Beruflich Dokumente
Kultur Dokumente
FORM
Phone: Karate Grade: GRADE DIVISION th th 8 to 7 Kyu th th th 6 , 5 & 4 Kyu rd 3 Kyu & Above
AGE GROUPS Up to 7 yr Incl. Male & Female 8 to 9 yr Incl. Male & Female 10 to 11 yr Incl. Male 10 to 11 yr Incl. Female 12 to 13 yr Incl. Male 12 to 13 yr Incl. Female 14 to 15 yr Incl. Male 14 to 15 yr Incl. Female 16 to 17 yr Incl. Male 16 to 17 yr Incl. Female Jnr Open Black Belt Male (14 17 yrs)* Jnr Open Black Belt Female (14 17 yrs)* 18 to 34 yr Incl. Male (up to 1st kyu) 18 to 34 yr Incl. Female (up to 1st kyu) Open Black Belt Male (18 yrs+)** Open Black Belt Female (18 yrs+)** 35 to 44 yr Incl. Male 35 to 44 yr Incl. Female 45 to 54 yr Incl. Male 45 to 54 yr Incl. Female 55 yr + Male 55 yr + Female Instructors Male Instructors Female
NOTE:
Kata
Kumite
TEAM EVENTS th Junior Team Kata 8 4 Kyu (under 18 yrs) rd Junior Team Kata 3 Kyu+ (under 18 yrs) Team Kata Male (18+ yrs) Team Kata Female (18+ yrs) Male Team Kumite (18+ yrs) Female Team Kumite (18+ yrs) TEAM NAMES Kata Team 1 2 3 Kumite Team 1 2 3 4 5
* 14 - 17 yrs Black Belts MUST enter Junior Open Division. ** 18 - 34 yrs Black Belts MUST enter Open Division. ** Both red & blue GKR /WKF mitts are required for Open division competitors
Signature:
Parents Signature:
(If under 18 years of age)
Name: Address:
D.O.B:
Please circle YES or NO to the following questions and statements. Do you have any allergies? e.g. aspirin; antibiotics; foods? Have you been in contact with any contagious diseases in the last 3 months? Are you taking any form of medication at present? YES YES YES NO NO NO
Emergency Contact Details: Please give two contact numbers where someone can be contacted in the event of an emergency 1. Name: Phone Number: 2. Name: Phone Number: Relationship: Other Number: Relationship: Other Number:
Declaration (Delete as applicable) I / My son / daughter is capable of taking part in the GKR Karate Tournament. I am willing to allow my son / daughter to participate in the above activity and confirm that they will be attending the tournament with / without a parent / guardian / a nominated person who has agreed to supervise my child. In the event of illness or injury, I agree to authorise members of staff attending / participating in the event to consent on my behalf for an anaesthetic to be administered or any other urgent medical treatment to be given on the advice of a qualified medical practitioner / qualified first-aid officer.
Date:
Mouth guards and standard white shin protectors, are compulsory. Chest protectors are compulsory for all female competitors 12 years+. Groin Protectors are compulsory for all male competitors.
NB: 1. Competitor to keep this page for tournament details. 2. Competitor must hand in entry form along with fees to instructor.