548th Annual East Coast Shotokan Karate Championships

Saturday, April 16, 2011

Dear Club Instructors,

The Washington, D.C. Shotokan Karate Club is looking forward to hosting you at the 48th Annual ECSKA Karate Championships on Saturday, April 16, 2011.

Youth events begin at 7:30 am sharp, and adult events are scheduled to begin at 10:30 am. We encourage participants to register Friday evening at the hotel. Competitors who are late will be disqualified and not allowed to compete.

This packet contains everything you need to register, make hotel reservations, and find the hotel and tournament sites. The tournament will take just one day, and we’ve included some information on local activities in case you want to take advantage of the DC area in spring.

To simplify registration, we have created a single registration form. A paper copy of this form is included with the copy of this packet that we are mailing to you. The form and packet are also available on at www.dckarate.com. We encourage you to complete this form in Excel and email it to us; the spreadsheet will automatically summarize the number of participants by event, and calculate your fees. You may also mail the registration form. Please note that fees, medical forms, waivers and parental consent forms must be signed and mailed even if you use the electronic registration form.

Deadlines for registering are as follows:

Monday, March 14 All electronic registrations must be emailed. If you choose to use paper, the paper copy of your completed registration form must be postmarked by this date.All medical, waiver, and consent forms, and fees, must be postmarked by this date. Cut-off for group rate hotel reservations

Wednesday, March 23 Final deadline for us to receive late registrations . Registrations received after March 23 will not be processed, so you may wish to use FedEx if you register late.

Please mail all materials for your dojo in one package. For questions regarding registration, you can call our club President, Linda Naiditch, at 202-544-7568 or email Lnaiditch@hotmail.com.

We look forward to seeing you in April.

Sincerely,

David Ernst, Chief InstructorWashington DC Shotokan Karate Club

48th Annual East Coast Shotokan Karate ChampionshipsInformation Packet and Forms

ContentsGeneral Information.........................................................................................................1

Fees and Admission Prices..............................................................................................2

Registration Submission Checklist...................................................................................2

Competitor Checklist........................................................................................................2

Transportation and Directions..........................................................................................3

Local Activities.................................................................................................................3

Schedule of Events..........................................................................................................5

Food.................................................................................................................................5

Youth Division – General Information...............................................................................6

Adult and Senior Divisions – General Information............................................................9

Registration Instructions and Sample Form...................................................................10

Tournament Sign-Up Form (for Internal Club Use)........................................................13

Competitor’s Medical Questionnaire..............................................................................14

Waiver/Release Agreement...........................................................................................15

Parental Consent and Release Form.............................................................................16

Tournament Program Advertising Form.........................................................................17

T-Shirt Design................................................................................................................17

48th Annual East Coast Shotokan Karate ChampionshipsGeneral InformationTournament BasicsDate Saturday, April 16, 2011 for all preliminaries and finalsTime 7:00 am to 6:00 pmLocation West Potomac High School

6500 Quander RoadAlexandria, VA 22307

Check-in Friday, April 15, 6:00-11:00 pm at Hampton InnSaturday, April 16 at West Potomac High Youth: 7:00 to 7:30. Youth events begin at 7:30 am. Adult: 9:00 to 10:15. Adult events begin at 10:30 am.All judges, please check in by 7:15 am.

Key DatesMonday, March 14 All paper registration packets must be postmarked by this date.

All electronic registrations must be emailed by this date. All medical, waiver, and consent forms, and fees must be postmarked.

Cut-off for group rate hotel reservations.

Wednesday, March 23 Deadline for us to receive late registration. Additional fee of $20 per competitor or team registered late. Please use guaranteed shipping method.

NO REGISTRATIONS OR SUBSTITUTIONS ACCEPTEDAFTER WEDNESDAY, MARCH 23, 2011

Registration SubmissionChecks payable to: Washington DC Shotokan Karate Club.

