PRESENTS THE 17th ANNIVERSARY OF “THE ROCK & ROLL CAPITAL OF THE WORLD” JUDO TOURNAMENT Sunday September 23th, 2012 Cloverleaf Recreation Center 8525 Friendsville Road Lodi, Ohio 44254 (330)-948-1323 Electronic Scoring ! Concession Stand ! Featuring Junior, Senior, Master & Kata Competition Medals will be awarded for 1st, 2nd, & 3rd for Shiai and Kata Competition Spectators Free Register for the Rock & Roll Tournament Saturday 9/22 at the All Women’s Judo Championships and pay Pre-registration prices. " ROCK & ROLL CAPITAL OF THE WORLD " 17th ANNIVERSARY JUDO TOURNAMENT DATE: Sunday, September 23, 2011 LOCATION: Cloverleaf Recreation Center 8525 Friendsville Road Lodi, Ohio 44254 (330)-948-2300 SANCTION: OJI: ELIGIBILITY: All contestants must provide a valid U.S.J.F., U.S.J.I., or U.S.J.A. card. Foreign contestants must have the proper ID from their home country. Membership registration available at the site. NOTE: 09-23-12, SCORING: Modified Double Elimination (4 or more in a division) Round Robin (3 or less in a division) MATCH TIMES: Sr. Men & Women Black & Brown Division 5 min. all other Divisions 3 min. RULES: The current rules of the International Judo Federation (IJF) as modified. 1. 2. 3. 4. GOLDEN SCORE will apply to ALL DIVISIONS. NO Kansetsu waza allowed in Junior Division Shime waza allowed for 13 yrs. of age and up Kansetsu waza allowed in all senior divisions regardless of age.(min. age for Sr. div. is 17) 5. Must be in Judo Gi to receive your Trophy 6. Current IJF Medical Rules – All Divisions 7. Blue & White belts required. Junior Boys: Age 6 & under Light Middle and Heavy 9/10 Light Middle and Heavy 13/14 Light Middle and Heavy Age 7/8 Light Middle and Heavy 11/12 Light Middle and Heavy 15/16 Light Middle and Heavy Junior Girls: Age 6 & under Light and Heavy 9/10 Light and Heavy 13/14 Light and Heavy Age 7/8 11/12 15/16 Light and Heavy Light and Heavy Light and Heavy Masters: 30-39 Years and older Light, Middle, Heavy 40 + Years and older Light, Middle, Heavy Senior Men: White & Green, Brown Belt, Black Belt (Brown Belt may enter Black Belt Div.) -132, -145, -161, -178, -198, -220, +220 Senior Women: White & Green, Brown & Black Belts -106, -114, -125, -139, -154, -172, +172 Kata: AWARDS: Nage No Kata, Katame No Kata, Ju No Kata, Goshinjutsu, Itsutsu No Kata - Mixed (coed) teams OK. Individual Competition - 1st, 2nd, & 3rd awards. Medals for Junior and Senior Divisions. Kata Competition Medals for 1st and 2nd place teams Best Technique Award for Senior & Junior division Fighting Spirit Award for Senior & Junior division Note: Individual Awards will be awarded right after the division concludes. Special Awards at the end of Jr.& Sr. division. ENTRY FEES: Pre-Registration by September 18 1. Same person entering more than one division 1st division $35. each additional is $15. 2. Family entries (must be from same family) 1st member $35. each additional is $ 15. Kata Teams 1st Kata $40, additional Kata’s $20 Registration at Tournament Site 1. Same person entering more than one division 1st division $45. each additional is $20. 2. Family entries (must be from same family) 1st member $45. each additional is $ 20. Kata Teams 1st Kata $50, additional Kata’s $30 SATURDAY’S REGISTRATION AND WEIGH IN DEADLINES: Division -------Jr.’s 6-10 & Kata Jr.’s 11-16 Master Seniors & Grappling TOURNAMENT DIRECTORS: E-Mail: Registration/Weigh in --------------------8:00 9:00 a.m. 9:00 - 10:00 a.m. 10:00 - 11:00 a.m. 11:00 - 12:00 p.m. Joe Schmidt 2498 Center Road Hinckley, Ohio 44233 (330) 273-1573 [email protected] HEAD REFEREE: TBA KATA JUDGES: TBA REFEREE MEETING: 9:00 - 9:45 a.m. Compete ------10:00 a.m. 11:00 a.m. 12:00 p.m. 1:00 p.m. Michael Mooney 11226 Frederick Lane Twinsburg, Ohio 44087 440-376-1376 [email protected] Cloverleaf Recreation Center 525 Friendsville Road - Lodi, Ohio 44254 Hotel Info: Host Hotel: Comfort Inn 4949 Park Ave. West Seville, OH 44273 http://www.comfortinn.com/hotel-seville-ohio-OH096/Hotel-Map Remember you must Mention “Judo Championship” when you reserve. Rate also includes hot breakfast in the morning. All rooms are equipped with Refrigerators, microwaves, coffee makers, irons and blow dryers. Amenities include wireless internet, heated Jacuzzi jet pool (nice big real pool), exercise room and laundry room for your convenience. Rates: $60/night + Tax, 2 adults or 2 adults with children (additional adult’s 18yrs. +$10 ea.). Suites: $85.00/night + Tax, 2 adults or 2 adults with children (additional adult’s 18yrs. +$10 ea.). Per Antoinette Wendzicki, General Manager Rate will be honored if you chose to come in Thursday or stay Sunday http://maps.yahoo.com/#mvt=m&lat=41.039335&lon=81.916465&zoom=14&q1=8525%20Friendsville%20Rd%2C%20Lodi%2C%20OH%2C%2044254& q2=4949%20Park%20Ave.