Arizona Karate Association
Western States Karate Championships
6326 N. 7th Street
Phoenix, Arizona 85014
Phone: 602-274-1136
Website: www.arizonakarate.com
E-mail: [email protected]
50th Western States Karate Championships 2014
Master your Instincts
By Shojiro Koyama with Lisa Anderson
Greetings:
I came to the United States in 1964, about a half a century ago. Unfortunately, I
don't speak English very well. Because of this, I have taught karate technique,
which looks like today's sports karate. But Japanese cultural martial arts – bunpu
ryodo – is a combination of philosophy and technique or fighting. In the
Japanese language, that is the meaning of budo. Budo is very much like
industry; for example, like the Sensei is responsible for students, the employer is
responsible for the employees and the employees’ families. Leadership, whether of a dojo or a
company, is very similar.
Fortunately, Kazuo Inamori, the former head of Kyocera, has written books on leadership and
success. His book A Passion for Success: Practical, Inspirational, and Spiritual Insight From
Japan’s Leading Entrepreneur (McGraw-Hill, 1995). While it might appear that industry and karate are
very different, but the philosophy of both is quite similar. The following are words of wisdom from
Mr. Inamori.
“You must learn to control your instincts. This will develop your intellect and give you the ability
to make the right decisions.
Human beings are born with both ‘instinct’ and ‘intellect’. Eating, drinking, fighting, and feeling
possessive or jealous are all part of the self-preservation instinct by which we protect our lives and
propagate our families. We often make decisions by using our instincts as a basis of judgment;
however, animals behave in much the same way. Better decisions may come if we look at the
situation objectively.
It is important to master your instincts. This will create some space in your mind where intellect
can grow and allow you to reason logically. What matters is just how much of your behavior is
controlled by intellect alone.
It is not easy to master our instincts. We cannot live without them, and I am not advocating that we
get rid of them altogether. The important thing is not to be ruled by them. We need the ability to
control our instincts at will.
Since humans tend to follow their instincts by nature, this challenge can be extremely difficult.
There is no simple way to do this. We need to catch our selfish desires as soon as they emerge and
use our intellect to suppress them”.
Control is the essence of Budo and Karate. As we practice our Karate, application of Control to our
lives allows us to learn and prosper from our Art. I wish you a prosperous day and life!
Shojiro Koyama
Chairman
Western States Karate Championships Association
2014 WSKC Tournament
www.arizonakarate.com
PRE-TOURNAMENT EVENTS
KARATE CLINIC and DAN EXAM
Given By:
Master Shojiro Koyama,
8th Dan
JKA/WF America – Western Region
Master Shojiro Koyama is the Chief Instructor of the JKA/WF Western Region and the Arizona
Karate Association located in Phoenix, AZ. Master Koyama has taught Traditional Shotokan
Karate in Phoenix for 50 years as a Japan Karate Association (JKA) instructor and a JKA Board
Director. Master Koyama has devoted his life to promoting and teaching the art of Karate-Do with
the premise that Karate is Lifetime Exercise and Lifetime Learning.
CLINIC
Open to All Students
6:00 pm - 7:00 pm
JKA DAN EXAM
Immediately following the clinic.
Testing is Limited to JKA/WF members only.
Friday, October 31, 2014, 6:00 p.m.
All Spectators Welcome!
Held at the Sports Club at City Square,
4000 N. Central Ave. Phoenix
(Same building as Hilton Garden Inn)
7:15 PM, Friday, October 31, 2014
NOTE:
IMPORTANT!
Participants must wear a traditional white karate
gi and should arrive early enough to be dressed
and warmed up prior to the start of the clinic.
There will be no time to warm up during the
clinic. Open to all ages, traditional styles, and
belt levels.
All students testing must have their Instructor’s
approval.
Examinees must present JKA Passport.
Cloth or vinyl hand pads and mouth guard
required, no exceptions
Clinic Fee: $25.00 per person
Photography and Videotaping are Permitted.
Please NO Flash Cameras!
(Cash or check accepted at the door.)