Email registrations to: Lnaiditch@hotmail.com

Send all fees and paperwork to:

Washington DC Shotokan Karate Club912 Independence Ave., SEWashington, DC 20003-3938

ContactsGeneral questions David Ernst – david.ernst24@gmail.com 202-352-6855

(except from March 23-30, please contact Linda Naiditch)

Registration/fees Linda Naiditch – Lnaiditch@hotmail.com 202-544-7568LodgingHotel Hampton Inn & Suites, Alexandria Old Town Area South

5821 Richmond Highway (Route 1)Alexandria, VA 22303www.alexandriaoldtown.hamptoninn.com

Rates Group rate=$109/night for two full bedsGroup Name “East Coast Shotokan”Reservations 1-703-329-1400 or 800-426-7866Website for reservations www.alexandriaoldtown.hamptoninn.com/shotokan_karateParking Free parking available

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Fees and Admission PricesCompetitor Registration FeesYouth Division (ages 8-17) $20 Individual, single event

$30 Individual, both events$35 Team kata (per team)

Adult Division (ages 18-44) $30 Individual, single event$40 Individual, both events$45 Team kata and kumite (per team per event)

+Senior Division (ages 45+) $30 Individual, single event$40 Individual, both events$45 Team kata (per team)

Spectator Admission PricesGeneral admission $5Children (6 & under), with an adult FreeCompetitors in uniform Free

Registration Submission Checklist Competitor registration form or Excel worksheet

Judge sign-up form or Excel worksheet

All competitors' medical questionnaires

All competitors' waiver/release agreements

Youth competitors' parental consent and release forms

Tournament program advertising form

Ad artwork digital file

Fees (Individual events, T-shirts, team events, ad fee)

Competitor Checklist Mouthpiece–mandatory (can be purchased at the tournament site)

ISKF Fist Protectors–Approved by the ISKF Technical Committee (can be purchased at the tournament site)

Current 2011 ISKF membership card (or onsite purchase for $50)

Standard white karate gi

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Transportation and DirectionsGround Transportation

From Dulles Airport Washington Flyer Taxi to hotel (approx. $71)

Washington Flyer Coach Service to West Falls Church Metro ($10), + $4.95 Metro fare during rush hour (see www.washfly.com/flyer_bus_schedule.htm)

Super Shuttle 800-258-3826 ($34 1st person + $10 additional)

From National Airport Taxi (approx. $20) or Super Shuttle 800 258 3826 ($16 for 1st person)

From Amtrak or Metro (subway)

Amtrak arrives at Union Station. Take Metro to Huntington (yellow line).

Hotel provides shuttle to/from Huntington Metro station. Service is based on availability of van. Call hotel front desk to arrange: 703-329-1400.

Directions to Hotel

Hampton Inn & Suites, Alexandria Old Town Area South is located at 5821 Richmond Highway (Route 1) in Alexandria, VA 22303. It is just south of the Washington Beltway (495/95).

From the beltway, take Exit #177A (Route 1 South) towards Ft. Belvoir. Then immediately follow signs to Fort Hunt Road (it can be accessed from either the left-most lane or the right lane).

Once on Fort Hunt Road, make an immediate left at Huntington, then another quick left onto the hotel's service road.

Directions from Hotel to Tournament (about 1.7 miles, 5 minutes)

The tournament location is West Potomac High School, 6500 Quander Road, Alexandria, VA 22307.

Exit the hotel parking lot on the service road and go left onto Fort Hunt Road

Turn right onto Belle View Blvd, the 2nd stop light.

Turn right onto Quander (there is a stop light)

Turn left into the school parking lot when you see the sign for West Potomac High School. It is actually the second driveway for the school. Door 13 is the entrance for the tournament.

Pass Door 13, then turn left. Extensive parking is straight ahead.

Local ActivitiesTourism in Alexandria, VA

The tournament will take place not far from historic “Old Town Alexandria” in Virginia. Old town has wonderful shops, restaurants, galleries, and a scenic waterfront. To help you plan your trip, or to find accommodations in Old Town, visit: http://visitalexandriava.com/.

Tourism in Washington, DC

We suggest visiting Washington DC’s official tourism website www.washington.org to help you find activities of interest. The site contains information on attractions and tours, as well as a listing of activities by date. The website includes 100 free or almost free activities in DC. You can also use it to order or download a printed visitor’s guide.

