1st JKA Shotokan Karate-Do Junior Tournament - JKA

1st JKA Shotokan Karate-Do Junior Tournament
June 20, 2015
1 – 4 pm
Hintonburg Community Centre
1064 Wellington St. Ottawa, ON, K1Y 2Y3
ELIGIBILITY
Open to all students who are members of JKA-SKD Canada and who are 6 – 14 years of
age.
REGISTRATION INFORMATION
Please send scanned registration forms and signed individual waiver forms to
[email protected] by Wednesday, June 10, 2015.
Registration fee:
$20
MAP
Hintonburg
Community Centre
1064 Wellington St.
Ottawa, ON
K1Y 2Y3
613-798-8874
CONTACT
613-404-9983
(Bio Aikawa)
1
-- 1st JKA Shotokan Karate-Do Junior Tournament --
JKA Migenkan
Ottawa Shōtōkan Karate-Dō
CATEGORIES
• Individual KATA
• Individual KUMITE
• Team KATA
Individual KUMITE:
- White gloves and mouth guard are required for Black belt contestant. Neither colored gloves
(e.g., blue or red) nor safety glasses are permitted.
Team KATA:
- Each team must consist of 3 contestants and each contestant is allowed to participate in ONE
team only.
Category
Rank-Kyu
Individual
KATA
Elimination
KATA Final
(Final 4)
Judging
System
Flag
System
Point
System
White
Yellow
Orange
Green
9th
Taikyoku
Shodan
(T1),
Heian
Shodan
(H1)
8th
H1
7th
H1, H2
6th
H1, H2, H3
Heian
Nidan
(H2)
Heian
Sandan
(H3)
Kihon
Ippon
Kumite:
Jodan (J)
Chudan (C)
Maegeri
(M)
H3
KUMITE
Flag
System
Kihon
Sanbon
Kumite
Kihon
Sanbon
Kumite
Team KATA
Point
System
T1, H1
H2
2
Purple/
Blue
4th and 5th
H2, H3, H4
Brown
Black
1st-3rd
Tekki
Shodan
Heian
Yondan (H4)
Heian
Godan
(H5),Tekki
Shodan
Bassai
Dai
Kihon Ippon
Kumite:
J, C, M,
Yokogeri
Kekomi (K)
Kihon
Ippon
Kumite: J,
C, M, K
Jiyu
Ippon
Kumite:
J, C, M,
K
Shodan
H2-H5,
Tekki
Shodan
Bassai Dai
(BD), Kanku
Dai (KD),
Jion (J), Enpi
(E)
Shobu
Ippon
Kumite
H4
H5, Tekki
Shodan
Bassai
Dai
BD, KD, J, E
JKA Migenkan
-- 1st JKA Shotokan Karate-Do Junior Tournament --
Ottawa Shōtōkan Karate-Dō
Individual Registration Form
Payment and signed registration form must be submitted by your dojo instructor by the
deadline and as specified on page 2.
Name:
Male 
Dojo:
Female 
Age:
White Belt (includes yellow stripe)
Yellow Belt
Orange Belt
Green Belt




