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