Transportation

www.godcgo.com is a site that can help you figure out how to get around while you are here. The Metro system trip planner is also invaluable: www.wmata.com

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Schedule of EventsFriday, April 15, 2011 Hampton Inn

6:00 –11:00 pm Competitor check-in

Saturday, April 16, 2011 West Potomac High School

7:00 am Youth contestants, officials and judges arrive

7:00 – 7:30 am Youth check-in

7:30 – 11:30 am * Bow-in; Youth eliminations and finals

8:00 am Food concession opens

9:00 – 9:30 am Adult and senior contestants arrive

9:00 – 10:15 am Adult and senior check-in

10:30 am Adult and senior eliminations begin, followed by finalsIndividual kataTeam kataIndividual kumiteTeam kumite (adults only)

5:00 * Awards ceremony and closing

*These times are approximate and will depend on number of contestants.

Food Hotel Food

Starting at 6:00 am, the hotel will serve a complimentary buffet breakfast, including continental fare as well as eggs and bacon or sausage.

Tournament Concession

A tournament concession will offer:

Breakfast from 8:00 am: Bagels, fruit, coffee, juices

Lunch 11:00-2:30: Sandwiches (curry chicken, grilled chicken, smoked turkey, tuna salad, egg salad, vegan and non-vegan veggie wraps, peanut butter and jelly), potato salad, chips, granola bars, fruit, sodas, juices.

The tournament location is a short drive from several restaurants on Route 1. With the fast pace of the tournament, competitors may not have time go offsite for food.

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Youth Division – General InformationAge-Rank Qualifications and Rules

All youth competitors must be between age 8 and 17 on the day of the tournament, with a current ISKF membership card.

IndividualThe competition may include up to five age categories as follows; the divisions will be adjusted as needed based on the number of competitors in each age/rank group.

Ages 8–9, 10–11 Boys and girls may be combined in the following groups:

Ungraded to 7 kyu kata kumite6 kyu to 4 kyu kata kumite

3 kyu and above kata kumiteAges 12–13, 14–15, 16–17 Boys and girls may be combined in the following groups:

Ungraded to 7 kyu kata kumite6 kyu to 4 kyu kata kumite

For age 12-13, boys and girls 3 kyu and above may be combined for kata but will be separate for kumite.For ages 14-15 and 16-17, boys and girls may be combined for kata but will be separate for kumite.

TeamTeam kata will be open to all ages, rank and gender and limited to only one team per club. There will be no team kumite for youths.

Kata DetailsContestants may not perform kata in competition higher than that required for their next promotion examination. The table below indicates the appropriate kata for each rank.

In the case of team kata, the kata performed must be in accordance with the status of the lowest ranking member of the team.

Rank Permitted KataUngraded Heian 18 kyu Heian 1, 27 kyu Heian 1, 2, 36 kyu Heian 1, 2, 3, 45 kyu Heian 1, 2, 3, 4, 54 kyu Heian 1, 2, 3, 4, 5; Tekki 13 kyu to 1 kyu Heian 1, 2, 3, 4, 5; Tekki 1, Jion, Bassai Dai, Empi, Kanku DaiShodan & above Any kata from The Best Karate series #5 - #11

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Kumite Details4th kyu or below

Kumite matches, team or individual, the method of the contest is ippon kumite (one-step sparring). The technique and target will be announced before each attack. At the start of each match, aka (red side) will initiate the attack.Ranks from beginner to 7 kyu will attack four times, using oi zuki to the face and mid-section with both right and left hands, but initiating the attack with the right side.Ranks from 6 kyu to 4 kyu will attack three times, using oi zuki to the face and mid-section, and front snap kick (mae geri), initiating the attack with the right side.The defending side must demonstrate two (2) different countering techniques among his/her defenses. Failure to do so will result in disqualification. Only one counterattack is permitted.In the case of a draw during an ippon kumite match, the referee shall instruct the contestants to repeat ippon kumite as above, but aka (red side) attacks with the left side first.

3rd kyu or above

The method of the contest is jiyu ippon kumite (one-step free sparring) or jiyu kumite (free sparring). For jiyu ippon kumite, the technique and target will be announced before each attack. At the start of each match, aka (red side) will initiate the attack.