2014 WSKC Tournament
www.arizonakarate.com
HOTEL ACCOMMODATIONS
Competitors and guests are encouraged to stay at:
Hilton Garden Inn
4000 N. Central Avenue
Rates:
Phoenix, Arizona, USA 85012
Occupancy
Rates
Tel: +1-602-279-9811
Single/Double/
$109.00 (plus tax)
Fax: +1-602-285-2932
Reservation Cut-Off Date: October 17, 2014
To reserve your room, please use the group code:
“WESTERN STATES KARATE”
PLEASE RESERVE EARLY!
(Room availability not guaranteed)
2014 WSKC Tournament
www.arizonakarate.com
Directions to the Phoenix Convention Center
Using Interstate 10
Take Exit 145 - Seventh Street and go South to Van Buren,
Monroe, or Washington Streets.
Proceed to the Parking Garage of your choice by navigating
the map below.
Using Interstate 17
Take Exit 195 - Seventh Street and go North to Washington,
Monroe, or Van Buren Streets.
Proceed to the Garage of your choice by navigating the map
below.
You may enter on either the 3rd Street or the 2nd Street entrance directly across from the Hyatt Regency
and proceed up the escalators to the 3rd Floor. To your left, you will find Ballrooms 301A and B.
Registration and merchandise sales will be outside the Ballrooms.
2014 WSKC Tournament
www.arizonakarate.com
TOURNAMENT EVENT SCHEDULES
All Events on this page are held in the Phoenix Convention Center, 100 N. Third St.,
West Ballrooms, 301 A&B
Registration Opens at 8 a.m., Competition begins at 9 a.m.
Attention Judges! Black Belt Judges Meeting (In front of the announcer’s table)
Saturday, Nov. 1st, 8:45 am
All black belts eligible to serve as corner judges or referees are required to attend a judges
meeting to be held the day of the tournament at 8:45 AM in front of the announcer’s table. All
JKA judges and referees must wear a white, long-sleeved shirt, gray slacks and maroon tie. No
watches, jewelry, or beepers are permitted in the match areas.
*********************************************************************************


Saturday, Nov. 1st, Begins at 9:00 AM
Open Tournament to Compatible Styles, no weapons
(Subject to Japan Karate Association rules of competition.)
Opening Ceremony, and preliminary WSKC eliminations to the last 16 events (see registration
form)
*********************************************************************************


Saturday, Nov. 1st, Begins Approximately at 3:00 PM
*********************************************************************************
2014 WSKC Tournament
www.arizonakarate.com
WSKC FEES, RULES & REGULATIONS
THIS IS A
CHARITY
EVENT.
PROCEEDS
WILL GO TO
THE 100 CLUB
OF ARIZONA!
**JKA SANCTIONED**Competitor Regulations
KATA
KUMITE
1.
2.
1.
Japan Karate Association Rules. 2
minutes 1 point (or 1/2 point plus
1/2 point = 1 point).
2.
No protective pads or foot covers
permitted. No plastic guards or
headgear.
3.
Contestants are required to provide
their own mouthpiece and FABRIC
OR VINYL HAND PADS.
4.
This is a NON-CONTACT
tournament. You will be
disqualified for lack of control.
5.
Out-of-bounds warnings will count
toward a decision. Third warning
will result in disqualification.
6.
Each contestant must wear a
complete Karate GI (uniform)
consisting of a top, bottom and belt.
3.
Point system.
Four corner judges and one chief
referee.
High & low scores eliminated.
Tournament Fees:
ONE EVENT:
(KATA OR KUMITE)
Registration by 10/24
After 10/24 up to
Day of Tournament
$30.00
$40.00
TWO EVENTS
Their Mission:
To provide immediate
financial assistance to
families of public
safety officers and
firefighters
who are seriously
injured or killed in
the line of duty, and
to provide resources
to enhance their
safety and welfare.
Registration by 10/24
After 10/24 up to
Day of Tournament
$40.00
$50.00
TEAM EVENTS:
(Fees are per team, per event)
Registration by 10/24
$ 50.00
After 10/24 up to
Day of Tournament
$ 80.00
TROPHIES & MEDALS
Medals will be awarded as follows:
Kata 1st, 2nd, 3rd place
Kumite 1st, 2nd, and 3rd place
Trophies will be awarded in selected
finals event.
ADMISSION
DONATION:
Admission Donations are
Accepted, Appreciated, and
go towards the Tournament
Charity.
No Admission Fee is
Required for Spectators.
Registration Instructions
REGISTER
IN
ADVANCE
REGISTRATION
OPEN NOW!
