May 30 , 2015 th 30th Annual Delta Woods Middle School 4401 NE Lakewood Way, Lee’s Summit, MO 64064 GRAND CHAMPION FORMS TROPHIES BLACK BELT COMPETITION Daedo E- Hogu & E- Headgear RECREATIONAL SPARRING DIVISIONS ALL COMPETITORS AGE 11 & UNDER RECEIVE A CHAMPIONSHIP MEDAL KIDS FUN AREA AMERICAN CHAMPIONS TAEKWONDO SERIES Northeast Iowa Championships Kansas City Classic Tournament of Champions Sponsored by: Masters Oren & Terry Gautreaux, Gautreaux’s Martial Arts Center American Masters Association P.O. Box 442 , Blue Springs, MO 64013 816.229.6611 Register at : www.TheKCclassic.com THE 30TH ANNUAL KANSAS CITY CLASSIC TAEKWONDO CHAMPIONSHIPS MAY 30, 2015 DELTA WOODS MIDDLE SCHOOL 4401 NE Lakewood Way, Lee’s Summit, MO 64064 Friday, May 29th 5 – 9m Saturday, May 30th Registration Fees Credential pick-up at Gautreaux’s Martial Arts Center, 2905 SW US Hwy 40, Blue Springs, MO 64015 816.229.6611 8 – 9am 8:30am 9:00am Credential pick-up at Delta Woods Middle School (venue) Coach and Official meeting Form Competition: Black Belt Forms Color Belt Forms Weapon Forms Grand Champion Forms Demo Team Competition Sparring Competition Gym #2: Daedo Sparring divisions for 12-14, 15-17, 18-32 Sparring Competition Gym #1: *All competitors age 33 & above and age 6 & below color belt & black belt will compete at the beginning followed by all other divisions, 12-14 Ringmaster Gym #1 Two Events: Pre-registration $59 if postmarked by May 15th Two Events: Registration $69 if postmarked after May 15th Third Event: $10 Day of Event: $79 only sparring Register at www.thekcclassic.com Coaching Fees $20.00 if postmarked by May 15th $25.00 if postmarked after May 15th & at the door 6-15 competitors = 2 free coaching passes, 16-25 competitors = 3 free coaching Passes, please contact us for 25 or more competitors Spectator Fees Adults (age 13 & older) $10 Children (age 6-12) $8, age 5 & under free Championship T-Shirt $20 limited supply available please order at registration and mark desired size Hotels There are several hotels in the Lee’s Summit, Blue Springs, Independence area, the venue is close to the intersection of Woods Chapel Rd and 291 Hwy Directors Master Oren & Terry Gautreaux TKDSCORE TKDSCORE is supplying the E-Hogu and E-Headgear for Daedo divisions. Limited supply of EFoot gear available at tournament. Must have E-Feet for Daedo competition 30TH ANNUAL KANSAS CITY “The CLASSIC” TAEKWONDO CHAMPIONSHIPS MAY 30, 2015 ATHLETE REGISTRATION Please mail registration to: Gautreaux’s Martial Arts Center (GMAC), P.O. Box 442, Blue Springs, MO 64013 Physical address: 2905 SW US Hwy 40, Blue Springs, MO 64015 816.229.6611 [email protected] Championship venue: Delta Woods Middle School, 4401 NE Lakewood Way, Lee’s Summit, MO 64064 ATHLETE NAME MARTIAL ART SCHOOL NAME ADDRESS ADDRESS CITY, STATE, ZIP CITY, STATE, ZIP PHONE # PHONE # PARENT NAME INSTRUCTOR NAME Athlete info: ______________ Belt ___________ Age ___________ Gender ___________Weight __________ Height Competition Divisions: ___________ Forms ___________ Sparring ___________ Weapons ___________ Demo Team Name of Demo Team _______________________ Daedo Division (Black Belt, age 12-14, 15-17, 18-32) ____________ Youth Sizes Small Medium Large Adult Sizes Small Medium Large X Large XX LargeAgreement Liability Waiver & Conduct Inconsideration of being allowed to participate, the undersigned does hereby waive and release, and voluntarily submit their application for participation in KC Classic tournament. The undersigned does hereby for himself, his heirs, executors, administrators, successors and assigns release and forever discharge the promoter and the organizers of the said tournament and their servants and agents and all those in any way connected with the running and management of same, any and all damages which may be sustained by me in connection with my association with or entry in the above athletic meet, or which may arise out of traveling to, participating in and returning from this athletic meet, including but not limited to GMAC, Oren and Terry Gautreaux, ACTS, Delta Woods, Blue Springs School District, City of Lee’s Summit, their employees, agents, officials, vendors, volunteers and first aid assistance, from any and all actions, causes of actions, claims and demands