A. Warnings, Fouls and Disqualifications

1. During an ippon kumite contest in which the defensive/counterattacking side does not employ at least two different types of counterattacks to the four offensive attacks, that contestant shall be disqualified. This disqualification shall be administered at the completion of the individual contest.

If, during an ippon kumite match, the initial defensive/counterattacking side uses only one type of counterattack on all four counterattacks, that side is still required to act as the offensive/attacking side for that individual match.

2. During ippon kumite matches, a contestant who utters verbal noises or engages in feints, false starts and/or other attempts to distract the opponent shall be given a warning. Upon a second instance, the contestant shall be disqualified.

3. During an ippon kumite match, if the offensive/attacking contestant announces one target area, then delivers a technique to a different area than that which was announced, that contestant shall be given a warning. A second violation shall lead to disqualification.

4. Prohibited Techniques When Counterattacking: The defensive contestant is not permitted to employ: sweeping techniques; any technique below the waist; nukite (spear hand strike) to the face or neck; wristlocks, joint manipulation or any technique aimed at a joint; grabbing; other techniques deemed dangerous by the judges. Use of any of these techniques will result in disqualification.

5. When counterattacking for an individual offensive technique, the defensive/counter-attacking contestant shall not employ multiple counterattacks as counter measure for a single offensive attack.

B. When announcing the target area during an ippon kumite match the following shall apply:

1. The announcement of the target area must be of significant volume to be heard by all of the judges for the match.

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2. The announcement of the target area must be made after the offensive/attacking contestant has assumed a stationary, forward stance position.

C. When delivering a technique, the offensive/attacking contestant may follow in the direction of the defensive/counterattacking contestant if the defensive side moves/shifts on an angle

D. CONTACT IS NOT PERMITTED UNDER ANY CIRCUMSTANCESE. Jiyu-Ippon Kumite: In matches in which the rank of either contestant is 3 kyu or above,

either team or individual, the method of the contest is jiyu ippon kumite (semi-free sparring), to employ ISKF rules.

1. The essence of jiyu ippon kumite, offensively, is to make one strong attack in order to catch your opponent defenseless. Defensively, one needs to make a strong counter-attacking measure, by itself or coupled with a block. The defending side must demonstrate two different countering techniques.

2. At the start of each match, aka (red side) will initiate the attack. Each attack must be clearly and loudly announced in the order of jodan oi zuki, chudan oi zuki, chudan mae geri and chudan yoko geri kekomi. The offensive side may use their favorite side to attack.

3. Prohibited Techniques

a. The offensive side may not use feints or noises to distract the opponent.b. The offensive side must make the attack once within the correct distance. Once

the correct distance has been established, the competitor cannot hesitate, stalk, or pursue the opponent without an offensive technique, or the referee will issue a warning.

c. The offensive side, upon completion of an attack, must maintain kamai (attack posture) and not immediately draw back the attack technique or step back out of counterattacking distance.

d. The offensive side cannot block counterattacking techniques or avoid them by body shifting (must maintain attack posture).

e. The offensive side cannot jump or slide with the lunge attacks.f. No grabbing or holding will be permitted by the offensive or defensive side.g. Escaping out of bounds by the defensive side will result in the following:

1st time: jogai keikoku out of bounds2nd time: jogai chui warning3rd time: jogai hansoku disqualification, loss of match

F. In final matches in which the rank of both contestants is 3 kyu or above, the method of the contest will be jiyu kumite (free sparring), according to ISKF rules. Each attack must be clearly and loudly announced in the order of jodan oi zuki, chudan oi zuki, chudan mae geri and chudan yoko geri kekomi.

Important Safety Note: In kumite matches, mouthpiece and ISKF-approved white, non-absorbing hand protectors

are required for all competitors, regardless of rank. No competitor will be permitted to compete without both.

Only safety glasses will be permitted to be worn during kumite events. Absolutely no jewelry of any type will be permitted to be worn by competitors or officials.

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Adult and Senior Divisions – General InformationAge-Rank Qualifications and RulesThe East Coast Shotokan Karate Association Tournament is open only to International Shotokan Karate Federation (ISKF)/East Coast members with a current ISKF membership card. Competitors must be 3 kyu or higher to compete in the adult or senior division. One's age on the day of the tournament determines whether a competitor is in the Adult or Senior Division.