2014 WSKC Tournament
1.
2.
Registration forms must be filled
out and the competitor must sign
the release (and parent/guardian if
competitor is under age 18.)
Contestants may enter only ONE
event in each category. You may
compete once in individual kata
and once in individual kumite. In
addition you may also compete
once in team kata and once in team
kumite. You must stay in your age
and gender group.
3.
4.
The registered person can pay
by cash, check or credit card.
Make checks payable to WSKC
Registrations should be mailed
faxed, or delivered to:
Arizona Karate Association
6326 N. 7th Street
Phoenix, AZ 85014
Telephone: (602) 274-1136
Fax:
(602) 943-3350
www.arizonakarate.com
WESTERN STATES KARATE CHAMPIONSHIPS WSKC 2014 INDIVIDUAL REGISTRATION
Please circle the events you wish to enter. Tournament entry fees (by Oct. 24th): One event $30, Two events $40
After October 24th, One event $40, Two events $50
EVENT
AGE
INDIVIDUAL KATA DIVISION BELT
EVENT
AGE
INDIVIDUAL KUMITE DIVISION BELT
3A
4A
5A
18 & UP
18 & UP
18 & UP
WOMEN WHITE, YELLOW, ORANGE
WOMEN GREEN, PURPLE
WOMEN BROWN
3B
4B
5B
18 & UP
18 & UP
18 & UP
WOMEN WHITE, YELLOW, ORANGE
WOMEN GREEN, PURPLE
WOMEN BROWN
6A
7A
8A
18 & UP
18 & UP
18 & UP
MEN WHITE, YELLOW, ORANGE
MEN GREEN, PURPLE
MEN BROWN
6B
7B
8B
18 & UP
18 & UP
18 & UP
MEN WHITE, YELLOW, ORANGE
MEN GREEN, PURPLE
MEN BROWN
9A
10A
5-6
5-6
YOUTH WHITE, YELLOW, ORANGE
YOUTH GREEN, PURPLE, BROWN
9B
10B
5-6
5-6
YOUTH WHITE, YELLOW, ORANGE
YOUTH GREEN, PURPLE, BROWN
11A
12A
13A
7-8
7-8
7-8
YOUTH WHITE, YELLOW, ORANGE
YOUTH GREEN, PURPLE
YOUTH BROWN, BLACK
11B
12B
13B
7-8
7-8
7-8
YOUTH WHITE, YELLOW, ORANGE
YOUTH GREEN, PURPLE
YOUTH BROWN, BLACK
14A
15A
16A
9-10
9-10
9-10
YOUTH WHITE, YELLOW, ORANGE
YOUTH GREEN, PURPLE
YOUTH BROWN, BLACK
14B
15B
16B
9-10
9-10
9-10
YOUTH WHITE, YELLOW, ORANGE
YOUTH GREEN, PURPLE
YOUTH BROWN, BLACK
17A
18A
19A
11-12
11-12
11-12
GIRLS WHITE, YELLOW, ORANGE
GIRLS GREEN, PURPLE
GIRLS BROWN, BLACK
17B
18B
19B
11-12
11-12
11-12
GIRLS WHITE, YELLOW, ORANGE
GIRLS GREEN, PURPLE
GIRLS BROWN, BLACK
20A
21A
22A
11-12
11-12
11-12
BOYS WHITE, YELLOW, ORANGE
BOYS GREEN, PURPLE
BOYS BROWN, BLACK
20B
21B
22B
11-12
11-12
11-12
BOYS WHITE, YELLOW, ORANGE
BOYS GREEN, PURPLE
BOYS BROWN, BLACK
23A
24A
25A
13-14
13-14
13-14
GIRLS WHITE, YELLOW, ORANGE
GIRLS GREEN, PURPLE
GIRLS BROWN, BLACK
23B
24B
25B
13-14
13-14
13-14
GIRLS WHITE, YELLOW, ORANGE
GIRLS GREEN, PURPLE
GIRLS BROWN, BLACK
26A
27A
28A
29A
30A
31A