for, upon or by reason of any damage, loss or injury to person and property and death, which heretofore has been undersigned participating in the said tournament. I also hereby agree that any photographs or films of myself, taken at the event may be used by the tournament directors for publication, broadcasting or for any other promotional purposes and I waive compensation in regard to hereto. I am fully aware of my personal physical and medical condition, and hereby acknowledge that I am physically fit to compete in this tournament. I have read the rules personally or have been instructed by my instructor, adult guardian or parent, as to the rules governing this tournament. I am fully prepared to follow the rules in a safe and disciplined fashion. I am aware that I am responsible for entering myself in the correct divisions. I agree to cooperate with all staff, officials and security personnel at all times. I agree to leave the competition floor at the conclusion of my contestant’s match(es). I completely agree with the liability waiver and conduct agreement by signing below. Signature _____________________________________________ Date _____________ Parent/Guardian _______________________________________ Date _____________ METHOD OF PAYMENT _______VISA _______ MC _______ DISCOVER _______ MONEY ORDER CC# _______________________________________ EXP DATE ___________ PRINT NAME ____________________________________________________ I agree to pay the total amount plus $2.95 service fee as a non-refundable charge to my credit card and I agree that it cannot be charged back or canceled without express written consent of the KC Classic directors REGISTRATION FEE DIVISION FEE DEMO TEAM Fee includes demo team members ( ) X $100 FIRST TWO DIVISIONS Postmarked by 5/15 ( ) X $59 FIRST TWO DIVISIONS Postmarked after 5/15 ( ) X $69 DAY OF EVENT ( ) X $79 ADDITIONAL DIVISIONS ( ) X $10 CHAMPIONSHIP T-SHIRT XXL add #3.00 ( ) X $20/23 GRAND CHAMPION FORMS TOTAL FREE to FORM WINNERS x If using a credit card add $2.95 GRAND TOTAL $ 30TH ANNUAL KANSAS CITY “The CLASSIC” TAEKWONDO CHAMPIONSHIPS MAY 30, 2015 COACH/REFERREE REGISTRATION Please mail registration to: Gautreaux’s Martial Arts Center (GMAC), P.O. Box 442, Blue Springs, MO 64013 Physical address: 2905 SW US Hwy 40, Blue Springs, MO 64015 816.229.6611 [email protected] Championship venue: Delta Woods Middle School, 4401 NE Lakewood Way, Lee’s Summit, MO 64064 Instructors will receive 2 FREE coaching passes for bringing 6-15 athletes, 3 FREE coaching passes for bringing 16-25 athletes. If you are bringing 25 or more athletes, please call us for special arrangements. Thank you! Coaching passes are $20. if postmarked by May 15, $25 if postmarked after May 15 COACH/REFEREE NAME MARTIAL ART SCHOOL NAME ADDRESS ADDRESS CITY, STATE, ZIP CITY, STATE, ZIP PHONE # PHONE # INSTRUCTOR NAME Liability Waiver & Conduct Agreement Inconsideration of being allowed to participate, the undersigned does hereby waive and release, and voluntarily submit their application for participation in KC Classic tournament. The undersigned does hereby for himself, his heirs, executors, administrators, successors and assigns release and forever discharge the promoter and the organizers of the said tournament and their servants and agents and all those in any way connected with the running and management of same, any and all damages which may be sustained by me in connection with my association with or entry in the above athletic meet, or which may arise out of traveling to, participating in and returning from this athletic meet, including but not limited to GMAC, Oren and Terry Gautreaux, ACTS, Delta Woods, Blue Springs School District, City of Lee’s Summit, their employees, agents, officials, vendors, volunteers and first aid assistance, from any and all actions, causes of actions, claims and demands for, upon or by reason of any damage, loss or injury to person and property and death, which heretofore has been undersigned participating in the said tournament. I also hereby agree that any photographs or films of myself, taken at the event may be used by the tournament directors for publication, broadcasting or for any other promotional purposes and I waive compensation in regard to hereto. I am fully