2015 OREGON OPEN CHAMPIONSHIP TOURNAMENT COMPETITOR EVENT INFORMATION Date: Location: SATURDAY, FEBRUARY 28TH, 2015 Mt. Hood Community College 26000 SE Stark Street, Gresham, OR 97030 Admission Fee per person: $10.00 (age 14 & up) $5.00 (age 6 ~ 13) FREE (under age 6) Check in 8:00 a.m. Competition begins at 9:00 a.m. FOLLOWING ARE THE COMPETING EVENTS FOR COLOR / BLACK BELT COMPETITIONS: 1. FORM COMPETITIONS - This is an ‘empty hand’ form competition. Belt Divisions: Beginner (white/yellow/orange) Intermediate (green/purple/blue) Advanced (brown/red) Black Belt Age Divisions: 4 & 5 yrs 6 & 7 yrs 8 & 9 yrs 10 ~ 12 yrs 13 & 14 yrs 15 ~ 17 yrs 18 ~ 28 yrs 29 ~ 32 yrs 33 ~ 39 yrs 40 ~ 45 yrs Executives 2. TEAM FORM COMPETITION - Team Form consists of minimum of two people, and no more than 5 people. - Team Form Division will be decided by the lowest rank member in the competing team. Division #1 Basic Form #1 Basic Form #2 Basic Form #3 Division #2 TaeGeuk 1 TaeGeuk 2 Division #3 TaeGeuk 3 TaeGeuk 4 Division #4 TaeGeuk 5 TaeGeuk 6 Division #5 TaeGeuk 7 TaeGeuk 8 Division #6 Goryo 3. BREAKING BOARDS - You may choose from Hammer Fist or Knife Hand technique to break the boards. (Punch technique is only allowed for Teen & Adults.) BEST BREAK – is decided by the number of boards broken on first try. If tied, then the number of boards broken on second try will be considered. Ages # of Boards Size Total Price 7 & under Three (3) Small $6.00 8 ~ 12 Five (5) Medium $10.00 13 ~ 17 Five (5) Large $10.00 18 ~ up Ten (10) Large $20.00 ** To guarantee uniformity, boards will be available to purchase on-site. CASH ONLY PLEASE. 4. SPARRING Required Equipments: - Hand & foot pads - Head guard - Mouth piece - Chest guard - Shin protector - Groin cup (males) Color Belts: 60 seconds sparring per round (two rounds allowed) – 30 seconds break time Black Belts: 90 seconds sparring per round (two rounds allowed) – 30 seconds break time Olympic Sparring – for All Belt Levels Olympic Sparring – for age 18 & up Black Belts Only -‐ No head contact -‐ Head contacts allowed -‐ Points scored by majority vote of ring officials -‐ Points scored by majority vote of ring officials 4. DEMO TEAM COMPETITION - Participating Demonstration Team will perform in front of all audiences, judges, and other competitors. - Participant must be a member of their TKD school’s demonstration team. - Demo Team performance will be 3 ½ minutes long. 2015 OREGON OPEN CHAMPIONSHIP TOURNAMENT COMPETITOR ENTRY FORM All entry forms must be filled out completely and all necessary documentation completed in order for you application to be accepted. All entry forms must be received by your TaeKwonDo School office by the early registration date posted in the corresponding tournament packet in order to receive the discounted rate. Applications will not be accepted by fax PRINT ALL INFORMATION Last Name: _______________________________ First Name: ______________________________ Gender: M F Address: ______________________________________________________________________________________________ City: ___________________________________________ State: _____________________ Zip: _______________________ Day Phone: ______________________________________ Cell Phone ____________________________________________ Email: ________________________________________________________________________________________________ TKD School Name: _________________________________________________ Instructor: ___________________________ Belt Rank_________________________________________________________ Age _________________________________ AUTHORIZATION FOR MEDICAL TREATMENT (for minor students) As a parent or legal guardian, I hereby authorize (participating minor student) _________________________________________, who is under the age of 18, medical treatment in the event of an injury or illness while participating in a OREGON OPEN CHAMPIONSHIP event by the TAEKWONDO OF AMERICA ASSOCIATION Medical Personnel and/or Hospital Medical Staff. Parent/Guardian’s Printed Name Parent/Guardian’s Signature Date AUTHORIZATION FOR MEDICAL TREATMENT (for adult students) I, (participating student)_______________________________________________________, consent to medical treatment in the event of an injuries/illnesses while participating in a OREGON OPEN CHAMPIONSHIP by the TAEKWONDO OF AMERICA ASSOCIATION Medical Personnel and/or Medical Staff. ________________________________________________________ __________________________________ (Student’s Signature) (Date) WAIVER AND RELEASE OF LIABILITY, ASSUMPTION OF RISK AND PARENTAL CONSENT AND INDEMNITY AGREEMENT In consideration of your acceptance of my entry or that of the minor child, I do hereby, for myself or the minor child, my heirs, executors, and administrators waive, release, discharge, covenant not to sue, and agree to indemnify and save and hold harmless any and all rights and claims for damages which I may have or may accrue to me against OREGON OPEN CHAMPIONSHIP and/or TAEKWONDO OF AMERICA ASSOCIATION, this athletic meet, it’s organizing committee, and all members of this athletic meet, or their respective officers, committees, medical committee, agents, representatives, successors, sponsors, advertisers, volunteers, owners and lesser of premises on which the athletic meet takes place, assignees and against any competitor for any and all damages which may be sustained by me or the minor child, 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. I understand that all entry fees are nonrefundable. Participant’s Printed Name Participant’s Signature (if over age 18) Date Parent/Guardian’s Printed Name Parent/Guardian’s Signature Date PLEASE SELECT DIVISIONS YOU WILL BE PARTICIPATING: ¨ 1. Color/Black Belt Form Competition Age: _________________________ Form Name: ___________________ Belt Level: ____________________ ¨ 2. Team Form Competition Division #_____________________ Form Name: ___________________ ¨ 3. Breaking Board Competition ¨ 4. Sparring Competition ¨ 5. Demo Team Competition EARLY REGISTRATION (by Friday, February 14th, 2015) 1 or 2 Events $70.00 3 Events $80.00 4 Events $90.00 5 Events $100.00 - Late Registration (received after 2/14/15), add $10.00 to the total. - Acceptable form of payment include: Cashier’s check, Money order, Personal check, or Cash. - Please make all checks payable to Your TaeKwonDo School. - Please turn in form and fee to Your TaeKwonDo School. (for Demo Team member ONLY) FOR OFFICE USE ONLY *If you have any questions, please contact your TaeKwonDo school instructor. DATE: ______________ ¨ CASH AMOUNT $_____________ ¨ CHECK NO. __________________