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Individual Registration Form
2012 U.S. Junior Team Trials 2012 USAWKF National Championships
4th New England International Chinese Martial Arts Championships
July 28 & 29, 2012
Organized by Malee’s School of Tai Chi & Kung Fu Sanctioned by the U.S.A. Wushu-‐Kungfu Federation
FIRST DEADLINE (LATE FEES AFTER THIS DATE): May 31 FINAL DEADLINE (NO REGISTRATIONS ACCEPTED AFTER THIS DATE): June 30
PLEASE PRINT OR TYPE LAST NAME: __________________________ FIRST: ___________________________ MI: _____________ STREET: ______________________________________________________________________________________ CITY: ________________________ STATE: ________ ZIP: ________________ PHONE (PRIMARY): _____________________ PHONE (ALTERNATE): _____________________ EMAIL: _______________________________________________________________________________________ DATE OF BIRTH: M ______ / D ______ / Y ______ AGE: _____ SEX (CIRCLE ONE): M F YEARS EXPERIENCE: ______________ SCHOOL: ____________________________________________ PRIMARY INSTRUCTOR: __________________________________________________________________ SCHOOL ADDRESS: ________________________________________________________________________ CITY: ________________________ STATE: ________ ZIP: ________________ PHONE: ____________________________ EMAIL: ________________________________________________ FAX: _________________________
WAIVER I, the undersigned, knowingly and without duress, do voluntarily submit my entry to the 2012 U.S. Junior Team Trials, the 2012 USA Wushu-‐Kungfu Federation National Championships, and the 4th New England International Chinese Martial arts Championships (hereinafter referred to as “the Championships”). I hereby assume all risk of physical and mental injuries, disabilities, and losses which may result from or in connection with my participation in the Championships. Hereinafter the USA Wushu-‐Kungfu Federation, USA National Tai Chi Chuan Federation, Malee’s School of Tai Chi & Kung Fu, and the University of New Haven are collectively referred to as “the Organizing Committee.” Acting for myself, my heirs, personal representatives and assignees, I do hereby release the Organizing Committee, its officers, agents, representatives, servants, employees, volunteers, and all other members from liability due to any injuries incurred and any resulting legal claims, actions, suits or controversies. I also understand that there is risk of injury involved in all the competitive divisions, particularly in fighting events, and I assume full responsibility for all my actions, activities or omissions during and in connection with the Championships. I fully understand that any medical attention or treatment afforded me by the Organizing Committee, its officers, agents, representatives, servants, employees, volunteers, and all other related members will be of the first aid type only, and I hereby release the Organizing Committee, its officers, agents, representatives, servants, employees, volunteers, and all other related members from any liability for such aid. I have read, understand, and agree to abide by the rules of this event, and accept all responsibility and associated liability for infringement of such rules. Additionally, I am fully aware of my personal medical condition and hereby certify that I am mentally and physically fit to compete. I consent to the use of photographs and/or video tapes of my participation in this event for promotional purposes, and hereby waive my rights to any form of compensation or claim.
Parent or legal guardian signature is required if participant is under eighteen (18) years of age ____________________________________________ ____________________________________________ _______________________ Signature of Participant Signature of Legal Guardian Date
Please attach TWO 2” x 2” passport-‐style photos to this application! You can also email it to us at [email protected]. These photos will be used to make your competitor ID card.
If you do not give us these photos beforehand, there will be a $25 on-‐site charge to take your
photo and finish your ID card.
NAME: ___________________________________
Individual & Group Registration Forms 2012 Junior Trials 2012 Nationals
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FEES – PLEASE FILL OUT CAREFULLY!