%20West%2C%20Seville%2C%20OH&gid2=15630948 Register for the Rock & Roll Tournament Saturday 9/22 at the All Women’s Judo Championships and pay Pre-registration prices. Hosted by: International Women’s Judo Alliance & Chu To Bu Judo Club Sanctioned by U.S.J.A: 12-058 Please join us for the 8th Annual All Women’s Judo Championships in Lodi, Ohio. We aim to provide you first class service and facilities for this premier W all Female Judoka, National and International. All Referee Male and Female welcome to officiate 8TH AWC SATURDAY, SEPT. 22, 2012 Registration & Weigh in 7:00 – 8:30 am Referees Meeting 9:00 am Opening Ceremonies 10:30 am ~ Coaches, Technical and Referee clinic and certification continued throughout Ev ~Special Guests~ Head Kata Judge and Clinician (Kime no Kata) Frances Glaze Chief Referee and Clinician TBA Competitor Clinician TBA Technical Certification Clinician: Deborah Fergus Pre-Registration is requested by 9/14/12 REFEREE/TECHNICAL AND KATA CLINICS – AFTER THE AWC TOURNAMENT +-4:00pm to 8:00pm at tournament site VENUE Cloverleaf Recreation Center 8525 Friendsville Rd Lodi, Ohio 44254 R&R SUNDAY, SEPT. 23, 2012 17TH ROCK AND ROLL The Rock and Roll Capitol of the World Judo Tournament will take place at the same Venue Sept. 23, 2012. See Flyer at the end. REGISTRATION INFORMATION Pre-Registration Shiai (plus Open) ends 9/14/12 On Site Registration Shiai (plus Open) Pre or on- site additional divisions no charge Pre-registration Kata (pair) any number of Kata On Site Registration Kata (pair) ) any number of Kata Novice Kata (pair) (includes up to two Kata**) Current IWJA Members Discount $ 40.00 $ 50.00 $ 40.00 $50.00 $ 20.00 -$10.00 Clinic registration (shiai / kata contestants, workers and Referee) Clinic registration (non shiai / kata contestants, workers and Referee) $ 10.00 $ 40.00 All funds USD Pre-registration by mail or credit card ends 09/14/12 Mail to DEBORAH L. FERGUS 2006 Wickwire Rd. Benton Harbor, MI 49022 Make checks payable to IWJA (postmarked by 09/14/12) [email protected] DIVISIONS JUNIOR (AGES) SENIOR MASTERS (AGES) 6-8 yr 9-10 11-12 13-14 15-16 White - Green Brown - Black 30-39 yr 40-49 50-59 60+ Light / Middle / Heavy categories in each Light / Middle / Heavy categories in each Light / Middle / Heavy categories in each Open Divisions for 6-12 and 13-16 years Open Division for 17 years and Up Open Division for 30 years and up Pooling may be adjusted on site to accommodate numbers at the discretion of the tournament director. Nage no Kata Tournament Director Deb Fergus [email protected] 269 208 1068 Katame no Kata KATA Ju no Kata Tournament Director & Registrar Julee Cope [email protected] Goshin-Jutsu Kime no Kata Tournament Liaison Louise Ullman [email protected] “THE ROCK & ROLL CAPITAL OF THE WORLD” JUDO TOURNAMENT 2012 Registration Form Send Pre-registration forms and entry fees made payable to Chu To Bu Judo Club, Inc. 11226 Frederick Lane Twinsburg, Ohio 44087 Circle ONE of the following: Juniors – Seniors - Masters (KATA) Ju no Kata - Katame no Kata - Nage no Kata – Goshinjutsu – Itsutsu no Kata (Submit separate form for each division you want to enter) Please Print Clearly (Kata Partner: ________________________________) Name: ______________________________________ Date of Birth: _____________ Address: _________________________________________ Rank: _____________ City: __________________________________ State: _______ Zip: ____________ Division: Male _____ Female _____ Phone #: (____) _____-____________ Current Age ___ E-MAIL Address ___________________ School ____________ Club: _________________________ Instructor’s Name: ______________________ USJI#: ___________ USJF#: ____________ USJA#: ___________ Expires: ____ Certificate Regarding Non-Black Belt Contestants I, _____________________, a Judo Instructor, who holds the Judo rank of Shodan or higher, which has been awarded under the auspices of the United States Judo Federation, United States Judo Association, or United States Judo, Inc., hereby certifies that the above Contestant, although