Purple/Blue Belt
Brown
Black belt



Event Fees: $20
Category (Please check appropriate boxes):
Individual KATA 
Individual KUMITE 
Team KATA 
MANDATORY REQUIREMENT: A signed waiver form must be submitted for a
contestant to participate in category above.
3
JKA Migenkan
-- 1st JKA Shotokan Karate-Do Junior Tournament --
Ottawa Shōtōkan Karate-Dō
Waiver/Release Agreement – Accord de renonciation
The undersigned is aware that there are risks and dangers inherent in participating at the 1st JKA Shotokan
Karate-Do Junior Tournament. In consideration of being permitted to participate at the 1st JKA Shotokan KarateDo Junior Tournament, I hereby release and waive any claims against Hintonburg Community Centre, the Japan
Karate Association, JKA-SKD Canada, Ottawa Shotokan Karate-Do, JKA Migenkan and any and all clubs, schools,
instructors, members, judges, officials, officers, directors and representatives relating thereto (collectively the
"Releases") for any injury or damage which I may suffer while participating at the 1st JKA Shotokan Karate-Do
Junior Tournament including travel to and from the the 1st JKA Shotokan Karate-Do Junior Tournament.
I understand and agree that this Release will have the effect of releasing, discharging, waiving and forever
relinquishing any and all actions, those causes of action that I may have or have had, whether past, present or
future, whether now known or unknown and whether anticipated or unanticipated by me, arising out of my
participation at the 1st JKA Shotokan Karate-Do Junior Tournament. This Release shall be binding upon me, my
heirs, successors, administrators, assigns and legal representatives.
I assume full responsibility for any and all risk of death or personal injury or property damage, which I may suffer
while participating at the 1st JKA Shotokan Karate-Do Junior Tournament. I expressly acknowledge and assume
any and all risk that my participation at the 1st JKA Shotokan Karate-Do Junior Tournament may subject me to
personal injury to bodily harm.
I confirm that I have no past or present medical condition, injury or other physical or mental restriction which
may cause or contribute to personal injury or property damage while participating at the 1st JKA Shotokan
Karate-Do Junior Tournament and if in case I have such a condition, I agree to forthwith nullify the Releases, as
the case may be, and withdraw from the 1st JKA Shotokan Karate-Do Junior Tournament.
I further agree by signing this Release, I shall indemnify and hold any of the Releases harmless from any and all
liability or costs, including legal fees, associated with or arising from my participation at the 1st JKA Shotokan
Karate-Do Junior Tournament.
I acknowledge that I have read this Release and that I understand the words and language in it. I sign this
Release freely and voluntarily.
///////////////////////////////
Je suis conscient qu'il y a des risques et dangers inhérents à la participation au 1er Tournoi junior de JKA
Shotokan Karaté-Do. En étant admis à participer à ces événements, je renonce à toute poursuite ou réclamation
contre Ottawa Shotokan Karate-Do, JKA Migenkan et tout officiel ou représentant, pour toute blessure ou
dommage que je pourrais subir en participant aux événements ci-haut mentionnés.
Je comprends et accepte que cet accord de renonciation aura pour effet de renoncer à toute poursuite ou action
présente ou future. Cette renonciation s'appliquera aussi à mes héritiers, successeurs, administrateurs et
représentants légaux.
J'assume la pleine responsabilité pour les risques de décès ou de blessure ou de dommage à la propriété qui
pourrait se produire lors de ma participation au 1er Tournoi junior de JKA Shotokan Karaté-Do. Je confirme que
je n'ai pas de condition médicale passée ou présente, blessure ou restriction physique ou mentale qui peut
contribuer à me blesser en participant au 1er Tournoi junior de JKA Shotokan Karaté-Do et si c'est le cas je
m'engage à en informer les organisateurs et à me retirer de cette compétition.
J'accepte en signant cette Renonciation à ne réclamer au aucun frais légal associé à ma participation à ce
Championnat.
Je reconnais avoir lu et compris les mots et le langage de cet accord. Je signe cet accord librement et
volontairement.
Signature:
(of parent if under 18 years of age/du parent si moins de 18 ans)
Print Name/Lettres moulées:
4
Date:
JKA Migenkan
-- 1st JKA Shotokan Karate-Do Junior Tournament --
Ottawa Shōtōkan Karate-Dō
Team Kata Registration Form
Dojo/Club:
Each team must consist of 3 contestant (may have any combination of males or females). Note:
Competitors are allowed to participate on one team only.
TEAM NAME:
TEAM MEMBER NAMES
RANK
AGE
CATEGROY (check one)
White  Purple 
Yellow  Brown 
Orange  Black 
Green 
TEAM NAME:
TEAM MEMBER NAMES
RANK
AGE
CATEGROY (check one)
White  Purple 
Yellow  Brown 
Orange  Black 
Green 
TEAM NAME:
TEAM MEMBER NAMES
RANK
JKA DAN CERTIFICATE #
CATEGROY (check one)
White  Purple 
Yellow  Brown 
Orange  Black 
Green 
5