Presents: NEW YORK OPEN Sunday, Oct. 9, 2016 More Information Phone: (914) 665-2752 Fax: (914) 665-2270 Email: [email protected] Registration forms available on the www.Tournamentinabox.com Web site at: www.b axterkarate.com $1000 Cash Prize KATA, KUMITE, KOBUDO & TEAM KATA Westchester Community College 75 Grasslands Road, Valhalla, NY. 10595 New York Open 22nd Annual Karate-Do Championships GENERAL INFORMATION Date: Sunday, October 9, 2016 Time: 9:00 AM. - Competitors are urged to arrive on time. Venue: Westchester Community College 75 Grasslands Road, Valhalla, NY 10595 Registrations: Applications must be received by October 7th Applications are also available on the web at www.baxterkarate.com Submit Applications and payments by Baxter Karate – Do, Inc. certified check or money order to: 156 Mount Vernon Avenue, Suite 205 Mt. Vernon, NY 10550 Call for more information: (914) 665-2752 Cell Phone: (917) 863-7555 Fax: (914) 665-2270 ; Email: [email protected] Fees: One event - $60.00 Two events - $65.00 Three events - $70.00 Team events - $75.00 Note: Late registration: after October 7th, an additional $15.00 fee per entry applies. All fees are final! Eligibility: This is an invitational tournament. Please check with tournament director. Awards: First, Second, and Third place will receive trophies. *Order of Events: 1. All Senior Black Belts Kata 9:15AM 2. All Children Kata & Kumite 9:15AM 3. All Senior Black Belts Kobudo 10AM 4. All Senior Black Belts Kumite 10:30AM 5. Junior Kata & Kumite 1:30PM 6. All Children Kobudo 2:30PM 7. All Senior Beg./Nov./Int. 2:30PM * The Tournament Director reserves the right to change or combine divisions Competitor’s Dress Code: . Solid white traditional gi. No jewelry during competition. Toe and fingernails must be trimmed short. Referee’s Dress Code: White shirt, blue tie, gray slacks, black shoes, and blue jacket. Rules & Regulations Kata: . All contestants must perform Okinawan or Japanese Kata. Beginner contestants (10th Kyu to 4th Kyu) must use Pinan (Heinan), Gekisai, Tioshi Shodan, Kanshiwa, Kanshu, Fukyugata, Taikyoku, Tekki Shodan, Naifanchi Shodan,Kihon Kata, etc. All Beg., Nov. & Int. competitor has the choice to repeat their kata or perform a different kata each round. All black belt divisions must perform a different kata in the final round. All kata will be performed simultaneously, except 16-17 years & adult black belt divisions. Weapons: . Only traditional weapons, Bo, Sai, Tonfa, Eku, Kama, Jo, are allowed. NO NUNCHAKU – STATE LAW. SWINGING OF KAMA (SICKLES) BY STRINGS WILL NOT Kumite: BE PERMITTED. WKF modified rules. One minute stop time. 8-Point System will be utilized. Adult black belt matches will be two minutes female & 3 minutes male, all matches will be Stop Time. Equipment: . MANDATORY: Protective headgear, red & blue WKF style kumite mitts, foot protectors, and mouthpieces are required for all participants; groin cups are required for males. Chest protectors for female participants is recommended and Body protectors recommended for all. Safety glasses with a restraining band will be allowed. Other types of eyewear are not acceptable in kumite. Baxter Karate, 2016 nd 22 Annual KARATE-DO CHAMPIONSHIPS October 9, 2016 at: 9:00AM Venue: Westchester Community College, 75 Grasslands Road, Valhalla, NY 10595 Name: ________________________, _______________________ Age: ______ Sex: Male � Female � Last First Address: _____________________________City: _____________ Weight: _________ Height: __________ State: _____ Zip: ____________ Email: ___________________________________ @ _____________ . ________ Belt Color/Rank: _________________ Dojo Name ____________________________________________________ Months/Yrs. Training: ______________ Sensei Name & Phone #: ________________________________________ I WISH TO COMPETE IN: All FEES ARE FINAL: • Kata Division: K- ______ - One event $60.00 • Kumite Division: S- ______ - Two events $65.00 • Kobudo Division: W- ______ - Three events $70.00 • Team Kata* Division: TK - _____ - Team Events $75.00 - After October 7th, additional $15.00 Please fill out Team Kata/Kumite Form Remit payment to: Baxter Karate-Do, Inc. Secondary Medical Coverage $50:00: Yes ___ No ___ 156 Mount Vernon Avenue � Mt. Vernon, NY 10550 Phone: (914) 665-2752 � Fax: (914) 665-2270 Email: [email protected] ADULT & MINOR AMATEUR ATHLETIC WAIVER & RELEASE OF LIABILITY In consideration of being allowed participating in any way in the 2016 New York Open Championship athletic/sport program, and related events and activities, the undersigned: 1. Agrees that prior to participating the participant and/or Parent or Guardian (if under 18), will inspect the facilities and equipment to be used, and if the participant and/or parent or guardian, believes anything is unsafe, they will immediately advised the supervisor of the New York Open Championship or other Tournament officials of each condition(s) and refuse to participate. 