Trailridge Middle School 7500 Quivira Lenexa, KS 66216 At the corner of Quivira and 75th Street Information Time Table Location David Clifton & American Sport Karate Centers Registration: 8:30-10:00 am Officials Meeting: 9:00 am Competition Starts: 9:30 am Trailridge Middle School 913-441-9999 8150 Monticello Terrace Shawnee, KS 66227 [email protected] [email protected] 7500 Quivira Road Lenexa KS, 66216 Weapons and Creative Divisions will be first, followed by forms and Sparring. Black Belt Competition Weapons Junior Black Belt Registration Fees Pre-Register and Save $$ See insert for all details Deadline: Feb.25th, 2015 No Checks !!! Cash, Money Order, or Credit Card (Visa, MasterCard) Awards/Staff *Awards 1st. 2nd. 3rd. for all Divisions *Trophies for youth *All Youth participants receive an award Open/Extreme Traditional bbwo-01 14-17 bbwo-02 13- bbwt-03 14-17 bbwt-04 13- Adult Black Belt Weapons Open/Extreme Traditional bbwo-12 18-34 m/f bbwo-13 35+ bbwt-14 18-34 female bbwt-15 18-34 male bbwt-16 35-49 bbwt-17 50+ (Music is optional in open or extreme weapons and forms-you must provide your own music box-promoters do not provide this service) Black Belt Competition Kata/Forms Junior Black Belt Open/Extreme Traditional bfo-05 bfo-06 bft-07 bft-08 bft-09 bft-10 bft-11 14-17 13- Promoter: David Clifton Chief Referee: Bob Leiker Registration: Kimberly Harrison Ring Director: David Clifton October 18th, 2014 Long’s Kickout Dec. 6, 2014 Jarrett Leiker Feb 7th, 2015 ASKC Championships Amerikick Long’s Shotokan Springfield, MO Independence, MO Kansas City, MO March 7th, 2015 Lenexa, KS March 20-21, 2015 April 2015 Jap/Okin Jap/Okin Korean Korean other Adult Black Belt Open/Extreme Traditional bbfo-20 18+ bbft-18 bbft-19 bbft-21 bbft-22 Upcoming Events Choptober 14-17 1314-17 1317- Philadelphia, PA Independence, MO 18-34 male 18-34 female 35-49 50+ Sparring Male/Female bbs-28 bbs-29 bbs-30 bbs-31 bbs-32 bbs-33 bbs-34 18-34 F 35 + F 18-34 M. Light 18-34 M. Mid 18-34 M Heavy 35-49 All 50 + M All Sparring Boys/Girls bbs-23 12-13 m bbs-24 14-15 m bbs-25 16-17 m bbs-26 12-14 f bbs-27 15-17 f * Any youth black belt not listed competes with under belts. Pro-Am 2006 RULES AT A GLANCE Weapons-Youth Creative Coed ubw-00 ubw-01 ubw-02 ubw-03 ubw-04 ubw-05 ubw-06 7- all 8-9 nov/int 8-9 adv 10-11 nov/int 10-11 adv 12-17 nov/int 12-17 adv (music is optional) Weapons-Youth Traditional ubwt-07 ubwt-08 ubwt-09 ubwt-10 ubwt-11 ubwt-12 ubwt-13 7 under all 8-9 nov/int 8-9 adv. 10-11 nov/int 10-11 adv. 12-17 nov/int 12-17 adv. Weapons-Adult Traditional ubw-64 ubw-65 ubw-66 ubw-67 18-39 nov/int 18-39 adv 40+ nov/int 40+ adv 1. You are not allowed to move up or down in age, belt rank, or weight divisions. 2. Required sparring equipment: mouth piece, cup (for male competitors, must be worn under the uniform), foam dipped head, hand, foot, and shin guards and face mask (youth only). Chest protectors are recommended but not required. 3. 2,1 point system (2 point head kicks, 1 point all other legal techniques) and total points are used for all sparring divisions. 4. 1 minute matches for all team sparring matches. All other sparring matches are 2 minutes or a 10 point spread. 5. No harassment/screaming/back talking/bad sportsmanship to the referees will be tolerated. 6. Divisions may be split or combined at the promoters discretion. Sparring-Youth Coed ubs-38 4- all coed* ubs-39 5 all coed* ubs-40 6-7 nov coed ubs-41 6-7 int coed ubs-42 6-7 adv coed ubs-43 8-9 nov coed ubs-44 8-9 int coed ubs-45 8-9 adv coed *1 min round per match (no music in traditional – must be recognized traditional weapons form.) Forms-Youth Traditional ubf-21 ubf-22 ubf-23 ubf-24 ubf-25 ubf-26 ubf-27 ubf-28 ubf-29 ubf-30 ubf-31 ubf-32 ubf-33 ubf-34 ubf-35 ubf-36 ubf-37 4 & under all 5 all 6-7 nov. 6-7 int. 6-7 adv. 8-9 nov. 8-9 int. 8-9 adv. 10-11 nov. 10-11 int. 10-11 adv. 12-13 nov. 12-13 int. 12-13 adv. 14-17 nov. 14-17 int. 14-17 adv. Competition age = Age you are on January 1, 2015. Sparring-Youth Male ubs-46 ubs-47 ubs-48 ubs-49 ubs-50 ubs-51 ubs-52 ubs-53 ubs-54 10-11 nov. 10-11 int. 10-11 adv. 12-13 nov. 12-13 int. 12-13 adv. 14-17 nov. 14-17 int 14-17 adv Sparring-Youth Female ubs-55 ubs-56 ubs-57 ubs-58 ubs-59 ubs-60 ubs-61 ubs-62 ubs-63 10-11nov. 10-11int. 10-11adv. 12-14nov. 12-14int. 12-14adv. 15-17nov. 15-17int. 15-17 adv. Novice = white, yellow, orange Intermediate = blue, green, purple Advanced = Red,Brown(will have light face contact in sparring,a mask is required) Open/Creat. Form Youth ubfo-14 ubfo-15 ubfo-16 ubfo-17 ubfo-18 ubfo-19 ubfo-20 7 under all 8-9 nov/int 8-9 adv 10-11 nov/int 10-11 adv 12-17 nov/int 12-17 adv (music is optional) Open/Creat. Form Adult ubfo-68 18+ all (music is optional, adult only may be empty hand or weapons) Team Sparring – Pre registered Only One from each age category Ubs-087 9-11, 12-14, 15-17 *team sparring held at end of the day **All Ranks may participate ***No face contact will be allowed ****Each round is 1 minute Team Forms (2+ players) ubtf-085 all ages all ranks Forms-Adult Traditional ubf-69 ubf-70 ubf-71 ubf-72 ubf-73 40+ nov. coed 40+ int/adv. coed 18-39 nov. coed 18-39 int. coed 18-39 adv. coed Sparring-Adult Female ubs-74 ubs-75 ubs-76 ubs-77 ubs-78 18-39 f nov. 18-39 f int. 18-39 f adv. 40+ f nov. 40+ f int./adv. Sparring-Adult Male ubs-79 ubs-80 ubs-81 ubs-82 ubs-83 ubs-84 18-39 m nov. 18-39 m int 18-39 m adv. 40+ m nov 40+ m int. 40+ m adv. 20 Official Registration 15 [Competition cards available at the event] You may copy this form- Post mark by 2-25-2015 Office use only Date Received:______________________ NO EXCEPTIONS First Name______________________________________ Last Name ______________________________________________M/F_______ Parents Name if under 18 First______________________________________Last______________________________________________ Address____________________________________________________City_______________________________State_______________ Zip_________________________Country____________EMail______________________________________________________________ Phone( )_____________________________________________D.O.B.