32A*(2)
13-14
13-14
13-14
13-14
15-17
15-17
15-17
BOYS WHITE, YELLOW, ORANGE
BOYS GREEN, PURPLE
BOYS BROWN
BOYS BLACK
GIRLS WHITE, YELLOW, ORANGE
GIRLS GREEN, PURPLE
GIRLS BROWN, BLACK
26B
27B
28B
29B
30B
31B
32B*(2)
13-14
13-14
13-14
13-14
15-17
15-17
15-17
BOYS WHITE, YELLOW, ORANGE
BOYS GREEN, PURPLE
BOYS BROWN
BOYS BLACK
GIRLS WHITE, YELLOW, ORANGE
GIRLS GREEN, PURPLE
GIRLS BROWN, BLACK
33A
34A
35A
36A*(2)
37A*(2)
38A*(2)
15-17
15-17
15-17
15-17
18 & UP
18 & UP
BOYS WHITE, YELLOW, ORANGE
BOYS GREEN, PURPLE
BOYS BROWN
BOYS BLACK
WOMEN BLACK
MEN BLACK
33B
34B
35B
36B*(2)
37B*(2)
38B*(2)
15-17
15-17
15-17
15-17
18 & UP
18 & UP
BOYS WHITE, YELLOW, ORANGE
BOYS GREEN, PURPLE
BOYS BROWN
BOYS BLACK
WOMEN BLACK
MEN BLACK
39A*(2)
40A
41A*(2)
42A
40 & UP
40-55
40-55
55 & UP
WOMEN BROWN, BLACK
MEN BROWN
MEN BLACK
MEN BLACK
39B*(2)
40B
41B*(2)
42B
40 & UP
40-55
40-55
55 & UP
WOMEN BROWN, BLACK
MEN BROWN
MEN BLACK
MEN BLACK
*The top two competitors in these events must remain for the finals. The number indicated is the # of individuals that will compete in the
finals. The WSKC reserves the right to combine divisions at its discretion.
DOJO (KARATE SCHOOL) ___________________________ INSTRUCTOR: __________________________________
NAME (First, then Last): ______________________________ AGE: ____ GENDER: M F BELT: _________________
GUARDIAN SIGNATURE (if under age 18): ______________________________________________________________
ADDRESS: ______________________________________________________ CITY: _____________________________
STATE: ___________ ZIP: ______________ PHONE: ______________________________ EMAIL: _____________________
No. of events
Registration by 10/27
Day of tournament
T-shirt
2014 WSKC Tournament
ONE
$30.00
$40.00
$15 youth
Two
$40.00
$50.00
$20 adult
Cash
Visa
Card number
Size:____________
Check (payable
MasterCard
Expiration date
To WSKC)
American Express
www.arizonakarate.com
WESTERN STATES KARATE CHAMPIONSHIPS
2014 TEAM KATA or KUMITE REGISTRATION FORM
Please circle the event you wish to enter:
EVENT
AGE
TEAM KATA DIVISION BELT
1A*(2)
2A*(2)
5-17
5-17
GIRLS & BOYS WHITE, YELLOW, ORANGE, GREEN, PURPLE
GIRLS & BOYS BROWN, BLACK
43A*(2)
44A*(2)
45A*(2)
18 & UP
18 & UP
18 & UP
MEN & WOMEN WHITE, YELLOW, ORANGE, GREEN, PURPLE
WOMEN BROWN, BLACK
MEN BROWN, BLACK
EVENT
AGE
TEAM KUMITE DIVISION BELT
44B*(2)
45B*(2)
18 & UP
18 & UP
WOMEN BROWN, BLACK
MEN BROWN, BLACK
Each team must have three members, and can also list an alternate.