(1) 2012 JUNIOR TRIALS REGISTRATION FEES
Basic Registration Fee: $100 $________
Each event: $25 x _______ events $________
USAWKF membership no. (REQUIRED):___________________
$25 late fee (after May 31) $________ (FINAL DEADLINE: JUNE 15)
Total: $________ (2) 2012 NATIONALS REGISTRATION FEES
Basic Registration Fee: $50 $________
Each event: $20 x _______ events $________
USAWKF membership discount: $5 $________
USAWKF membership no.: ________________
USANTCCF membership discount: $5 $________
USANTCCF membership no.: _____________
Traditional Team Trials: $50 $________ See panel for more info
Grand Champion Trophy Trial: $30 $________ See panel for more info
$20 late fee (after May 31) $________ (FINAL DEADLINE: JUNE 30)
Total: $________ (3) 4th New England ICMAC
Basic Registration Fee: $50 $________
Each event: $20 x _______ events $________
USAWKF membership discount: $5 $________
USAWKF membership no.: ____________________
USANTCCF membership discount: $5 $________
USANTCCF membership no.: ________________
Grand Champion Trophy Trial: $30 $________
$20 late fee (after May 31) $________ (FINAL DEADLINE: JUNE 30)
Total: $________
(4) SPECTATOR TICKETS & MERCHANDISE Saturday Tickets: (does NOT include Masters Demo) $________ $10 x _____ people
Sunday Tickets: $________ $10 x _____ people
Masters Demo (Saturday, 8 pm) $________ $20 x _____ people
Both Days plus Master Demo: $30 $________ $30 x _____ people
Official Tournament T-‐Shirts: $________ $12 x _____ t-‐shirts S _____ M _____ L _____ XL _______ (pick these up with your registration package)
Total: $________
See next page for Room & Board
and Totals
This event will select the twelve under-‐18 athletes who will compete at the 4th World Junior Wushu Championships, to be held September 17-‐25, 2012, in Macau, China.
This is the selection process for the Traditional Team, which will compete at the 5th World Traditional Wushu Championships in Huangshan, China, from November 5-‐10, 2012. If you sign up for the Trials and get at least one 3rd place finish in an advanced-‐level event, you automatically qualify for the team.
This is a chance for competitors to go home with a beautiful trophy in recognition of their outstanding achievement at the event. Each athlete with the best overall results in his age category AND signs up for the Trophy event will receive a Grand Champion trophy!
(7) TOTALS FOR (1) THROUGH (5)
(1) Junior Team Trials Fees $________ (2) 2012 Nationals Fees $________ (3) 4th New England ICMAC Fees $________ (4) Spectator Tickets Fees $________ (5) Room & Board Fees $________
(6) Room & Board Fees $________
Total: $________
NAME: ___________________________________
Individual & Group Registration Forms 2012 Junior Trials 2012 Nationals
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FEES (CONTINUED)
PLEASE NOTE!!!
The 1-‐bed and 2-‐bed apartment rooms are shared with other people. You may request to room with someone else you know for these rooms. Please do so here (make sure your friends do the same!):
Name Competitor? (Yes/No) ______________________________________________ _________ ______________________________________________ _________ ______________________________________________ _________ ______________________________________________ _________ ______________________________________________ _________
NOTE ABOUT ROOMS:
Linens per person include: 2 towels, 2 wash cloths, sheets, summer blanket, and pillow case (pillow extra). Includes toilet paper but no soap or other toiletries. Beds are full size, so they can only sleep one person.
Families and groups will probably prefer suites. Individuals and couples may like the apartment rooms better.
Please keep in mind that these are university residence halls, so they might not be as roomy as a motel or hotel room.
The University of New Haven has generously offered their residence halls for participants and other guests. These rooms are just a five-‐minute walk from the competition area!
There are four kinds of rooms: two kinds of suites, which are private, and two kinds of apartment rooms, which are shared with one or three other rooms. All beds are full size, accommodating one person only.
