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Workshop for Kata Judges and 4th Annual Pacific Northwest Kata Championship Sponsored by: Seattle Dojo USJF Sanction # TBA Saturday, September 30, 2017 Eligibility: Open to current members of the USJF, USA Judo/USJI, USJA or Judo Canada or other national governing body for international competitors. Competitors must present current membership card and proof of insurance at check-in. Tournament Coordinator: Karen Nagai, 206-850-1342 (cell) or [email protected] Judges’ Workshop: 10:00am-11:30am, discuss IJF Kata Evaluation Criteria, view and score video of Nage No Kata, Katame No Kata, and Ju No Kata, discuss kata resources, certification procedure. Lunch will be provided for workshop participants. There is no workshop fee, but participants will be invited to judge during the competition. Please RSVP to Karen Nagai if you plan to attend. Kata Tournament: 1:00pm, mat will be open by noon for competitors; competition will be held in Nage No Kata, Katame No Kata, and Ju No Kata. If there are sufficient numbers, Advanced and Novice divisions will be created. Please contact Karen Nagai if your team wishes to demonstrate other Kodokan kata. Entries: We will collect all registration paperwork and fees at check-in. Competitors Fee: $20.00 per entry, for any number of kata. You may enter three kata with the same partner or with different partners ONCE per kata. In other words, you may not "compete against yourself" in the same division. Check-in and registration is from noon to 12:30 p.m. Saturday, September 30, at the tournament site. Competition will begin at 1:00 p.m. Workshop Participant Name: ________________________________________ Dojo:_________________________ USJF/USA Judo/USJA Membership Number: ___________________ Expires:____________ Current certification (Kata, Level, Organization): Example-Nage No Kata, B Level, USA Judo ____________________________________________________________________________ ____________________________________________________________________________ 4th Annual Pacific Northwest Kata Championship Sponsored by Seattle Dojo USJF Sanction # ______________ Saturday, September 30, 2017, 1:00 p.m. ENTRY FORM Competitor’s Name: Address: City: State: Phone: Email Age: Male: Female: Rank: Dojo/Club: USJF USA Judo USJA Canada Card Number: Expiration Date: Tori Uke Kata Nage no Kata Katame no Kata Ju no Kata Total kata entered ____ In consideration of your accepting this entry, I ________________, intending to be legally bound hereby for myself, my heirs, executors and administrators, waive the release any and all rights or damages that I may have against the Seattle Judo Dojo Inc. and the member clubs, officials and members of the Northwest Yudanshakai, United States Judo Federation, USA Judo Inc. or USJA for any and all injuries suffered by me at said event. Signature of Contestant____________________________________________Date__________________ Signature of Parent or Guardian (if under 18 years of age)___________________________________________Date__________________ If assistance/accommodation is needed (circle appropriate): Vision loss/Blindness Hearing loss/deafness Type of assistance/accommodation needed or name of person assisting 4th Annual Pacific Northwest Kata Championship Sponsored by Seattle Dojo USJF Sanction #: ________ September 30, 2017 1:00 p.m. CERTIFICATE REGARDING NON-BLACK BELT CONTESTANT I, _____________________, a judo instructor who holds the judo rank of ___________ (must be Shodan or higher) under the auspices of a nationally recognized organization, who is Currently registered with a national Judo Organization, hereby certify that, ______________________, A non-black belt competitor is competent to participate in the 2017 Pacific Northwest Kata Championship. Instructor’s Signature___________________________________Date______________________ USJF/USA Judo/USJA or Other Organization______________________ Membership Number_______________Expiration Date_____ .

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