2. Acknowledge and fully understands that each participant will be engaging in activities that involve risk of serious injury, including permanent disability and death, and serve social and economic losses which might result not only from their action, inaction or negligence but the actions, inaction or negligence of others, the rules of play, or the condition of the promises or of any equipment used. Further, the participant, and/or parent or guardian acknowledge that there may be other risks not known or not reasonably foreseeable at this time. The participant and/or parent or guardian assumes all the forgoing risks and accepts personal responsibility for the damages following such injury, permanent disability or death. 3. Releases, waives, discharge and covenants not to sue the Baxter Karate-Do, Mr. Cleveland Baxter, the USA-NKF its officers, Westchester Community College its officers, its affiliated clubs, regional sports organizations, their respective administrators, directors, agents, coaches and other employees of the organization, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessees of premises used to conduct the event, all of which are hereinafter referred to as “releases” from any and all liability to each of the undersigned, his or her heirs and next of kin for any and all claims, demands, losses or damages on account of injury including death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the release or otherwise. 4. All entries are final; no refunds will be given. I fully understand that any medical treatment given will be of a first aid treatment type only. I consent that any pictures furnished by me or any pictures taken of me in connection with the tournament can be used for publicity, promotion or television showing now or in the future, and I waive compensation in regard thereto. All participation in any event or class in this tournament is by permission only. The Director or his authorized agent(s) reserve the right to refuse entry to any person, school, team or club The undersigned has read the above waiver and release, understand that they have given up substantial rights by signing it and sign it voluntarily. 5. Statement of Health. By my signature below, I certify and declare that I am in sound health, with valid medical or health insurance coverage in effect at this time, and there is no reason why I cannot participate in this competition. The undersigned has read the above waiver and release, understand that they have given up substantial rights by signing it and sign it voluntarily. __________________________________________ ________________________________________ ______________________ Signature of Contestant (If under 18 Signature of parent/guardian) Date New York Open 22nd Annual Karate-Do Championships Tournament Schedule - October 9, 2016 Westchester Community College ♦ 75 Grasslands Road, Valhalla, NY 10595 9:00 AM – National Anthem & Introductions Beg.: White, Yellow, Orange Belt Nov.: Blue, Green, Purple Belt Int.: Brown Belt Tournament Director: Sensei Cleveland Baxter Adv.: Black Belt Chief Referee: Sensei Ramon Hiraldo Grand Champion Kata & Kumite: Trophies to 1st, 2nd and 3rd place Kobudo Kata Adult Kata Youth 12 years & younger (Beg./Nov.) W-1 Female 18-34 (Beg.) K-42 Juniors 13 – 17 years W-2 Female 18-34 (Nov.) K-43 Adults 18 years & over W-3 Female 18-34 (Int.) K-44 Children 12 & younger (Adv. Brown & Black Belt) W-4 Male 18 – 34 (Beg.) K-45 Juniors 13 – 17 years W-5 Male 18 – 34 (Nov.) K-46 Adults 18 years & older W-6 Male 18 – 34 (Int.) K-47 Female 35 + (Beg.) K-48 Youth Kata & Kumite Female 35 + (Nov.) K-49 Female 35+ (Int./Adv.) K-50 5 year old and younger (Beg./Nov.) K-1, S-1 Male 35+ (Beg.) K-51 Boys 6-7 year old (Beg.) K-2, S-2 Male 35+ (Nov.) K-52 Boys 6-7 Years old (Nov.) K-3, S-3 Male 35+ (Int.) K-53 Boys 6-7 Years old (Int./Adv.) K-4,S-4 Girls 6-7 Years old (Beg.) K-5,S-5 Adult Kumite Girls 6-7 Years old (Nov.) K-6,S-6 Female 18-34 (Beg.) S-42 Girls 6-7 Years old (Int./Adv.) K-7,S-7 Female 18-34 (Nov.) S-43 Boys 8-9 Years old (Beg.) K-8,S-8 Female 18-34 (Int.) S-44 Boys 8-9 years old (Nov.) K-9,S-9 Male 18 – 34 (Beg.) S-45 Boys 8- 9 years old (Int./Adv.) K-10,S-10 Male 18 – 34 (Nov.) S-46 Girls 8-9 years old (Beg.) K-11,S-11 Male 18 – 34 (Int.) S-47 Girls 8-9 years old (Nov.) K-12,S-12 Female 35 + (Beg.) S-48 Girls 8-9 years old (Int./Adv.) K-13,S-13 Female 35+ (Nov.) S-49 Boys 10-11 years old (Beg.) K-14,S-14 Female 35+ (Int./Adv.) S-50 Boys 10-11 years old (Nov.) K-15,S-15 Male 35+