May 2,
. 2015
'
~
BEN KIKER'S
UNITED KARATE STUDIOS
37th Annual
Mid·- south Karate Championship
--
Gilmer High School
408 Bobcat Trail
Ellijay, GA 30540
All Adult Team Fighti.Q.g Stfl_rts at 9AM
Black Belt Weapons Start at 9AM
37th Annual Mid-South Karate Championship
Tournament Director Ben Kiker
5'Tall
1st Place Trophy
***CHANGE***
WEAPONS DIVISIONS: 1st- 4th Place
Kids- Boys & Girls (10 & under)
Intermediate - Boys & Girls (11 - 13)
Junior-Boys & Girls (14-17)
Under Black Belts- Adults (18 & up)
(White-Blue)
(Brown-Black)
(White-Blue)
(Brown-Black)
(White-Blue)
(Brown-Black)
(White-Blue)
(Brown-Red)
Black Belt Weapons Start at 9AM
All Adult Team Fighting Starts at 9AM
Registration: 8 a.m. until12 noon
Children's weapons begin at 9 a.m.
Adult divisions will follow as children's
divisions are completed.
Continuous Fighting begins at 11 a.m.
Entry Fee:
~re-registration
Women's Black Belts (18-29)
Executive Women's Black Belts (30-39)
Women's Black Belt Weapons (40 & up)
Men's Black Belts (18-29)
Executive Men's Black Belts (30-39)
Senior Men's Black Belts (40-49)
Master Men's Black Belts (50 & up)
CREATIVE FORMS: 1st- 4th Place
(With or without music or partner)
Children's Creative Forms (10 & under)
.
Children's Creative Forms (11-17)
Underbelt Creative Forms men & women (18 & up)
Black Belt Creative Forms men & women (18 & up)
Soft Style Black-Belt Forms men & women (18 & up)
•
atthe Door
$5 Spectator Fee
Children under 6 - Free with a Parent
$30 T earn Sparring - Day Of Event
Pre-registration Before April 28, 2015
GIRLS DIVISIONS: 1st- 4th Place
FORMS
FIGHTING
5 & 6 Yr. Old (White-Yellow)
(Green-Black) No Wt. Division
7 & 8 Yr. Old (White-Yellow)
(Green-Blue)
(Brown-Black) No Wt. Division
9 & 10 Yr. Old (White-Yellow)
11 - 13 Yr. Old (Green-Blue)
14-17 Yr. Old (Brown-Red)
No Wt. Division
(Black)
(All Belts)
(All Belts)
(White-Red)
(Black only)
(Black only)
BOYS DIVISIONS: 1st- 4th Place
5 Yr. Old & Under
6Yr. Old
7Yr.Oid
8Yr.Oid
9Yr. Old
10Yr.Oid
11 Yr. Old
Intermediate Boys (12-13)
Junior Boys (14-15)
For More Information, Contact
Ben Kiker, Tournament Director
United Karate Studio
1132 East Walnut Avenue
Dalton, Georgia 30721
Phone (706) 226-3318- Studio
(Black Only)
(Black Only)
(Black Only)
(Black Only)
(Black Only)
(Black Only)
(Black Only)
Super Junior Boys (l(i-17)
..
FORMS
(White-Black)
(White-Yellow)
(Green-Black)
(White-Yellow)
(Green-Blue)
(Brown-Black)
(White-Yellow)
(Green-Blue)
(Brown-Red)
(Black)
(White-Yellow)
(Green-Blue)
(Brown-Red)
(Black)
(White-Yellow)
(Green-Blue)
(Brown-Red)
(Black)
(White-Yellow)
(Green-Blue)
(Brown-Red)
(Black)
FIGHTING
Big& Small
Big& Small
Big& Small
Big&Small
Big& Small
Big&Small
Big&Small
Big& Small
Big& Small
Big& Small
Big&Small
Big& Small
Big& Small
Big& Small
Big& Small
Big& Small
Big& Small
Big& Small
·\ Big & Small
Big& Small
Big& Small
Big& Small
ADULTUNDERBELTFORMS
ADULT UNDERBELT FIGHTING: 1st- 4th Place
1st- 41h Place
Women (18-29)
Men (18-29)
Executive Men (30-39)
Senior Men ( 40-49)
Master Men (50 & Up)
Executive Women (30-39)
Senior Women (40 & Up) •
(White-Yellow)
(Green-Blue)
(Brown-Red)
(White-Yellow)
(Green-Blue)
(Brown-Red)
(White-Yellow)
(Green-Blue)
(Brown-Red)
ADULT BLACK BELT FORMS
1st- 4th Place
Women
Executive Women
Senior Women
Masters Women
Men
Executive Men
Senior Men
Masters Men
Old Masters Men
Enchanted Men
(18-29)
(30-39)
(40-49)
(50 & up)
(18-29)
(30-39)
(40-49)
(50-54)
(55-59)
(60 & up)
Women
(18-29)
(White-Yellow)
(Green-Blue)
(Brown-Red)
Executive Women
(30- 39)
Senior Women
(40 & Up)
M~,n
(White-Yellow)
(Green-Blue)
(Brown-Red)
(White-Yellow)
(Green-Blue)
(Brown-Red)
(White-Yellow)
(18-29)
(Green-Blue)
(Brown-Red)
Executive Men
(30-39)
Senior Men
(40 & Over)
TEAM SPARRING
Lt. Wt.