______/_______/______Age______________ Age Jan.1-2015 Rank_____________________________________________ Yrs In Martial Arts________ Weight______________ Height____________ SchoolName__________________________________________________Instructor___________________________________________ School Address___________________________________________________________________Phone( )_______________________ City___________________________________________State_________________________________________Country_____________ ZipCode_____________________________TeamName___________________________________________________________________ Pre-Register by 02-25-2015 Competitors 1 Event Pre $40 $10 $30 Additional Events Team Forms/Sparring (per team) ***NEW LOWER PRICES*** Door $50 $15 $45 Spectator Passes and Fees (Child Age 6-12) (5 & Under Free) Gen. Admission Adult $7 Child $5 Under 5 Free $7 $7 Free Totals ______________x ___________ ______________x___________ ______________x___________ = ______________________ = ______________________ = ______________________ please pick up your wrist bands at registration ______________x___________ ______________x___________ ______________x___________ = ______________________ =______________________ =______________________ Registered Division Numbers 1.____________2___________3____________4____________5___________6___________7____________8________ ___ Registration Checklist 1.Release waiver signed and dated 2.Divisions numbers are filled in correctly 3.Please be sure totals are correct 4.Credit card information is correct No Refund Policy No refunds or credits for any Registrations Money Orders are payable to Clifton Enterprises Inc. send to: ASKC 8150 Monticello Terrace Shawnee, Ks. 66227 #_____________-___________-____________-_________________ Security Code_________________ Billing Zip Code _____________ Exp.________________,20________________ Signature___________________________________________________ (Please write your card number legibly, should your card not clear you will be assessed a $10 fee) I (Print name)_________________________________the undersigned release American Sport Karate Centers, operated by Clifton Enterprises Inc., David Clifton, all officials, Shawnee Mission Unified School District 512, Pro-am, and all associated with the American Sport Karate Championships, promoters, any and all other persons associated with this event in any capacity, from any liability due to injuries, etc., that I may incur as a result of my attendance and/or participation at any Pro-Am event. Furthermore, I hereby waive any compensation what so ever for the use of pictures, movies, media coverage, etc., utilized by those associated with this event, for profit making motives, at anytime. I understand that I am entirely responsible for obtaining permission from the artists of any music I use for my competition and verify this by signing this document. I agree to indemnify, defend and hold harmless all of the above named parties from any liability or compensation for use of such music and further state that the above named parties may use such music in any recorded performances of myself for profit making motives at any time. I clearly understand that the fighting aspect of this sport and competition involves bodily contact and completely release and hold harmless all of the above named parties for any injuries I may sustain. I have read, understand and agree to abide by the rules associated with Pro-Am events and assume all responsibility and any associated liability for infringement of such rules. Additionally, I am fully aware of my personal medical condition, have personal medical insurance and hereby certify that I am mentally and physically fit to compete at said tournaments and also understand that a valid birth certificate should be presented to compete at Pro-Am events. Competitor Signature_______________________________________________________________________________Date___________________ Signature of parent or guardian if under 18______________________________________________________________Date___________________ David Clifton 19th American Sport Karate Championships 8150 Monticello Terrace Shawnee, Ks.,66227 [email protected] [email protected] Top Ten Reasons to attend this event……………..Don’t Miss This Event 1. FUN for everyone 2. Try out the team events 3. One of the top regional tournaments in the country 4. Great, fun, and friendly competition 5. Organized Event…..Starts ON-Time…..Ends-ON-Time….Not all Day!!!!! 6. Professional Referees 7. World & Regional Champions in Action st nd 8. Trophies for 1 and 2 Place Youth Underbelts 9. Everybody is treated fairly 10. Meet Some New Friends
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