(5) ROOM AND BOARD Check √ the option you want
[ ] 3-‐bed suite ($100 per night)
Accommodates up to 3 people
Circle the nights you will be staying
Friday Saturday Sunday
______ nights x $100 per night = $ _______
Linens included. Pillows not included. Bring your own or:
Pillows: $10 x ______ people = $________
[ ] 6-‐bed suite ($168 per night)
Accommodates up to 6 people
Two rooms, one bathroom connecting them, all doors lock
Circle the nights you will be staying
Friday Saturday Sunday
______ nights x $168 per night = $ _______
Linens included. Pillows not included. Bring your own or:
Pillows: $10 x ______ people = $________
[ ] 2-‐bed apartment room ($76/night)
Accommodates up to 2 people
Two rooms in apartment, share two bathrooms, one living area, one kitchen
Circle the nights you will be staying
Friday Saturday Sunday
______ nights x $76/night x ____ rooms = $ _______
Linens included. Pillows not included. Bring your own or:
Pillows: $10 x ______ people = $________
[ ] 1-‐bed apartment room ($50/night)
Accommodates 1 person only
Four rooms in apartment, share two bathrooms, one living area, one kitchen
Circle the nights you will be staying
Friday Saturday Sunday
______ nights x $50/night x ____ rooms = $ _______
Linens included. Pillows not included. Bring your own or:
Pillows: $10 x ______ people = $________
(6) MEAL PLAN
Unlimited access to buffet
Breakfast, lunch, dinner
Circle all days that apply Friday – Saturday – Sunday
$25 per day x _____ days x _____ people
Total: $ ________
NAME: ___________________________________
Individual & Group Registration Forms 2012 Junior Trials 2012 Nationals
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2012 U.S. JUNIOR TEAM TRIALS REGISTRATION
U.S. citizens only – must be current member of USAWKF
There are three age groups. Please make a check mark (√) next to the group you are registering in, and then make a check mark in the space provided for each event you are competing in. Registration fee (REQUIRED): [ √ ] $100. Events: $25 x _____ events = $________ Total: $__________.
[ ] Group A: Athletes born between January 1, 1994 and December 31, 1996 (inclusive). Barehand Event (required):
[ ] Changquan (2nd international compulsory)
[ ] Nanquan (international compulsory)
[ ] 42 Form Taijiquan (international compulsory) Weapon Event (required: AT LEAST one short OR one long): Long Weapon [ ] Staff (2nd international compulsory) [ ] Spear (2nd international compulsory) [ ] Southern Staff (international compulsory) Short Weapon
[ ] Broadsword (2nd international compulsory) [ ] Straight Sword (2nd international compulsory) [ ] Southern Broadsword (international compulsory) [ ] 42 Form Taiji Sword (international compulsory)
NAME: ___________________________________
Individual & Group Registration Forms 2012 Junior Trials 2012 Nationals
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[ ] Group B: Athletes born between January 1, 1997 and December 31, 1999 (inclusive). Barehand Event (required):
[ ] Changquan (1st international compulsory)
[ ] Nanquan (international compulsory)
[ ] 24 Form Taijiquan (international standard) Weapon Event (required: AT LEAST one short OR one long): Long Weapon [ ] Staff (1st international compulsory) [ ] Spear (1st international compulsory) [ ] Southern Staff (international compulsory) Short Weapon
