – 8 to 10 year old Girls Individual Kata Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Registration Deadline: June 30, 2018.
10
Contestant Registration – 8 to 10 year old Girls Individual Kumite Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Registration Deadline: June 30, 2018.
11
Contestant Registration – 8 to 10 year old Boys Individual Kata Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Registration Deadline: June 30, 2018.
12
Contestant Registration – 8 to 10 year old Boys Individual Kumite Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Registration Deadline: June 30, 2018.
13
Contestant Registration – 11 to 13 year old Girls Individual Kata Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Registration Deadline: June 30, 2018.
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Contestant Registration – 11 to 13 year old Girls Individual Kumite Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Registration Deadline: June 30, 2018.
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Contestant Registration – 11 to 13 year old Boys Individual Kata Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Registration Deadline: June 30, 2018.
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Contestant Registration – 11 to 13 year old Boys Individual Kumite Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Registration Deadline: June 30, 2018.
17
Contestant Registration – 14 to 16 year old Girls Individual Kata Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Registration Deadline: June 30, 2018.
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Contestant Registration – 14 and 16 year old Girls Individual Kumite Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Registration Deadline: June 30, 2018.
19
Contestant Registration – 14 to 16 year old Boys Individual Kata Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Registration Deadline: June 30, 2018.
20
Contestant Registration – 14 to 16 year old Boys Individual Kumite Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Registration Deadline: June 30, 2018.
21
Contestant Registration – 17 to 19 year old Girls Individual Kata Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Registration Deadline: June 30, 2018.
22
Contestant Registration – 17 to 19 year old Girls Individual Kumite Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Registration Deadline: June 30, 2018.
23
Contestant Registration – 17 to 19 year old Boys Individual Kata Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Registration Deadline: June 30, 2018.
24
Contestant Registration – 17 to 19 year old Boys Individual Kumite Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Registration Deadline: June 30, 2018.
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Junior Team Registration – 8 to 11 year old Girls Team Kata Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
26
Junior Team Registration 8 to 11 year old Boys Team Kata Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
27
Junior Team Registration 8 to 11 year old Girls Team Kata Bunkai Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
28
Junior Team Registration 8 to 11 year old Boys Team Kata Bunkai Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
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Junior Team Registration 8 to 11 year old Girls Team Enbu Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
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Junior Team Registration 8 to 11 year old Boys Team Enbu Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
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Junior Team Registration – 12 to 15 year old Girls Team Kata Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
32
Junior Team Registration – 12 to 15 year old Boys Team Kata Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
33
Junior Team Registration – 12 to 15 year old Girls Team Kata Bunkai Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
34
Junior Team Registration – 12 to 15 year old Boys Team Kata Bunkai Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
35
Junior Team Registration – 12 to 15 year old Girls Team Enbu Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
36
Junior Team Registration – 12 to 15 year old Boys Team Enbu Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
37
Teen Team Registration – 16 to 19 year old Girls Team Kata Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
38
Teen Team Registration – 16 to 19 year old Girls Team Kata Bunkai Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
39
Teen Team Registration – 16 to 19 year old Girls Team Enbu Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
40
Teen Team Registration – 16 to 19 year old Boys Team Kata Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
41
Teen Team Registration – 16 to 19 year old Boys Team Kata Bunkai Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
42
Teen Team Registration – 16 to 19 year old Boys Team Enbu Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
43
Contestant Registration – Women’s Individual Kata Age 20-39 Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
Registration Deadline: June 30, 2018.
44
Contestant Registration – Women’s Individual Kumite Age 20-39 Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
Registration Deadline: June 30, 2018.
45
Contestant Registration – Men’s Individual Kata Age 20-39 Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
Registration Deadline: June 30, 2018.
46
Contestant Registration – Men’s Individual Kumite Age 20-39 Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
Registration Deadline: June 30, 2018.
47
Team Registration – Women’s Team Kata Age 20-39 Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
48
Team Registration – Women’s Team Kata Bunkai Age 20-39 Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
49
Team Registration – Women’s Team Enbu Age 20-39 Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
50
Team Registration – Men’s Team Kata Age 20-39 Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
51
Team Registration – Men’s Team Kata Bunkai Age 20-39 Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
52
Team Registration – Men’s Team Enbu Age 20-39 Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
53
Team Registration – Women’s Team Kumite Age 20-39 Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
54
Team Registration – Men’s Team Kumite Age 20-39 Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
55
Contestant Registration – Masters Women’s Individual Kata Age 40-49 Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
Registration Deadline: June 30, 2018.
56
Contestant Registration – Masters Women’s Individual Kumite Age 40-49 Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
Registration Deadline: June 30, 2018.
57
Contestant Registration – Masters Men’s Individual Kata Age 40-49 Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
Registration Deadline: June 30, 2018.
58
Contestant Registration – Masters Men’s Individual Kumite Age 40-49 Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
Registration Deadline: June 30, 2018.
59
Team Registration – Master Women’s Team Kata Age 40-49 Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
60
Team Registration – Master Women’s Team Kumite Age 40-49 Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
61
Team Registration – Master Women’s Team Kata Bunkai Age 40-49 Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
62
Team Registration – Master Women’s Team Enbu Age 40-49 Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
63
Team Registration – Master Men’s Team Kata Age 40-49 Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
64
Team Registration – Master Men’s Team Kumite Age 40-49 Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
65
Team Registration – Master Men’s Team Kata Bunkai Age 40-49 Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
66
Team Registration – Master Men’s Team Enbu Age 40-49 Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
67
Contestant Registration – Masters Women’s Individual Kata Age 50+ Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
Registration Deadline: June 30, 2018.
68
Contestant Registration – Masters Women’s Individual Kumite Age 50+ Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
Registration Deadline: June 30, 2018.
69
Contestant Registration – Masters Men’s Individual Kata Age 50+ Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
Registration Deadline: June 30, 2018.
70
Contestant Registration – Masters Men’s Individual Kumite Age 50+ Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
1
2
3
4
Registration Deadline: June 30, 2018.
71
Team Registration – Master Women’s Team Kata Age 50+ Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
72
Team Registration – Master Women’s Team Kata Bunkai Age 50+ Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
73
Team Registration – Master Women’s Team Enbu Age 50+ Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
74
Team Registration – Master Men’s Team Kata Age 50+ Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
75
Team Registration – Master Men’s Team Kata Bunkai Age 50+ Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
Registration Deadline: June 30, 2018.
76
Team Registration – Master Men’s Team Enbu Age 50+ Organization/Country: _________________________________________________________________ Please type or print in capital (block) letters clearly the following information:
Name Rank Age
Team 1
1
2
3
Alternate:
Team 2
1
2
3
Alternate:
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