10 th CHOJINKAI CHILDRENS/CADETS/JUNIORS
OPEN KARATE CHAMPIONSHIPS
Penrith Leisure Centre: Sunday March 13 th 2016
ENTRY FORM - PAGE 1 of 7
CONDITIONS OF ENTRY
1. Closing date – Saturday 5th March 2016 (No entries on the day) No entry fee refunds.
2. Latest WKF Rules will apply with certain modifications, see “Rules of the Day”
3. All competitors must enter via club or association (excluding members of WUKF/WKC) and have a valid licence with relevant insurance covering accidents at this event.
Individual entry is not permitted.
4. The representative signing the form below must be a person holding a responsible position in the club or association, i.e Chairman, Secretary, Instructor or Coach.
Particulars of Entry
Club Name………………………………Style………………..Karate Governing Body Mem………..…….
Representative ………………………………… Position in Organisation ……………………………..
Address……………………………………………………………………………………………………………
Tel No: …………………….. Mobile: …………………….. Daytime Tel No: ………………………………
No of Pairs/Team Entries…………………. @ £16 (2) or £24 (3) per team = £
No of INDIVIDUAL KATA Entries………………..…………@ £12 per entry = £
No of INDIVIDUAL KUMITE Entries
………………..…...... @ £12 per entry = £
No of KICKMASTER Entries…………….……......................@ £6 per entry = £
Total Entries enclosed £…………. Cheque payable to “Chojinkai Karate”
Or BANK TRANSFER: HSBC Sort Code, 40 16 22: Acc No, 41836188: Name, Chojinkai Karate
DECLARATION
I confirm that all the entrants have been advised of and will comply with the conditions of entry.
I have also advised all competitors of the risk of competition karate and they fully realise and accept these risks. I have checked and can confirm that they all have a valid licence and relevant insurance.
Signed……………………..……….…. Print Name……………..….……………..
REFEREES/JUDGES/TABLE OFFICIALS
Names of Officials Specify Role Qualification/Experience
…………………..…….. ………………. ……………………………….
A fee will be paid to National Governing Body Qualified Officials, from an allocated budget, determined from the number of entries fees received.
If you would like confirmation of receipt of your entry by Email - please supply.
PLEASE PRINT EMAIL CLEARLY: .
PLEASE SEND YOUR ENTRIES by POST or EMAIL, TOGETHER WITH YOUR CHEQUE PAYABLE
TO “Chojinkai Karate” BY THE CLOSING DATE OF 5th March 2016 to:-
Doug James, “Greenacres”, High Hesket, Carlisle, Cumbria, CA4 0HS.
Or BANK TRANSFER: HSBC Sort Code, 40 16 22: Acc No, 41836188: Name, Chojinkai Karate
PAGE 1 of 7

No
10 th CHILDRENS OPEN: Penrith Leisure Centre:Sun March 13 th
KICKMASTER KUMITE
– 6 to 7 yrs
6/7 yrs – BOYS
Name
OPEN GRADE
No Name
6/7 yrs – GIRLS
OPEN GRADE
No Name No Name
4
5
1
2
4
5
1
2
3 6 3 6
KICKMASTER KUMITE – 8/9 yrs plus 9 & under
8/9 years BOYS 8 /9 years GIRLS 9 yrs & under
9 th to 4 th Kyu 9 th to 4 th Kyu BOYS & GIRLS
Brown/Black
No
1
Name Grade No
1
Name Grade No
1
Name Grade
2 2 2
3 3 3
BOYS/GIRLS KATA – 9 th to 7 th Kyu – Pinan/Heian 1, 2 & 3 Kata Only
NOTE: Both individuals WILL perform their Kata on Tatami at same time
6 to 9 years 10 to 13 years
No
1
2
3
Name Grade No
1
2
3
Name Grade
4 4
BOYS/GIRLS KATA – 6 th to 4 th Kyu - any Pinan/Heian Kata
NOTE: If a high entry, both individuals will perform their Kata on Tatami at same time
6 to 9 years 10 to 13 years
No
1
2
3
Name Grade No
1
2
3
Name Grade
4 4
BOYS KATA – Black/Brown Belt – any Kata, free choice, no repeat
NOTE: Both individuals WILL perform their Kata on Tatami SEPERATELY in Black/Brown Belt Events
BOYS & GIRLS BLACK/BROWN BELT EVENT MAY BE AMALGAMATED IF LOW ENTRY IN EACH
6 to 9 years 10 to 13 years
No
1
2
Name Grade No
1
2
Name Grade
3 3
GIRLS KATA – Black/Brown Belt – any Kata, free choice, no repeat
6 to 9 years 10 to 13 years
No
1
2
3
Name Grade No
1
2
3
PAGE 2 of 7
Name Grade