[ ] Broadsword (1st international compulsory) [ ] Straight Sword (1st international compulsory) [ ] Southern Broadsword (international compulsory) [ ] 32 Form Taiji Sword (international standard)
[ ] Group C: Athletes born between January 1, 2000 and December 31, 2005 (inclusive). Barehand Event (required): [ √ ] Changquan (no. 3 elementary routine) Weapon Event (required): AT LEAST one short OR one long):
Long Weapon [ ] Staff (no. 3 elementary routine)
[ ] Spear (no. 3 elementary routine)
Short Weapon
[ ] Broadsword (no. 3 elementary routine) [ ] Straight Sword (no. 3 elementary routine)
2012 U.S. JUNIOR TEAM TRIALS REGISTRATION
NAME: ___________________________________
Individual & Group Registration Forms 2012 Junior Trials 2012 Nationals
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USAWKF NATIONAL CHAMPIONSHIPS REGISTRATION Place an X in the box next to the events you wish to register for
Advanced Level Only All Events are National Ranking Events
At the sole discretion of the Organizing Committee, events and divisions may be combined or divided at any time prior to competition. A. Youth External Events
100. Traditional Kung Fu -‐ Barehand
[ ] 101. Children 7 & under [ ] 102. Children 8-‐10 [ ] 103. Children 11-‐14 [ ] 104. Teen boys, 15-‐17, Northern [ ] 105. Teen boys, 15-‐17, Southern [ ] 106. Teen girls, 15-‐17, Northern [ ] 107. Teen girls, 15-‐17, Southern
200. Traditional Kung Fu – Weapons
[ ] 201. Children 7 & under [ ] 202. Children 8-‐10 & under [ ] 203. Children 11-‐14, Short/Other [ ] 204. Children 11-‐14, Long [ ] 205. Teen boys, 15-‐17, Short/Other [ ] 206. Teen boys, 15-‐17, Long [ ] 207. Teen girls, 15-‐17, Short/Other [ ] 208. Teen girls, 15-‐17, Long
300. Contemporary Wushu -‐ Barehand
[ ] 301. Children 7 & under [ ] 302. Children 8-‐10 [ ] 303. Children 11-‐14 [ ] 304. Teen boys, 15-‐17, Changquan [ ] 305. Teen boys, 15-‐17, Nanquan [ ] 306. Teen boys, 15-‐17, Other [ ] 307. Teen girls, 15-‐17, Changquan [ ] 308. Teen girls, 15-‐17, Nanquan [ ] 309. Teen girls, 15-‐17, Other
400. Contemporary Wushu -‐ Weapons
[ ] 401. Children 7 & under [ ] 402. Children 8-‐10 [ ] 403. Children 11-‐14, Short/Other [ ] 404. Children 11-‐14, Long [ ] 405. Teen boys, 15-‐17, Broadsword [ ] 406. Teen boys, 15-‐17, Straight Sword [ ] 407. Teen boys, 15-‐17, Staff [ ] 408. Teen boys, 15-‐17, Spear [ ] 409. Teen girls, 15-‐17, Broadsword [ ] 410. Teen girls, 15-‐17, Straight Sword [ ] 411. Teen girls, 15-‐17, Staff [ ] 412. Teen girls, 15-‐17, Spear B. Adult Events
500. Traditional Kung Fu – Barehand
[ ] 501. Men’s, 18-‐35, Northern [ ] 502. Men’s, 18-‐35, Southern [ ] 503. Men’s, 36+, All Styles [ ] 504. Women’s, 18-‐35, Northern [ ] 505. Women’s, 18-‐35, Southern [ ] 506. Women’s, 36+, All Styles
