Roger Haines and Steven Allen
25th Annual
Saturday, May 30, 2015
Northwest Recreation Center
1600 Princeton Drive
Dayton, Ohio 45406
(937) 333-3332
Overall Black Belt Grand Champion Mens Sparring — $300
Overall Black Belt Grand Champion Womens Sparring — $100
Overall Black Belt Grand Champion Forms/Weapons — $100
Grand Champion Jr. Black Belt Boys & Girls
Grand Champion Underbelt Beg. Boys & Girls
Grand Champion Underbelt Inter. Boys & Girls
Grand Champion Underbelt Adv. youth Boys & Girls
For more information, call (937)470-3681 or (937) 554-2919
WHEN: Saturday, May 30, 2015
Padded Weapons at 10:00am
TOURNAMENT LODGING
10:30am - SHARP - Black Belt Meeting
Tournament starts at 11:00am
Tournament Site
Northwest Recreation Center
1600 Princeton Drive, Dayton, Ohio
REGISTRATION
Pre-Registration*
$35.00 for 4 events paid advance
Must be postmarked by May 23, 2015
Americas Best Value Inn
Red Roof Inn South
7130 Miller Lane
Take Exit 59 from I-75 North
$42.00 + tax per day
Code (Nationals Rate)
4 people per room
(937) 898-3606
222 Byers Road
Take Rt. 725 West to Byers Road
$59.99 + tax per day
No Code
4 people per room
(937) 866-0705
Driving directions
From the North: I-75 South take exit 54B toward OH– 48/Main St.
Turn left on Main then turn right Monument go over the bridge at the light
turn left go one block make right on to Salem. Follow Salem about 2 miles
to Princeton Drive. Turn left onto Princeton Dr. and follow to Rosedale Dr.
The Northwest Recreation Center is on the left.
At the door:
$45.00 at the door
$25.00 Padded Weapons
Money Orders/Checks made to Steven Allen
From the South: I-75 North to Salem Avenue Exit. Continue North on
Mail to: Region 8 Nationals
P.O. Box 60367
Dayton, OH 45406
Salem Avenue about 2 miles to Cornell Drive. Cornell Drive is at the top of
the hill. Turn left at the light on to Cornell, follow Cornell to the first stop
sign. Turn left onto Catalpa forks into Rosedale Dr. Follow Rosedale for
two stop signs at the second stop sign. At the second stop sign turn right
onto Princeton Dr. The Northwest Recreation Center is on the left .
ENTRY FEE
SPECTATORS
$8.00…...10 and older
$5.00……4-9
Free……..3 and under are
TOURNAMENT ARVITRATOR
Grand Master Anthony Price
Grand Master Roger Haines
EQUIPMENT REQUIREMENTS
Safety equipment, groin protector and mouthpiece
are mandatory in all divisions
PRE-REGISTRATION FEE: $35.00 ( Postmarked by
May 23, 2015)
Please make checks/money orders payable to Steven Allen.
Name__________________________________________ Age_______ Birthday______________ Sex______
Address__________________________________________ City__________ State______ Zip____________
Telephone___________________________ Email
Studio Name________________________________________ Instructor Name_________________________
Studio Address______________________________________ City___________ State_______ Zip________
Division
Rank
Weapons___ Forms___ Fighting___ Padded Weapons___
I release Roger Haines, Steven Allen, the City of Dayton Department of Recreation & Youth Services, Northwest Recreation Center, Tri-State, NASKA,
and all other persons and businesses associated with this event, the Region 8 Nationals 2015 from an liability due to injuries, etc. that I may incur as a
result of my attendance and/or participation at this event. I understand that fighting aspect of this sport and competition involves body contact I have read,
understand and agree to abide by the rules with this event and assume all responsibility and associated liability for infringement of such rules.
Additionally, I am fully aware of my medical condition and hereby certify that I am mentally and physically able to compete at this event. I also
understand that valid birth certificate or acceptable proof of age should be presented upon request.