Competitors 18 to 44 years of age must compete in the Adult Division. Competitors age 45 or older must compete in the Senior Division and may not

compete in any Adult kata or kumite event (team or individual).

Adult Individual EventsBrown and black belt adult division individuals will compete in separate events, but for the senior division, they may be combined for kata depending on the number of competitors. There will be senior men’s and senior women’s individual kumite if there are sufficient competitors.

Kata Initial rounds are Heian #2-5 and Tekki 1. Subsequent rounds are sentei kata (Bassai-dai, Jion, Empi, and Kanku-dai), followed by personal choice of kata.

Shodan and above must perform any kata from The Best Karate series #5 – #11.

Team KataEach ISKF East Coast Club may send one men’s adult team, one women’s adult team, and one senior team which may be men, women, or mixed.

Team KumiteEach ISKF East Coast Club may send one men’s and/or one women’s kumite team. Each team will consist of three members and one alternate who must all be registered in advance with no substitutions made after registration. There will not be a Senior’s kumite team event.

Important Safety Note: In kumite matches, mouthpiece and ISKF-approved white, non-absorbing hand protectors

are required for all competitors, regardless of rank. No competitor will be permitted to compete without both.

Only safety glasses will be permitted to be worn during kumite events. Absolutely no jewelry of any type will be permitted to be worn by competitors or officials.

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Registration Instructions and Sample Form Complete the Excel registration worksheet that is attached separately, renaming the file to include your club’s name (e.g. Registration_YourClubName.xls).

[A paper form can be submitted if preferred. But note that the Excel worksheet will automatically calculate all fees, check age vs. division, and summarize event counts.] Complete all of the gray-shaded columns of the Excel "Registration List" worksheet, or all columns on the paper form, following the formats shown at the top of each column.

List each competitor once. Indicate all events in which the competitor will participate with an "X." Leave blank cells for events in which any people are not competing. You may type your entries, or use the dropdown menus for Division, Sex, and event participation. Spelling of entries must match the dropdown options exactly. Use the delete key if you wish to remove an entry.

You may wish to give your members the "Tournament Sign-Up" form to gather registration information. These should not be submitted with your registration. Please list club members who are willing to serve as judges in the “List of Judges” tab or on the paper form provided in this packet. ***Review/complete the “SUMMARY - Club Info, Event & Fee” tab to verify the participant counts, fees, and team composition that are generated by your registration list.

Example worksheet follows:

First Name Last Name Division Sex Age RankIndividual

KataIndividual

Kumite Team KataTeam

Kumite T-Shirt

Indiv Event Fees

T--Shirt Fees

Late Fees

Total Individual

Fees

Youth Adult Senior

Male Female

Age (as of

4/16/11)

Dan 1 - Dan 10 Kyu 1 - Kyu 9

(Kyu 9=ungraded)(word first, then #)

X=Competing

X=Competing

X=Competing as captain, member, or

alternate

X=Competing as captain, member, or

alternate

Youth sizes: YS, YM, YL Adult sizes: S, M, L, XL $20/shirt

$20 per person

sent after 3/14/11

Jim Johnson, Sr. Adult Male 40 Kyu 3 X X X X L $40 $20 $60

Richard Smith Adult Male 25 Dan 1 X X X $30 $20 $50

Daniel Thomas Adult Male 29 Dan 2 X X $0 $0 $0

Mike Phillips Adult Male 44 Dan 4 X X $0 $0 $0

Jim Johnson, Jr. Youth Male 12 Kyu 9 X YL $ 20 $20 $40

Maria Rodriguez Youth Female 14 Kyu 5 X X X X YM $30 $20 $50

Donald Haupt Youth Male 15 Kyu 6 X X X S $20 $20 $40

Nancy Mason Youth Female 13 Kyu 4 X X S $0 $20 $20

Dennis Mahoney Youth Male 17 Kyu 3 X X $0 $0 $0

Peter Clark Senior Male 50 Dan 3 X X $40 $0 $40

Susan Antonucci Senior Female 52 Kyu 1 X M $30 $20 $50

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Club Name: ________________________________________________________________ Chief Instructor Signature: _______________________________________