DOJO (KARATE SCHOOL): _______________________________ Instructor________________________________
TEAM NAME: ___________________________________________________________________________________
TEAM MEMBER 1 (CAPTAIN) _____________________________________________________________________
*WAIVER REC’D_______
AGE:____________
GENDER M F BELT____________
TEAM MEMBER 2
*WAIVER REC’D_______
_______________________________________________________________________
AGE:____________
GENDER M F BELT_____________
TEAM MEMBER 3
*WAIVER REC’D_______
_______________________________________________________________________
AGE:____________
GENDER M F BELT_____________
ALTERNATE (OPTIONAL)
*WAIVER REC’D_______
_______________________________________________________________________
AGE:____________
GENDER M F BELT_____________
*EACH TEAM MEMBER MUST SIGN A WAIVER/RELEASE AGREEMENT
MANDATORY: Entire Payment in Full with Submission of Form
ENTRY FEES TEAM:
Registration by 10/24: $50.00
Cash
Visa
Check (make payable to WSKC)
MasterCard
American Express
Day of Tournament: $80.00
If Paying by Charge Card Please Complete the Following Information
________________________________________________________
Card Number
Expiration Date
________________________________________________________
Signature
(MUST SIGN)
(Office Use Only) Cash
Check
Charge
Initials ___________
WAIVER / RELEASE AGREEMENT
Event: Western States Karate Championships, (and/or including Clinic, Dan Exam and International Family Kumite Competition)
and like activities (collectively, "Events")
I, as a visitor or participant (the "Releasor"), being on premises used by, owned or operated by an employee or volunteer of
Western States Karate Championship Organization, an Arizona non-profit corporation or Cystic Fibrosis Foundation of Arizona, a
Delaware non-profit corporation, including its affiliates, Arizona Karate Association, an Arizona corporation, Japan Karate
Association/World Federation – America, and any and all other clubs, schools, instructors, members, judges, officials, representatives
and other participants, sponsors, sanctioning organizations or any subdivision thereof, persons participating in the Event, the
promoters and their sponsors, advertisers, owners and lessees of premises used to conduct the Events, premises and event inspectors,
surveyors, underwriters, consultants and others who gave recommendations, directions, or instructions or engage in risk evaluations or
loss control activities regarding the premises or Event and each of them, their directors, offers, agents, and employees (collectively,
"Releasee"), for observing or participating in any way in any Events including but not limited to any activity coordinated, organized,
provided by or conducted by Releasee, including but not limited to being a participant in martial arts training, instruction,
demonstration or competition (or like activity), for myself, my personal representatives, heirs, and next of kin, AGREE AS FOLLOWS:
1.
ACKNOWLEDGE, AGREE AND REPRESENT THAT MARTIAL ARTS TRAINING AND THE ACTIVITIES OF THE EVENTS AND
RELEASEES ARE INHERENTLY VERY DANGEROUS and involve the risk of serious injury and/or death and/or property damage. If I feel
anything to be unsafe I will immediately advise an appropriate employee of Releasee of the same and I will immediately leave the
premises and/or refuse to participate further in the Events. I expressly acknowledge that my participation in the Events may subject me
to personal injury or bodily harm and I assume any and all risks of that participation. I also understand that in order to be allowed to
participate in and/or receive instruction at the Events, I must give up my right to hold Releasee liable for any injury or damage which
I may suffer while participating in and/or receiving instruction at the Events. I also expressly acknowledge that injuries received may
be compounded or increased by negligent rescue operations or procedures of the Releasees. I understand and agree that by signing
this Release and Waiver of Liability, Assumption of Risk and Indemnity Agreement (this "Agreement"), I am assuming full
responsibility for any and all risk of personal injury or death or for property damage suffered by me while participating in and/or
receiving instruction at the Events and for any travel to and from the Events and in all lodging or any other activities which may be
related directly, indirectly or incidentally to the Events
2.
FURTHER ACKNOWLEDGE, AGREE AND REPRESENT understand and agree that any fees or costs required for necessary or
requested medical attention shall be my sole responsibility and that I shall not seek indemnification or contribution from any Releasee
in connection therewith. I also understand that the Releasee shall not be responsible for any incidental, consequential or exemplary
damages of any kind even if they are notified or the possibility of such in advance. I also understand and agree that any damage to
any lodging sites or the tournament site that I cause is my full responsibility. In no case are said damages the responsibility of any
Releasee.
3.
RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE RELEASEE AS TO ALL LIABILITY TO ME, MY PERSONAL
REPRESENTATIVES, ASSIGNS, HEIRS, AND NEXT OF KIN FOR ANY AND ALL LOSS OR DAMAGE, AND ANY CLAIM OR DEMANDS
THEREFOR ON ACCOUNT OF INJURY TO ME, ANY OTHER PERSON OR PROPERTY OR RESULTING IN DEATH OR BODILY INJURY TO ME
OR OTHERS ARISING OUT OF OR RELATED TO THE EVENTS OR RELEASEES' ACTIVITIES, WHETHER CAUSED BY THE NEGLIGENCE OF
THE RELEASEES OR OTHERWISE. Further release, discharge, waive and forever relinquish any and all actions or causes of action that
I may have or have had, whether past, present or future, whether known or unknown, and whether anticipated or unanticipated by me,
arising out of my participation in and/or receipt of instruction at the Events. Knowing this, and in consideration of being permitted to
participate in and/or receive instruction at the Events, I hereby release and agree to indemnify and hold harmless the Releasees
individually and their entities, and their officers, agents, principals, partners, shareholders, directors and employees from any and all
liability or costs, including attorney fees, associated with or arising from my participation in and/or receipt of instruction at the Events.