10 th CHILDRENS OPEN: Penrith Leisure Centre:Sun March 13 th
Two Competitors
– If more than one team denote A, B or C
Boys/Girls Pairs Kata
– Name of Team ……………………………
9 th to 4 th Kyu – Pinan/Heian Only
NOTE: if a high entry - both pairs will perform their Kata on Tatami at same time
Boys/Girls Pairs Kata – Name of Team ……………………………
Brown/Black Belts - both pairs will perform Advanced Kata Seperately
Two Competitors – If more than one team denote A, B or C
Boys/Girls Pairs Kata – Name of Team ……………………………
9 th to 4 th Kyu
– Pinan/Heian Only
NOTE: if a high entry - both pairs will perform their Kata on Tatami at same time
Boys/Girls Pairs Kata
– Name of Team ……………………………
Brown/Black Belts - both pairs will perform Advanced Kata Seperately
Three Competitors – If more than one team denote A, B or C
Boys/Girls 3 Team Kata – Name of Team ……………………………
9 th to 4 th Kyu – Pinan/Heian Only
Boys/Girls 3 Team Kata
– Name of Team ……………………………
Brown/Black Belts
Three Competitors – If more than one team denote A, B or C
Boys/Girls 3 Team Kata – Name of Team ……………………………
9 th to 4 th Kyu – Pinan/Heian Only
Boys/Girls 3 Team Kata
– Name of Team ……………………………
Brown/Black Belts
PAGE 3 of 7

No
1
2
3
4
5
No
1
2
3
4
5
No
1
2
3
4
5
No
1
2
3
4
5
10 th CHILDRENS OPEN: Penrith Leisure Centre:Sun March 13 th
GIRLS KUMITE 6/7 Years GIRLS KUMITE 8/9 Years
(These categories may be split further, if a large varience in Height/ Weight etc)
6/7 yrs –
OPEN GRADE
8/9 years
9 th to 6 th Kyu
8/9 years
5 th Kyu & above
No
1
2
3
4
5
Name Grade No
1
Name Grade No
1
Name
2 2
3 3
4 4
5 5
GIRLS KUMITE 10 to 11 Years – Under 38 Kilo
9 th to 4 th Kyu Brown/Black
Grade
Name Grade No
1
2
3
4
Name
5
GIRLS KUMITE 10 to 11 Years
– 38 Kilo & Above
9 th to 4 th Kyu Brown/Black
Grade
Grade Name Grade No
1
Name
2
3
4
5
GIRLS KUMITE 12 to 13 Years
– Under 43 Kilo
9 th to 4 th Kyu Brown/Black
Name Grade No
1
2
3
4
Name
5
GIRLS KUMITE 12 to 13 Years
– 43 Kilo & Above
9 th to 4 th Kyu Brown/Black
Name Grade No
1
2
3
4
5
PAGE 4 of 7
Name
Grade
Grade

No
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
10 th CHILDRENS OPEN: Penrith Leisure Centre:Sun March 13 th
BOYS KUMITE 6/7 Years BOYS KUMITE 8/9 Years
(These categories may be split further, if a large varience in Height/ Weight etc)
6/7 yrs –
OPEN GRADE
8/9 years
9 th to 6 th Kyu
8/9 years
5 th Kyu & above
No
1
Grade
2
3
4
5
No
Name Grade No
1
Name Grade No
1
Name
2
3
2
3
4 4
5 5
BOYS KUMITE 10 to 11 Years – Under 40 Kilo
9 th to 4 th Kyu Brown/Black
Grade Name Grade No
1
2
3
4
Name
No
5
BOYS KUMITE 10 to 11 Years – 40 Kilo & Above
9 th to 4 th Kyu Brown/Black
Grade Name Grade No
1
2
3
4
Name
No
5
BOYS KUMITE 12 to 13 Years – Under 45 Kilo
9 th to 4 th Kyu Brown/Black
Name Grade No Name Grade
1
2
3
4
5
BOYS KUMITE 12 to 13 Years
– 45 Kilo & Above
9 th to 4 th Kyu Brown/Black
Name Grade No
1
2
3
4
5
Name Grade
PAGE 5 of 7