_____________________________________________________________
___________________________________________________
SIGNATURE
SIGNATURE OFF PARENT OR GUARDIAN (IF UNDER 18)
120 Division
Jr. Black Belt Weapons
Youth Underbelt Fighting
13 yrs. & under B/G
14 -17 yrs. B/G
5 yrs. & under Beginner B/G
5 yrs. & under Intermediate B/G
6 - 7 yrs. Beginner B/G
6 - 7 yrs. Intermediate B/G
6 - 7 yrs. Advance B/G
8 - 9 yrs. Beginner Girls
8 - 9 yrs. Intermediate Girls
8 - 9 yrs. Advance Girls
8 - 9 yrs. Beginner Boys
8 - 9 yrs. Intermediate Boys
8 - 9 yrs. Advance Boys
10 - 11 yrs. Beginner Girls
10 - 11 yrs. Intermediate Girls
10 - 11 yrs. Advance Girls
10 - 11 yrs. Beginner Boys
10 - 11 yrs. Intermediate Boys
10 - 11 yrs. Advance Boys
12 - 13 yrs. Beginner Girls
12 - 13 yrs. Intermediate Girls
12 - 13 yrs. Advance Girls
12 - 13 yrs. Beginner Boys
12 - 13 yrs. Intermediate Boys
12 - 13 yrs. Advance Boys
14 - 15 yrs. Beginner Girls
14 - 15 yrs. Intermediate Girls
14 - 15 yrs. Advance Girls
14 - 15 yrs. Beginner Boys
14 - 15 yrs. Intermediate Boys
14 - 15 yrs. Advance Boys
16 - 17 yrs. Beginner Girls
16 - 17 yrs. Intermediate Girls
16 - 17 yrs. Advance Girls
16 - 17 yrs. Beginner Boys
16 - 17 yrs. Intermediate Boys
16 - 17 yrs. Advance Boys
Jr. Black Belt Forms
9 yrs. & under B/G
10 -11 yrs. B/G
12 - 13 yrs. B/G
14 - 15 yrs. B/G
16 - 17 yrs. B/G
Black Belt Fighting
9 yrs. & under B/G
10 - 11 yrs. B/G
12 - 13 yrs. Girls
12 - 13 yrs. Boys
14 - 15 yrs. Girls
14 - 15 yrs. Boys
16 - 17 yrs. Girls
16 - 17 yrs. Boys
Youth Underbelt Weapons
10 yrs. & Under Beginner B/G
10 yrs. & Under Intermediate B/G
10 yrs. & Under Advanced B/G
11 - 13 yrs. Beginner B/G
11 - 13 yrs. Intermediate B/G
11 - 13 yrs. Advanced B/G
14 - 17 Beginner B/G
14 - 17 Intermediate B/G
14 - 17 Advanced B/G
Youth Underbelt Forms
5 yrs. & under Beginner B/G
5 yrs. & under Intermediate B/G
6 - 7 yrs. Beginner B/G
6 - 7 yrs. Intermediate B/G
6 - 7 yrs. Advance B/G
8 - 9 yrs. Beginner B/G
8 - 9 yrs. Intermediate B/G
8 - 9 yrs. Advance B/G
10 - 11 yrs. Beginner B/G
10 - 11 yrs. Intermediate B/G
10 - 11 yrs. Advance B/G
12 - 13 yrs. Beginner B/G
12 - 13 yrs. Intermediate B/G
12 - 13 yrs. Advance B/G
14 - 15 yrs. Beginner B/G
14 - 15 yrs. Intermediate B/G
14 - 15 yrs. Advance B/G
16 - 17 yrs. Beginner B/G
16 - 17 yrs. Intermediate B/G
16 - 17 yrs. Advance B/G
Black Belt Weapons
18 - 34 yrs. Men
18 - 34 yrs. Woman
35 - & Over Men
35 - & Over Woman
Black Belt Forms
18 - 34 yrs. Men
18 - 34 yrs. Woman
35 - & Over Men
35 - & Over Woman
Black Belt Fighting
18 - 34 yrs. Men Lt. Wt. (164 & Under)
18 - 34 yrs. Men Mid Wt. (165-180)
18 - 34 yrs. Men Hvy. Wt. (180-over)
35 & Over Men (All Weights)
18 - 34 yrs. Women (All Weights)
35 & Over Women (All Weights)
ADULT BLACK BELT
GRANDS
Mens Overall Grand
Champion Winner
$300
Take All …….
Adult Underbelt Weapons
18 - 34 yrs. Beginner M/W
18 - 34 yrs. Int/Adv M/W
35 - & Over Beginners M/W
35 - & Over Int/Adv M/W
Womens Sparring Overall
Grand Champion.......$100
Adult Underbelt Forms
Black Belt Forms/Weapons
Overall Grand
Champion..................$100
18 - 34 yrs. Beginner M/W
18 - 34 yrs. Int/Adv M/W
35 - & Over Beginners M/W
35 - & Over Int/Adv M/W
Adult Underbelt Fighting
18 - 34 yrs. Beginner Men
18 - 34 yrs. Int/Adv Men
18 - 34 yrs. Beginner Women
18 - 34 yrs. Int/Adv Women
35 - & Over Beginners Men
35 - & Over Int/Adv Men
35 - & Over Beginner Women
35 - & Over Int/Adv Women
SPARRING POINTS
1 Point All Hand Techniques and Kicks to the Body/ 2 Points Kicks to the Head
3 Points Spinning Kicks to the Head.
7 Points or Most Points After 2 Minutes
LIGHT FACE CONTACT ALL SPARRING DIVISIONS
Please mail all
correspondences to:
Region 8 Nationals
P.O. Box 60367
Dayton, OH 45406