600. Traditional Kung Fu – Weapons [ ] 601. Men’s, 18-‐35, Short/Other [ ] 602. Men’s, 18-‐35, Long [ ] 603, Men’s, 36+ [ ] 604. Women’s, 18-‐35, Short/Other [ ] 605. Women’s, 18-‐35, Long [ ] 606, Women’s, 36+ 700. Contemporary Wushu – Barehand [ ] 701. Men’s, 18+, Changquan [ ] 702. Men’s, 18+, Nanquan [ ] 703. Men’s, 18+, Other [ ] 704. Women’s, 18+, Changquan [ ] 705. Women’s, 18+, Nanquan [ ] 706. Women’s, 18+, Other 800. Contemporary Wushu – Weapons [ ] 801. Men’s, 18+, Short [ ] 802. Men’s, 18+, Long [ ] 803. Men’s, 18+, Other [ ] 804. Women’s, 18+, Short [ ] 805. Women’s, 18+, Long [ ] 806. Women’s, 18+, Other C. Internal Events 900. Taijiquan [ ] 901. Men’s, Yang style [ ] 902. Men’s, Chen style [ ] 903. Men’s, Wu style [ ] 904. Men’s, Wu/Hao style [ ] 905. Men’s, Sun style [ ] 906. Men’s, Other styles [ ] 907. Women’s, Yang style [ ] 908. Women’s, Chen style [ ] 909. Women’s, Wu style [ ] 910. Women’s, Wu/Hao style [ ] 911. Women’s, Sun style [ ] 912. Women’s, Other styles 1000. Other Internal Barehand [ ] 1001. Men’s, Baguazhang [ ] 1002. Men’s, Xingyiquan [ ] 1003. Men’s, Other [ ] 1004. Women’s, Baguazhang [ ] 1005. Women’s, Xingyiquan [ ] 1006. Women’s, Other
1100. Internal Weapons [ ] 1101. Men’s, Taiji Sword [ ] 1102. Men’s, Long [ ] 1103. Men’s, Other [ ] 1104. Women’s, Taiji Sword [ ] 1105. Women’s, Long [ ] 1106. Women’s, Other D. Contact Events 1200. Push Hands – Restricted Step [ ] 1201. Men’s, 0-‐160 lbs. [ ] 1202. Men’s, 161+ lbs. [ ] 1203. Womens’, 0-‐130 lbs. [ ] 1204. Womens’, 131+ lbs. 1300. Push Hands – Moving Step [ ] 1301. Men’s, 0-‐160 lbs. [ ] 1302. Men’s, 161+ lbs. [ ] 1303. Women’s, 0-‐130 lbs. [ ] 1304. Women’s, 131+ lbs. 1400. Continuous Light Contact Sparring – Youth If you do not have at least 2 years experience in sparring, we strongly suggest that you register in the beginning division for the 4th New England ICMAC instead (see page […]). [ ] 1401. Children, 8 & under [ ] 1402. Children, 9-‐11 [ ] 1403. Children, 12-‐14 [ ] 1404. Teen Boys , 15-‐17 0-‐145 lbs. [ ] 1405. Teen Boys , 15-‐17, 146+ lbs. [ ] 1406. Teen Girls , 0-‐120 lbs. [ ] 1407. Teen Girls , 121+ lbs. 1500. Continuous Light Contact Sparring – Adult If you do not have at least 2 years experience in sparring, we strongly suggest that you register in the beginning division for the 4th New England ICMAC instead (see page […]). [ ] 1501. Men’s, 0-‐160 lbs. [ ] 1502. Men’s, 161+ lbs. [ ] 1503. Women’s, 0-‐130 lbs. [ ] 1504. Women’s, 131+ lbs.
4th NEW ENGLAND INTERNATIONAL CMA CHAMPIONSHIPS REGISTRATION Circle all events you wish to register for
Experience Levels – Beginner, 0-‐2 years – Intermediate, 2-‐4 years – Advanced, 4+ years You may register in only one experience level for all external events, one for all internal events, and one for all contact events At the sole discretion of the Organizing Committee, events and divisions may be combined or divided at any time prior to competition.
A. Youth External Events
1600. Traditional Kung Fu -‐ Barehand
[ ] 1601. Children 7 & under, beginner [ ] 1602. Children 7 & under, int-‐adv [ ] 1603. Children 8-‐10, beginner [ ] 1604. Children 8-‐10, int-‐adv [ ] 1605. Children 11-‐14, beginner [ ] 1606. Children 11-‐14, int-‐adv [ ] 1607. Teen boys, 15-‐17, beginner [ ] 1608. Teen boys, 15-‐17, int-‐adv [ ] 1609. Teen girls, 15-‐17, beginner [ ] 1610. Teen girls, 15-‐17, int-‐adv
1700. Traditional Kung Fu – Weapons