No
1
10 th CHILDRENS OPEN: Penrith Leisure Centre:Sun March 13 th
GIRLS TEAM KUMITE
Three Competitors – If more than one team denote A, B or C
Girls Team Kumite – Name of Team ……….………………………
9 Years & under – Any Grade – Open Weight
Girls Team Kumite – Name of Team ……….………………………
10 to 11 Years – Any Grade – Open Weight
Girls Team Kumite – Name of Team ……….………………………
12 to 13 Years – Any Grade – Open Weight
BOYS TEAM KUMITE
Three Competitors
– If more than one team denote A, B or C
Boys Team Kumite – Name of Team ……….………………………
9 Years & under – Any Grade – Open Weight
Boys Team Kumite – Name of Team ……….………………………
10 to 11 Years – Any Grade – Open Weight
Boys Team Kumite – Name of Team ……….………………………
12 to 13 Years – Any Grade – Open Weight
CADET/JUNIOR INDIVIDUAL KATA – 14 to 17 years
9th to 7th KYU
Pinan/Heian 1,
2 or 3 Only
6th to 4th KYU
Any
Pinan/Heian
Brown/Black
Any Kata
Free Choice
Name Grade No
1
Name Grade No
1
Name Grade
2
3
4
5
2
3
4
2
3
4
5 5
NOTE: Brown/Black Belt Kata, may be split if a high number of Male & Female entrants
Two Competitors – If more than one team denote A, B or C
Cadet/Junior - Pairs Kata
– Name of Team ……….………………………
9 th to 4 th Kyu – Pinan/Heian Only
NOTE: if a high entry - both pairs will perform their Kata on Tatami at same time
Cadet/Junior - Pairs Kata
– Name of Team ……….………………………
Brown/Black Belt - both pairs will perform Advanced Kata Seperately
Three Competitors – If more than one team denote A, B or C
Cadet/Junior -3 Team Kata – Name of Team …….………………………
9 th to 4 th Kyu
– Pinan/Heian Only
Cadet/Junior - 3 Team Kata
– Name of Team …….………………………
Brown/Black Belt
PAGE 6 of 7

No
1
2
3
4
5
No
1
2
3
No
1
2
3
No
1
2
3
No
1
2
3
10 th CHILDRENS OPEN: Penrith Leisure Centre:Sun March 13 th
GIRLS CADET KUMITE 14 to 15 Years
– Under 53 Kilo
9 th to 4 th Kyu Brown/Black
Name Grade No
1
2
Name
3
GIRLS CADET KUMITE 14 to 15 Years – 53 Kilo & Over
9 th to 4 th Kyu Brown/Black
Grade
Name Grade No
1
2
Name
3
BOYS CADET KUMITE 14 to 15 Years – Under 58 Kilo
9 th to 4 th Kyu Brown/Black
Grade
Name Grade No
1
2
Name
3
BOYS CADET KUMITE 14 to 15 Years
– 58 Kilo & Over
9 th to 4 th Kyu Brown/Black
Grade
Name Grade No
1
2
Name
3
JUNIOR INDIVIDUAL KUMITE – 16/17 Years
Grade
FEMALE JUNIOR
Any Grade/Open Weight
Name Grade No
1
2
3
4
5
MALE JUNIOR
Any Grade/Open Weight
Name Grade
BOYS/GIRLS – CADET/JUNIOR TEAM KUMITE
Boys Cadet Team Kumite – Name of Team ……….………………………
14 to 15 Years – Any Grade – Open Weight
Girls Cadet Team Kumite – Name of Team ……….………………………
14 to 15 Years – Any Grade – Open Weight
Male Junior Team Kumite – Name of Team ………………………………
Male Only – 16/17 years – Any Grade – Open Weight
Female Junior Team Kumite – Name of Team ………………………..
Female Only – 16/17 years – Any Grade – Open Weight
PAGE 7 of 7