Contact person: Name ___________________________________ Phone # ________________________________ Email _____________________________________________

Registration Form (Use the attached electronic worksheet, or make copies of this form and submit on paper)

First Name Last Name Division Sex Age RankIndividual

KataIndividual

KumiteTeam Kata

Team Kumite T-Shirt

Indiv Event Fees

T-Shirt Fees

Late Fees

Total Individual

Fees

Youth Adult Senior

Male Female

Age (as of

4/16/11)

Dan 1-Dan 10

Kyu 1-Kyu 9(Kyu

9=ungraded) X=

Competing X=

Competing

X=Competing as captain, member,

or alternate

X=Competing as captain, member,

or alternate

Youth sizes: YS, YM, YL Adult sizes: S, M, L, XL

$20/ shirt

$20 per person

sent after

3/14/11

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Club Name: ________________________________________________________________ Chief Instructor Signature: _______________________________________

Contact person: Name ___________________________________ Phone # ________________________________ Email _____________________________________________

List of Judges (Use electronic worksheet, or copy and submit this form)First Name Last Name Judge's Rank

A, B, C, DPhone Number Email Address

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Tournament Sign-Up Form (for Internal Club Use)If desired, clubs may use this form to gather registration information from their individual members. PLEASE DO NOT SUBMIT THESE FORMS WITH REGISTRATION.

BASIC INFORMATION

Name: ______________________________ _________________________________First name Last Name

Rank: ________ kyu / dan (circle one)

Age: ________ (Write in age that you will be on 4/16/11)

Division: □ Youth (Ages 8 to 17)

□ Adult (18 to 44)

□ Senior (45+)

EVENT PARTICIPATIONCheck the appropriate box for each event in which you will be participating

Individual Events: □ Individual Kata

□ Individual Kumite

Team Events: □ Team Kata

□ Team Kumite

T-SHIRT ORDER ***All T-shirts must be pre-ordered***

T-Shirt ($20): Adult sizes: □ X-Large □ Large □ Medium □ Small

Youth sizes: □ Youth Large □ Youth Medium □ Youth Small

JUDGING SIGN-UP

Will you serve as a tournament judge? □ Yes □ No

Judge rank: □ A □ B □ C □ D □ No Rank

Judge's phone number: ______________________________________________

Judge's email address: ______________________________________________ (print clearly)

***Judges, please report to the tournament site at 7:00 am on Saturday, April 16.***

Note:Anyone who is 45 or older as of April 16, 2011 is a Senior and may not compete in any event of the Adult division.

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Competitor’s Medical QuestionnaireRequired for Each Contestant

The International Shotokan Karate Federation, East Coast Shotokan Karate Association, and Washington DC Shotokan Karate Club reserve the right not to allow an individual to compete in the 2011 International Shotokan Karate Federation East Coast Tournament based on an underlying medical condition. If you are not allowed to compete, your application fee will be returned to you.

Name: Age Sex Rank (Age on 4/16/11)

Club: Instructor:

Emergency contact: Name _____________________________________________

Phone_____________________________________________

Do you have a history of any of the following conditions? (If yes to any, please explain)

Yes No Heart murmur

Hypertension

Recent infection

Bone fracture in the past six months

Concussion or severe head injury in past six months

Seizures

Eye injury

Severe bone bruises requiring padding

Kidney injury

Blood-borne contagious disease (e.g., HIV/AIDS, hepatitis)

Allergy to medication (list all):

Other relevant conditions

Are you presently taking any medications? Yes No

If yes, please specify:

Signature of Contestant Date(Parent or Guardian if contestant is under 18 years of age)

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Waiver/Release AgreementRequired for Each Contestant48th Annual International Shotokan Karate Federation Karate East Coast Tournament

In participating in the International Shotokan Karate Federation (ISKF) East Coast Tournament (“Tournament”), I understand and accept that:

1. My participation in the Tournament is voluntary.

2. I understand that there are risks and dangers inherent in martial arts training and in participating in and receiving instruction at the Tournament. I assume full responsibility for all risks associated with the Tournament, including my personal injury, death or property damage.