This includes, but is not limited to, the event that bodily harm or injury of any kind or any accidents due to my willful act, negligent
act, failure to act, mistakes, or for any reason whatsoever, while participating in the Events. I further understand and agree that this
Agreement binds on my spouse, my heirs, my personal representative, my assigns, my children, any guardian ad litem and me for said
children. I understand that if I am signing this Agreement on behalf of my minor child, I will be giving up the same rights for said
minor as I would be giving up if I signed this document on my own behalf.
4.
AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS the Releasees and each of them from any loss, liability, damage, or
cost I may incur arising out of or related to the Events or Releasees' activities, whether caused by the negligence of the Releasees or
otherwise.
5.
AGREE THAT THIS AGREEMENT extends to all acts of negligence by the Releasees, including negligent rescue operations,
and is intended to be as broad and inclusive as is permitted by the laws of Arizona, that venue is proper in Arizona and that the law of
Arizona shall govern any dispute as to this Agreement. If any portion thereof is held invalid, the balance shall, notwithstanding,
continue in full legal force and effect.
2014 WSKC Tournament
www.arizonakarate.com
6.
GRANT RELEASEE THE RIGHT to photograph, record, broadcast, telecast, and use in perpetuity throughout the world in all
media now and hereafter known or devised: my name, likeness, recorded voice, performance, picture, nickname and any material
furnished by me in connection with any use whatsoever, including by way of illustration but not limited to the promotion of Releasees'
newsletter(s), advertisement(s), brochure(s), media coverage, and television program(s) connected therewith, whether or not in
conjunction with other material utilizing similar rights in any form of Releasees' choosing. I unconditionally authorize Releasee to
exhibit the same, with or without advertising sponsorship, and to assign said rights at Releasee's option and waive any inspection or
approval of the above-described material, and release Releasee from any liability for any claim of alteration, or faulty mechanical
reproduction, and likewise with respect to any distortion or illusion or sound reproduction.
7.
RELEASE Releasee and each of them and their assignees, from any and all claims for damages for libel, slander, invasion of
privacy or any other claims based upon use of the above-described material.
8.
ACKNOWLEDGE THAT I MAY INCUR OR SUFFER A VIOLATION OF PERSONAL RIGHTS OR OTHER LOSS OR DAMAGE, which
are some way caused or connected with participation in the Events, but which are unknown and unanticipated at the time I sign this,
and assume this risk and agree that this applies to all unknown or unanticipated results of my participation in the Events, as well as
those known and anticipated and I hereby waive all rights under California Civil Code Section 1542, which reads:
A general release does not extend to claims which the creditor does not know or suspect to exist in his/her favor at the time of
executing the Release, which if known by him/her must have materially affected his/her settlement with the debtor.
I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY
SIGNING IT AND HAVE SIGNED IT VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME AND
INTEND MY SIGNATURE TO BE A COMPLETE UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY
LAW, AND INTEND EACH TERM TO BE BINDING ON ME.
Printed Name ___________________________________
Signature_______________________________________
Mailing Address _________________________________
Date __________________________________________
Signature of Witness ______________________________
PARENT OR GUARDIAN'S SIGNATURE IF SIGNER IS UNDER 18 (EIGHTEEN) YEARS OF AGE
Printed Name of Parent or Adult Guardian
Signature ______________________________________
_________________________________________
Mailing Address
Date __________________________________________
_________________________________________
City, State, Zip Code
_________________________________________
Signature and Title of Witness
_________________________________________
2014 WSKC Tournament
www.arizonakarate.com
WELCOME
TO THE
2014
th
50 ANNUAL
WESTERN STATES
KARATE CHAMPIONSHIPS
2014 WSKC Tournament
www.arizonakarate.com