aware of my personal physical and medical condition, and hereby acknowledge that I am physically fit to compete in this tournament. I have read the rules personally or have been instructed by my instructor, adult guardian or parent, as to the rules governing this tournament. I am fully prepared to follow the rules in a safe and disciplined fashion. I am aware that I am responsible for entering myself in the correct divisions. I agree to cooperate with all staff, officials and security personnel at all times. I agree to leave the competition floor at the conclusion of my contestant’s match(es). I completely agree with the liability waiver and conduct agreement by signing below. Signature ____________________________________________________________________________________ Date _____________________ Parent/Guardian ______________________________________________________________________________ Date _____________________ COACH REGISTRATION FEE METHOD OF PAYMENT _______VISA ________ MC ________ DISCOVER ________ MONEY ORDER CC# _____________________________________ EXP DATE ____________ PRINT NAME __________________________________________________ SIGNATURE____________________________________________________ I agree to pay the total amount plus $2.95 service fee as a non-refundable charge to my credit card and I agree that it cannot be charged back or canceled without express written consent of the KC Classic directors Coach ( ) X $20 Coach ( ) X $25 postmarked by 5/15 postmarked by 5/15 Grand Total $ 30th Annual Kansas City Classic Taekwondo Championships May 30, 2015 FORMS This is a modified double-elimination format. Any traditional forms accepted. Beginners: (white, yellow, orange belts) Intermediates: (green, purple, blue belts) Advanced: (brown, red belts) Black Belt: all black belt dan/poom rank Age/Division 6 & under Combined M/F 7–8 M/F 9 – 11 M/F 12 – 14 M/F 15 – 17 M/F 18 – 32 M/F 33 – 42 M/F 43 + M/F Divisions will be combined or divided to ensure a fair and fun competitive environment for everyone. GRAND CHAMPION FORMS Winners receive 5’ Trophies. This is a single elimination format. GC Forms comprise of the first place winners from all form divisions. There is no additional charge. Age/Division 8 & under All Belts 9 – 11 Color Belts 9 - 11 Black Belts 12 – 14 Color Belts 12 – 14 Black Belts 15 – 17 All Belts 18 + All Belts DEMO TEAM The demo team competition is a single elimination format. Teams consist of any number of members and perform to music. Please keep your performances to 5 minutes or less. SPARRING Divisions will be combined and divided to ensure safety, fairness and fun in a competitive environment determined by age, weight and height. We will have national and recreational divisions, please advise at staging. Sparring rounds & rules available for coaches at 8:30am meeting. Age/Division 6 & under Combined M/F 7–8 M/F 9 – 11 M/F 12 – 14 M/F 15 – 17 M/F 18 – 32 M/F 33 – 42 M/F 43 + M/F Divisions will be combined or divided to ensure a balanced and fun competition for everyone. DAEDO DIVISIONS We will be using the E-Hogus and E-Headgear. There will be a limited supply of Daedo feet available at venue. Recreational divisions are available for black belt competitors that do not wish to compete with the Daedo system, please advise at staging. Matches will consist of three 90 second rounds. 12 – 14 BB Male 12 – 14 BB Female Will be divided in staging 15 – 17 BB Male 15 – 17 BB Female up to 106 up to 97 106.1 – 122 97.1 - 108 122.1 – 139 108.1 – 121.3 139.1 – 161 121.4 – 138.9 161 + 139+ 18 – 32 BB Male 18 – 32 BB Female up to 127.6 up to 107.8 127.7 – 149.6 107.9 – 125.4 149.7 – 176 125.5 – 147.7 176.1 + 147.8 + Please mail registration to GMAC , PO Box 442, Blue Springs, MO 64013 or register online at www.thekcclassic.com If you have any questions please contact us at 816.229.6611 Thank you for your participation! May 30 , 2015 th 30th Annual Delta Woods Middle School 4401 NE Lakewod Way Lee’s Sumit, MO 64064 GRAND CHAMPION FORMS TROPHIES BLACK BELT COMPETITION DAEDO E - Hogu & E - Headgear RECREATIONAL SPARRING DIVISIONS ALL COMPETITORS AGE 11 & UNDER WIN A CHAMPIONSHIP MEDAL KIDS FUN AREA Special delivery for............ The Kansas City Classic PO Box 442 Blue Springs, Mo 64013
© Copyright 2024