Hvy. Wt.
Lt.Wt.
Hvy. Wt.
Lt.Wt.
Hvy.Wt.
Lt. Wt.
Mid.Wt.
Hvy. Wt.
Lt.Wt.
Mid.Wt.
Hvy. Wt.
Lt.Wt.
Mid. Wt.
Hvy. Wt.
(White-Yellow)
(Green-Blue)
(Brown-Red)
(White-Yellow)
(Green-Blue)
(Brown-Red)
1st & 2"d Place
3 Member Children's Team
(10 & Under) All Belts
3 Member Children's Team
(11-13) All Belts
3 Member Children's Team
(14-17) All Belts
Women's 3 Member Team
(18 & Up) All Belts Including Black
Men's 3 Member Team
(18 & Up) White Thru Red- No Black Belts
Men's 3 Member ·BJack Belt Team
(18 & Up) Black Belts Only
Continuous·Fighting
Men Lt. Wt.
Men Middle Wt.
Men Lt. Heavy Wt.
Men Heavy Wt.
Women Lt. Wt.
Women Heavy Wt.
BLACK BELT FIGHTING: 1st- 4th Place
Women (18-29)
Executive Women (30-39)
Senior Women (40-49)
Masters Women (50 & Up)
Men (18-29)
Executive Men (30-39)
Senior Men (40-49)
Masters Men (50-54)
$20 Additional Charge for
Continuous Fighting
Adult
Continuous Fighting will start at
11:00
Old Masters (55-59)
Enchauted-Men ' 60 & up)
Lt.Wt.
Mid.Wt.
Hvy. Wt.
(no weight division)
(no weight division)
(no weight division)
Lt. Wt.
Mid.Wt.
Lt.Hvy. Wt.
Hvy.Wt.
Lt.Wt.
Mid. Wt.
Lt.Hvy. Wt.
Hvy. Wt.
Lt.Wt.
Mid. Wt.
Lt.Hvy. Wt.
Hvy. Wt.
Lt.Wt.
Hvy.Wt.
Lt.Wt.
Hvy. Wt.
Lt. Wt.
Hvy.Wt.
Ben Kiker
United Karate Studios
,..
1132 E. Walnut Avenue
Dalton, Georgia 30721
DIRECTIONS:
From South -Go 75N to 575N. At the Pickens County
Line this becomes APD 515.
From North -75S to the exit for Hwy 136 Resaca
(south of Dalton). Turn left and cross back over 75.
Follow 136 through Resaca (turn left then right over RR
tracks - sign says Talking Rock). Continue until you
intersect at Blaine Store. Turn left and after
approximately 3 miles turn left again to get on APD 515.
Go North (left) on 515.
Then -Continue into Gilmer County until the 1" light (Longhorn's on right). Turn left at the light. Will intersect with Old Highway 5 -turn
right. Turn left across from the Civic Center. Gilmer High School sign will be on the left- continue up the hill to the second left. The
gymnasium is on the left - parking lot is on the other side of the gym.
Pre-register and save $1 0. This completed form must be received by April 28th along with $35 payable to:
United Karate Studios, 1132 East Walnut Ave., Datton, GA 30721. Form must be filled out completely.
Name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Style: - - - - - - - - - - I n s t r u c t o r : - - - - - - - - - - - Freefighting: - - - - - - - - - - - - F o r m s : - - - - - - - - - - Weapons: - - - - - - - - - - - - - - A g e : - - - - - - - - R a n k : - - - - - - - - - - - - - - - - - - - - Weight: _ _ _ _ _ _ _ _ _ _ _ __
School name & a d d r e s s : - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Your complete a d d r e s s : - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Email:--------------------,----I understand that participation in the Mid-South Karate Championship at Gilmer High School on May 2, 2015 could result in accident and/or injury. By signing
below I understand and agree that I will accept full responsibility for any accident/injury that could occur. I release Ben Kiker, United Karate Studios, Gilmer High
School, any officials or competitors from any responsibility whatsoe\ler involving-my personal safety and welfare at or resutting from this event. I am solely
responsible for myself.
Competitor: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Guardian/Parent: _ _ _ _ _ _ _ _ _ _ _ _ _ _ __:_ __