not having been awarded the Judo rank of Shodan or higher, is of sufficient aptitude and skill in Judo to compete in the above described event. ____________________________________ Signature of Judo Instructor Please note Judo Insurance must be current. The Tournament Director reserves the right to make any changes necessary for the successful operation of the event. Please remember to sign the Waiver on the reverse side of this form. FOR OFFICIAL USE ONLY: M / F AGE: ___ INSURANCE: ___ WEIGHT: ______ DIVISION:_______ DOB: ____________ RANK: __________________ WARNING! WAIVER AND RELEASE OF LIABILITY AND AGREEMENT TO PARTICIPATE In consideration of being permitted to participate in any way, including travel to and from, the 2012 Rock & Roll Capital of the world Judo Tournament and related events and activities of United States Judo, Inc., United States Judo Association, United States Judo Federation, Ohio Judo, Inc., City of Lodi, Cloverleaf Recreation Center, Chu To Bu Judo Club, Inc. and the American Judo and Self Defense Club, I hereby: 1. Acknowledge that I am familiar with the sport of Judo and understand the rules governing the sport of Judo. 2. Agree that, prior to participating, I will inspect the mats, equipment, facilities, competition pools or divisions, and the elimination or scoring system to be used, and if I believe anything is unsafe or beyond my capability, I will immediately advise my coach, supervisor, and/or a tournament official of such condition(s) and refuse to participate. 3. Acknowledge and fully understand that I will be engaging in a contact sport that might result in serious injury, including permanent disability or death, and severe social and economic losses due not only my own actions, inactions or negligence, but also to the action, inaction or negligence of others, the rules of the sport of Judo, or conditions of the premises or of any equipment used. Further, I acknowledge that there may be other risks not known to me or not reasonably foreseeable at this time. 4. Knowing the risks involved in the sport of Judo, I assume all such risks and accept personal responsibility for the damages following such injury, permanent disability or death. 5. Release, waive and discharge and covenant not to sue the United States Judo, Inc., United States Judo Association, United States Judo Federation, Ohio Judo, Inc., City of Lodi, Cloverleaf Recreation Center, Chu To Bu Judo Club, Inc, and the American Judo and Self Defense Club together with their affiliated clubs, their respective administrators, directors, agents, coaches, and other employees or volunteers of the organization, event officials, medical personnel, other participants, their parents, guardian(s), supervisors and coaches, sponsoring agencies, sponsors, advertisers, and, if applicable, owners, lessors, and lessees of premises used to conduct the event, all of whom are hereafter referred to as "releasee", from any and all claims, demands, losses, or damages on account of injury, including permanent disability or death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the releasee or otherwise to the fullest extent permitted by law. I HAVE READ THE ABOVE WARNING, WAIVER AND RELEASE, UNDERSTAND THAT I GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND KNOWING THIS, SIGN IT VOLUNTARILY. I AGREE TO PARTICIPATE KNOWING THE RISKS AND CONDITIONS INVOLVED AND DO SO ENTIRELY ON MY OWN FREE WILL. I AFFIRM THAT I AM AT LEAST 18 YEARS OF AGE, OR, IF I AM UNDER 18 YEARS OF AGE, I HAVE OBTAINED THE REQUIRED CONSENT OF MY PARENT/GUARDIAN AS EVIDENCED BY THEIR SIGNATURE BELOW. ___________________________________ Participant _______________________________ Signature __________ Date FOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT TIME OF REGISTRATION) This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release, as provided above, of all the Releases, and for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child's involvement or participation in these programs as provided above, even if arising from their negligence, to the fullest extent permitted by law. I have instructed the minor participant as to the above warnings and conditions and their ramifications. ___________________________________ Parent/Guardian (Please Print) ________________________________ Parent/Guardian's Signature __________ Date
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