[ ] 1701. Children 7 & under, beginner [ ] 1702. Children 7 & under, int-‐adv [ ] 1703. Children 8-‐10, beginner [ ] 1704. Children 8-‐10, int-‐adv [ ] 1705. Children 11-‐14, short/other, beginner [ ] 1706. Children 11-‐14, short/other, int-‐adv [ ] 1707. Children 11-‐14, long, beginner [ ] 1708. Children 11-‐14, long, int-‐adv [ ] 1709. Teen boys, 15-‐17, short/other, beginner [ ] 1710. Teen boys, 15-‐17, short/other, int-‐adv [ ] 1711. Teen boys, 15-‐17, long, beginner [ ] 1712. Teen boys, 15-‐17, long, int-‐adv [ ] 1713. Teen girls, 15-‐17, short/other, beginner [ ] 1714. Teen girls, 15-‐17, short/other, int-‐adv [ ] 1715. Teen girls, 15-‐17, long, beginner [ ] 1716. Teen girls, 15-‐17, long, int-‐adv
1800. Contemporary Wushu -‐ Barehand
[ ] 1801. Children 7 & under, beginner [ ] 1802. Children 7 & under, int-‐adv [ ] 1803. Children 8-‐10, beginner [ ] 1804. Children 8-‐10, int-‐adv [ ] 1805. Children 11-‐14, beginner [ ] 1806. Children 11-‐14, int-‐adv [ ] 1807. Teen boys, 15-‐17, beginner [ ] 1808. Teen boys, 15-‐17, intermediate [ ] 1809. Teen boys, 15-‐17, changquan, advanced [ ] 1810. Teen boys, 15-‐17, nanquan, advanced [ ] 1811. Teen boys, 15-‐17, other, advanced [ ] 1812. Teen girls, 15-‐17, beginner [ ] 1813. Teen girls, 15-‐17, intermediate [ ] 1814. Teen girls, 15-‐17, changquan, advanced [ ] 1815. Teen girls, 15-‐17, nanquan, advanced [ ] 1816. Teen girls, 15-‐17, other, advanced
1900. Contemporary Wushu -‐ Weapons
[ ] 1901. Children 10 & under, beginner [ ] 1902. Children 10 & under, int-‐adv [ ] 1903. Children 11-‐14, short/other, beginner [ ] 1904. Children 11-‐14, short/other, int-‐adv [ ] 1905. Children 11-‐14, long, beginner [ ] 1906. Children 11-‐14, long, int-‐adv [ ] 1907. Teen boys, 15-‐17, broadsword, beg [ ] 1908. Teen boys, 15-‐17, broadsword, int-‐adv [ ] 1909. Teen boys, 15-‐17, str. sword, beg [ ] 1910. Teen boys, 15-‐17, str. sword, int-‐adv [ ] 1911. Teen boys, 15-‐17, staff, beginner [ ] 1912. Teen boys, 15-‐17, staff, int-‐adv [ ] 1913. Teen boys, 15-‐17, spear, beginner [ ] 1914. Teen boys, 15-‐17, spear, int-‐adv
1900. Contemporary Wushu – Weapons (cont.) [ ] 1915. Teen girls, 15-‐17, broadsword, beg [ ] 1916. Teen girls, 15-‐17, broadsword, int-‐adv [ ] 1917. Teen girls, 15-‐17, str. sword, beg [ ] 1918. Teen girls, 15-‐17, str. sword, int-‐adv [ ] 1919. Teen girls, 15-‐17, staff, beginner [ ] 1920. Teen girls, 15-‐17, staff, int-‐adv [ ] 1921. Teen girls, 15-‐17, spear, beginner [ ] 1922. Teen girls, 15-‐17, spear, int-‐adv B. Adult External Events 2000. Traditional Kung Fu – Barehand 2001. Men’s, 18-‐35, Northern, beginner 2002. Men’s, 18-‐35, Southern, beginner 2003. Men’s, 18-‐35, Northern, intermediate 2004. Men’s, 18-‐35, Southern, intermediate 2005. Men’s, 18-‐35, Northern, advanced 2006. Men’s, 18-‐35, Southern, advanced 2007. Men’s, 36+, All Styles, beginner 2008. Men’s ,36+, All Styles, int-‐adv 2009. Women’s 18-‐35, Northern, beginner 2010. Women’s 18-‐35, Southern, beginner 2011. Women’s 18-‐35, Northern, intermediate 2012. Women’s 18-‐35, Southern, intermediate 2013. Women’s 18-‐35, Northern, advanced 2014. Women’s 18-‐35, Southern, advanced 2015. Women’s, 36+, All Styles, beginner 2016. Women’s, 36+, All Styles, int-‐adv 2100. Traditional Kung Fu – Weapons 2101. Men’s, 18-‐35, short/other, beginner 2102. Men’s, 18-‐35, long, beginner 2103. Men’s, 18-‐35, short/other, intermediate 2104. Men’s, 18-‐35, long, intermediate 2105. Men’s, 18-‐35, short, advanced 2106. Men’s, 18-‐35, long, advanced 2107. Men’s, 