10thCHOJINKAI CHILDRENS/CADETS/JUNIORS
OPEN KARATE CHAMPIONSHIPS
Penrith Leisure Centre:Sunday March 13th2016
ENTRY FORM - PAGE 1 of 7
CONDITIONS OF ENTRY
- Closing date – Saturday5th March2016 (No entries on the day) No entry fee refunds.
- Latest WKF Rules will apply with certain modifications, see “Rules of the Day”
- 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 = £
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 5th March 2016to:-
Doug James, “Greenacres”,High Hesket, Carlisle, Cumbria,CA4 0HS.
Or BANK TRANSFER: HSBC Sort Code, 40 16 22: Acc No, 41836188: Name, Chojinkai Karate
PAGE 1 of 7
10th CHILDRENS OPEN:Penrith Leisure Centre:Sun March 13th
KICKMASTER KUMITE – 6 to 7 yrs
6/7 yrs – BOYSOPEN 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 BOYS9th 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
BOYS/GIRLS KATA – 9th to 7th Kyu – Pinan/Heian 1, 2 & 3 Kata Only
NOTE: Both individualsWILLperform their Kata on Tatami at same time
6 to 9 years / 10 to 13 yearsNo / Name / Grade / No / Name / Grade
1 / 1
2 / 2
3 / 3
4 / 4
BOYS/GIRLS KATA – 6th to 4th Kyu - anyPinan/Heian Kata
NOTE: If a high entry, both individuals will perform their Kata on Tatami at same time
6 to 9 years / 10 to 13 yearsNo / Name / Grade / No / Name / Grade
1 / 1
2 / 2
3 / 3
4 / 4
BOYS KATA – Black/Brown Belt – any Kata, free choice, no repeat
NOTE: Both individuals WILL perform their Kata on Tatami SEPERATELY in Black/Brown Belt Events
BOYS & GIRLS BLACK/BROWN BELT EVENT MAY BE AMALGAMATED IF LOW ENTRY IN EACH
6 to 9 years / 10 to 13 yearsNo / Name / Grade / No / Name / Grade
1 / 1
2 / 2
3 / 3
GIRLS KATA – Black/Brown Belt – any Kata, free choice, no repeat
6 to 9 years / 10 to 13 yearsNo / Name / Grade / No / Name / Grade
1 / 1
2 / 2
3 / 3
PAGE 2 of 7
10th CHILDRENS OPEN: Penrith Leisure Centre:Sun March 13th
PAIRS KATA - 6 to 9 Years– mixed/same sex
Two Competitors – If more than one team denote A, B or C
Boys/Girls Pairs Kata – Name of Team ……………………………
9th to 4th Kyu – Pinan/Heian Only
NOTE: if a high entry - both pairs will perform their Kata on Tatami at same time
Boys/Girls Pairs Kata – Name of Team ……………………………
Brown/Black Belts- both pairs will perform Advanced Kata Seperately
PAIRS KATA - 10 to 13 Years– mixed/same sex
Two Competitors – If more than one team denote A, B or C
Boys/Girls Pairs Kata – Name of Team ……………………………
9th to 4th Kyu – Pinan/Heian Only
NOTE: if a high entry - both pairs will perform their Kata on Tatami at same time
Boys/Girls Pairs Kata – Name of Team ……………………………
Brown/Black Belts- both pairs will perform Advanced Kata Seperately
3 TEAM KATA - 6 to 9 Years– mixed/same sex
Three Competitors – If more than one team denote A, B or C
Boys/Girls 3 Team Kata – Name of Team ……………………………
9th to 4th Kyu – Pinan/Heian Only
Boys/Girls 3 Team Kata – Name of Team ……………………………
Brown/Black Belts
3 TEAM KATA - 10 to 13 Years– mixed/same sex
Three Competitors – If more than one team denote A, B or C
Boys/Girls 3 Team Kata – Name of Team ……………………………
9th to 4th Kyu – Pinan/Heian Only
Boys/Girls 3 Team Kata – Name of Team ……………………………
Brown/Black Belts
PAGE 3 of 7
10th CHILDRENS OPEN: Penrith Leisure Centre:Sun March 13th
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/BlackNo / 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/BlackNo / 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/BlackNo / 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/BlackNo / Name / Grade / No / Name / Grade
1 / 1
2 / 2
3 / 3
4 / 4
5 / 5
PAGE 4 of 7
10th CHILDRENS OPEN: Penrith Leisure Centre:Sun March 13th
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/BlackNo / 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/BlackNo / 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/BlackNo / 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/BlackNo / Name / Grade / No / Name / Grade
1 / 1
2 / 2
3 / 3
4 / 4
5 / 5
PAGE 5 of 7
10th CHILDRENS OPEN: Penrith Leisure Centre:Sun March 13th
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
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
CADET/JUNIOR INDIVIDUAL KATA – 14 to 17 years
9th to 7th KYUPinan/Heian 1,2 or 3 Only / 6th to 4th KYU
Any Pinan/Heian / Brown/Black
Any Kata
Free Choice
No / Name / Grade / No / Name / Grade / No / Name / Grade
1 / 1 / 1
2 / 2 / 2
3 / 3 / 3
4 / 4 / 4
5 / 5 / 5
NOTE: Brown/Black Belt Kata, may be split if a high number of Male & Female entrants
PAIRS KATA - 14 to 17 Years– mixed/same sex
Two Competitors – If more than one team denote A, B or C
Cadet/Junior- Pairs Kata – Name of Team ……….………………………
9th to 4th Kyu – Pinan/Heian Only
NOTE: if a high entry - both pairs will perform their Kata on Tatami at same time
Cadet/Junior - Pairs Kata – Name of Team ……….………………………
Brown/Black Belt -both pairs will perform Advanced Kata Seperately
3 TEAM KATA - 14 to 17 Years– mixed/same sex
Three Competitors – If more than one team denote A, B or C
Cadet/Junior -3 Team Kata – Name of Team …….………………………
9th to 4th Kyu – Pinan/Heian Only
Cadet/Junior - 3 Team Kata – Name of Team …….………………………
Brown/Black Belt
PAGE 6 of 7
10th CHILDRENS OPEN: Penrith Leisure Centre:Sun March 13th
GIRLS CADET KUMITE 14 to 15 Years – Under 53 Kilo
9th to 4th Kyu / Brown/BlackNo / 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/BlackNo / 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/BlackNo / 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/BlackNo / Name / Grade / No / Name / Grade
1 / 1
2 / 2
3 / 3
JUNIOR INDIVIDUAL KUMITE – 16/17 Years
FEMALE JUNIORAny Grade/Open Weight / MALE JUNIOR
Any Grade/Open Weight
No / Name / Grade / No / Name / Grade
1 / 1
2 / 2
3 / 3
4 / 4
5 / 5
BOYS/GIRLS – CADET/JUNIOR TEAM KUMITE
Boys Cadet Team Kumite – Name of Team ……….………………………
14 to 15 Years – Any Grade – Open Weight
Girls Cadet Team Kumite – Name of Team ……….………………………
14 to 15 Years – Any Grade – Open Weight
Male Junior Team Kumite – Name of Team ………………………………
Male Only – 16/17 years – Any Grade – Open Weight
Female Junior Team Kumite – Name of Team ………………………..
Female Only – 16/17 years – Any Grade – Open Weight
PAGE 7 of 7