3. I will not sue or make any demands or claims against the International Shotokan Karate Federation, the East Coast Shotokan Karate Association and the Washington DC Shotokan Karate Club, Inc. and their officers, directors, instructors, members, judges, officials, representatives, and volunteers (collectively “Organizers”) for personal injury or property damages or loss related to my participation in the Tournament. THIS WAIVER INCLUDES, BUT IS NOT LIMITED TO, INJURY OR LOSS CAUSED BY, OR ARISING FROM, ORGANIZERS’ NEGLIGENCE.

4. I am solely responsible for insuring myself and my property at the Tournament.

5. I will pay medical fees or costs related to my participation in the Tournament and will not seek reimbursement or contribution from the Organizers.

6. The Organizers are not responsible for any incidental, consequential, or exemplary damages of any kind even if they are notified in advance that those may occur.

7. The Organizers or their designees may use my name, image, or likeness in any media relating to the Tournament without paying me for that use.

8. This Agreement is binding on me, my family and heirs and assigns.

9. If I sign this Agreement on behalf of my minor child, I agree that all this Agreement’s terms apply to me.

10. I have read this release and understand all of its items. By registering for this tournament and signing this waiver, I agree to all of these terms and conditions.

Participant’s Name

Signature:

Date:

Address:

Signer is: Participant Parent or guardian of Participant

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Parental Consent and Release FormThis form is for minor participants and must be filled out by Parent or Legal Guardian. Please print clearly and supply all the information.

First Aid

I hereby give permission for the doctor, nurse, nurse practitioner or medical staff at the 2011 International Shotokan Karate Federation East Cost Tournament (“Tournament”) to administer minor first aid or seek emergency medical care for my son/daughter

_______________________________________ (name of minor) during his/her participation at the Tournament. I understand that this permission covers the average emergencies such as, but not limited to, strains, sprains, cuts, bruises, scrapes, bumps, skin rashes, minor bites, allergic reactions, upset stomach, diarrhea, minor burns, suspected minor fractures, fevers, and other similar occurrences. This permission is valid only during the Tournament.

Emergency Care

If my child needs emergency medical care, I hereby give permission for my child to be treated in the emergency room and by the medical professionals of the hospital or medical center nearest to or most easily accessible to the Tournament. This permission includes, but is not limited to, fractures, allergic reactions, minor concussions, contusions, lacerations, foreign bodies in the eyes or skin, fevers, diagnostic x-rays, suturing, minor burns, etc. I also give permission for my child to receive a tetanus booster (if needed). I understand that in cases of major significance, such as a fracture, appendicitis, or any illness or injury which would require admission to a hospital, more consents will be necessary for treatment. If such a situation should arise, I further understand that the hospital and Tournament representatives will make every attempt to reach me.

I have signed and attach the Waiver and Release form for my child.

________________________________________ _______________________________Signature of Parent/Legal Guardian Date

________________________________________ _______________________________Print name Emergency Contact Number

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Tournament Program Advertising FormPlease submit via email by the March 16 registration deadline to: Lnaiditch@hotmail.com

Club: _______________________________________

Ad size desired: □ Back cover, inside or outside (7 ½" x 10") Color $300□ Front cover inside (7 ½" x 10") Color $300□ Full page, inside (7 ½" x 10") Black/white $200□ Half page, inside (7 ½" x 5") Black/white $125□ Quarter page, inside (3 ¾" x 5") Black/white $75□ Eighth page, inside (3 ¾" x 2 ½ ") Black/white $40

Type of ad: □ Customized ad, artwork is being submittedAll artwork should be in final format and dimensions. Electronic ads should be high resolution (300 dpi) and ideally in JPG format. We can also accept TIFF, EPS, and PDFs. A scannable printed ad in the final size, or a business card, may be submitted.

□ Standard ad, which we will create for your clubFor quarter-page ads or larger, we will create a standard ad for your club. It will wish contestants good luck on behalf of your club and chief instructor, both of whom will be named.

T-Shirt DesignPlease pre-order your T-shirt. Shirts will only be available if ordered in advance. Shirts will be distributed during check-in at the hotel, or at the tournament after lunch.Shirts are short sleeved white T-shirts, with red ink and black outlined letters. $20/shirt. Available in youth sizes YS, YM, YL or adult sizes S, M, L, XL.

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