36+, All Weapons, beginner 2108, Men’s, 36+, All Weapons, int-‐adv 2109. Women’s, 18-‐35, short/other, beginner 2110. Women’s, 18-‐35, long, beginner 2111. Women’s, 18-‐35, short/other, intermediate 2112. Women’s, 18-‐35, long, intermediate 2113. Women’s, 18-‐35, short, advanced 2114. Women’s, 18-‐35, long, advanced 2115. Women’s, 36+, All Weapons, beginner 2116. Women’s, 36+, All Weapons, int-‐adv 2200. Contemporary Wushu – Barehand 2201. Men’s, 18+, beginner 2202. Men’s, 18+, changquan/other, intermediate 2203. Men’s, 18+, nanquan, intermediate 2204. Men’s, 18+, changquan, advanced 2205. Men’s, 18+, nanquan, advanced 2206. Men’s, 18+, other, advanced 2207. Women’s, 18+, beginner 2208. Women’s, 18+, changquan/other, int 2209. Women’s, 18+, nanquan, intermediate 2210. Women’s, 18+, changquan, advanced 2211. Women’s, 18+, nanquan, advanced 2212. Women’s, 18+, other, advanced
2300. Contemporary Wushu – Weapons 2301. Men’s, 18+, All Weapons, beginner 2302. Men’s, 18+, short/other, intermediate 2303. Men’s, 18+, long, intermediate 2304. Men’s, 18+, short, advanced 2305. Men’s, 18+, long, advanced 2306. Men’s, 18+, other, advanced 2307. Women’s, 18+, beginner 2308. Women’s, 18+, short/other, intermediate 2309. Women’s, 18+, long, intermediate 2310. Women’s, 18+, short, advanced 2311. Women’s, 18+, long, advanced 2312. Men’s 18+, other, advanced C. Internal Events 2400. Taijiquan 2401. Men’s, 45 & under, all styles, beginner 2402. Men’s, 45 & under, all styles, intermediate 2403. Men’s, 45 & under, Yang style, advanced 2404. Men’s, 45 & under, Chen style, advanced 2405. Men’s, 45 & under, Wu style, advanced 2406. Men’s, 45 & under, Wu/Hao style, advanced 2407. Men’s, 45 & under, Sun style, advanced 2408. Men’s, 45 & under, Other styles, advanced 2409. Women’s, 45 & under, all styles, beginner 2410. Women’s, 45 & under, all styles, intermediate 2411. Women’s, 45 & under, Yang style, advanced 2412. Women’s, 45 & under, Chen style, advanced 2413. Women’s, 45 & under, Wu style, advanced 2414. Women’s, 45 & under, Wu/Hao style, advanced 2415. Women’s, 45 & under, Sun style, advanced 2416. Women’s, 45 & under, Other styles, advanced 2417. Men’s/Women’s, 46-‐65, all styles, beginner 2418. Men’s/Women’s, 46-‐65, all styles, int-‐adv 2419. Men’s/Women’s, 66+, all styles, beginner 2420. Men’s/Women’s, 66+, all styles, int-‐adv 2500. Other Internal Barehand 2501. Men’s/Women’s 45 & under, All other, beg 2502. Men’s/Women’s 45 & under, Baguazhang, int 2503. Men’s/Women’s 45 & under, Xingyiquan, int 2504. Men’s/Women’s 45 & under, Other, int 2505. Men’s 45 & under, Baguazhang, advanced 2506. Men’s 45 & under, Xingyiquan, advanced 2507. Men’s 45 & under, Other, advanced 2508. Women’s 45 & under, Baguazhang, advanced 2509. Women’s 45 & under, Xingyiquan, advanced 2510. Women’s 45 & under, Other, advanced 2511. Men’s/Women’s 46+, All other, beginner 2512. Men’s/Women’s 46+, All other, intermediate 2513. Men’s/Women’s 46+, All other, advanced 2600. Internal Weapons 2601. Men’s/Women’s, Taiji Straight Sword, beginner 2602. Men’s/Women’s, Other, beginner 2603. Men’s/Women’s, Taiji Straight Sword, int 2604. Men’s/Women’s, Other, intermediate 2605. Men’s, Taiji Straight Sword, advanced 2606. Men’s, Other Short, advanced 2607. Men’s, Long, advanced 2608. Women’s, Taiji Straight Sword, advanced 2609. Women’s, Other Short, advanced 2610. Women’s, Long, advanced
NAME: ___________________________________
Individual & Group Registration Forms 2012 Junior Trials 2012 Nationals
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At the sole discretion of the Organizing Committee, events and divisions may be combined or divided at any time prior to competition. D. Contact Events 2700. Push Hands – Restricted Step 2701. Men’s 45 & under, 0-‐160 lbs., beginner 2702. Men’s 45 & under, 0-‐160 lbs., int-‐adv 2703. Men’s 45 & under, 161+ lbs., beginner 2704. Men’s 45 & under, 161+ lbs., int-‐adv 2705. Men’s 46+, 0-‐160 lbs., beginner 2706. Men’s 46+, 0-‐160 lbs., int-‐adv 2707. Men’s 46+, 161+ lbs., beginner 2708. Men’s 46+, 161+ lbs., int-‐adv 2709. Women’s 45 & under, 0-‐130 lbs., beginner 2710. Women’s 45 & under, 0-‐130 lbs., int-‐adv 2711. Women’s 45 & under, 131+ lbs., beginner 2712. Women’s 45 & under, 131+ lbs., int-‐adv 2713. Women’s 46+, 0-‐130 lbs., beginner 2714. Women’s 46+, 0-‐130 lbs., int-‐adv 2715. Women’s 46+, 131+ lbs., beginner 2716. Women’s 46+, 131+ lbs., int-‐adv
2800. Push Hands – Moving Step 2801. Men’s 45 & under, 0-‐160 lbs., beginner 2802. Men’s 45 & under, 0-‐160 lbs., int-‐adv 2803. Men’s 45 & under, 161+ lbs., beginner 2804. Men’s 45 & under, 161+ lbs., int-‐adv 2805. Men’s 46+, 0-‐160 lbs., beginner 2806. Men’s 46+, 0-‐160 lbs., int-‐adv 2807. Men’s 46+, 161+ lbs., beginner 2808. Men’s 46+, 161+ lbs., int-‐adv 2809. Women’s 45 & under, 0-‐130 lbs., beginner 2810. Women’s 45 & under, 0-‐130 lbs., int-‐adv 2811. Women’s 45 & under, 131+ lbs., beginner 2812. Women’s 45 & under, 131+ lbs., int-‐adv 2813. Women’s 46+, 0-‐130 lbs., beginner 2814. Women’s 46+, 0-‐130 lbs., int-‐adv 2815. Women’s 46+, 131+ lbs., beginner 2816. Women’s 46+, 131+ lbs., int-‐adv
2900. Continuous Light Contact Sparring – Youth 2901. Children, 8 & under, beginner 2902. Children, 8 & under, int-‐adv 2903. Children, 9-‐11, beginner 2904. Children, 9-‐11, int-‐adv 2905. Children, 12-‐14, beginner 2906. Children, 12-‐14, int-‐adv 2907. Teen Boys, 0-‐130 lbs., beginner 2908. Teen Boys , 0-‐130 lbs., int-‐adv 2909. Teen Boys, 131+ lbs., beginner 2910. Teen Boys , 131+ lbs., int-‐adv 2911. Teen Girls, 0-‐120 lbs., beginner 2912. Teen Girls , 0-‐120 lbs., int-‐adv 2913. Teen Girls, 121+ lbs., beginner 2914. Teen Girls , 121+ lbs., int-‐adv 3000. Continuous Light Contact Sparring – Adult 3001. Men’s, 0-‐160 lbs., beginner 3002. Men’s, 0-‐160 lbs., int-‐adv 3003. Men’s, 161+ lbs., beginner 3004. Men’s, 161+ lbs., int-‐adv 3005. Women’s, 0-‐130 lbs., beginner 3006. Women’s, 0-‐130 lbs., int-‐adv 3007. Women’s, 131+ lbs., beginner 3008. Women’s, 131+ lbs., int-‐adv
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Individual & Group Registration Forms 2012 Junior Trials 2012 Nationals
4th NEICMAC Page 8 of 8
4th NEW ENGLAND INTERNATIONAL CMA CHAMPIONSHIPS REGISTRATION (CONTINUED) Circle all events you wish to register for
Experience Levels – Beginner, 0-‐2 years – Intermediate, 2-‐4 years – Advanced, 4+ years You may register in only one experience level for all external events, one for all internal events, and one for all contact events