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Lenny LeBlanc Memorial Open
JUDO TOURNAMENT
Saturday, October
25, 2008
Sanctioned by:
USJA
and CT. Judo Inc. Sanction # 081025
Co-Directors: Larry Bumpus and Greg Perry
For more information call Larry Bumpus at (860) 887-4620, Greg Perry at (860) 710-3171
or
e-mail: kazoku@sbcglobal.net
LOCATION: Kelly
Middle School – 25 Mahan Dr. – Norwich CT 06360
TIME: Masters (over 35 yr. old) and, or Kata: Weigh-in,
check-in 9:00 - 9:30 AM.
Juniors
- 16 years old and under: Weigh-in 9:00 - 10:30 AM.
17 years
old and older: Weigh-in 9:00 - 11:00 AM.
Competition to begin when divisions are set.
ELIGIBILITY:
All contestants must be members of U.S.J.A., U.S.J.F. OR U.S.J.I. and
can join at the tournament site. Open to all judoka from all states.
ADVANCED ENTRY FEES: $25 per contestant per division if received by
10/17/2007. Additional Div. $20. Send advanced registration fees to: Larry
Bumpus 28 Stony Ridge Rd. Norwich, CT. 06360-5220.
ONSITE ENTRY FEES $35.00 per contestant per division – make check payable
to Larry M Bumpus.
AWARDS: 1st, 2nd, and
3rd place Trophies awarded as Divisions are completed.
Club Team Awards: 1st,
2nd and 3rd awarded at conclusion of tournament
SCORING: True Double
Elimination and pool system.
FOOD:
Available at the tournament site. No food or drink allowed in gym area.
Water only. Officials and staff will have complimentary food and beverage provided.
RULES: Modified IJF Rules Will
Govern. Armlocks permitted only in Senior Brown/Black Belt Divisions. Chokes permitted
only in 13 years and older divisions. Golden Score Rules will be in effect. Dynamic
edge rule to be determined the day of shiai.
THE TOURNAMENT DIRECTOR RESERVES THE RIGHT TO MAKE ANY
CHANGES NECESSARY TO ENSURE SAFETY AND FAIRNESS FOR ALL COMPETITORS
BELT DIVISIONS: Junior Division A: White, Yellow, Orange; Junior
Division B: Green and Higher Belts
WEIGHT DIVISIONS:
¨
Masters: Men & Women
age 35 and over: To be determined after registration.
¨
Girls weight and age
divisions will be determined after registration.
¨
Boys weight and age
divisions will be determined after registration.
¨
Senior Women White through
Green: Light, Medium & Heavy
¨
Senior Men White through
Green: Light, Medium & Heavy
¨
Senior Women Open: Light,
Medium & Heavy
¨
Senior Men Open: -132,
-145, -161, -178, -198, -220, 221+
DIRECTIONS
From Hartford and
points west:
Take Route 2 east or
Route 32 south to the end of the connector.
Stay in center lane
as you approach the intersection.
At the traffic light
follow Route 169 toward Taftville for .5 mile to the next traffic light.
Take a right onto Ox
Hill Road and continue for .3 mile to Mahan Drive.
Turn right and Kelly
is located .3 mile on the right, just past Three Rivers Community College.
From 395 North:
Tae exit 81 merge
onto 2 East/Route 32 South toward Norwich and continue as above.
From 395 South:
Take exit 81E merge
onto 2 East/Route 32 South toward Norwich and continue as above.
INDIVIDUAL COMPETITION ENTRY FORM
Use this one form for
all division you are entering
MAKE CHECKS PAYABLE TO: Larry M. Bumpus
ADVANCED ENTRY FEES:
$25.00 PER CONTESTANT $20 FOR
ADDITIONAL DIVISIONS IF RECEIVED BY 10/17/2008.
Mail to:
Larry M. Bumpus 28 Stony Ridge Rd Norwich CT 06360-5220
ENTRY FEES: $35.00
PER CONTESTANT PER DIVISION
IF RECEIVED BY AFTER 10/17/2008
GENDER_________AGE as of 10/25/2008:_____________ Approx. Weight: ______
NAME:___________________________________________________________
Street Address/P.O. Box_____________________________________
City__________________ State_______ Zip Code________________
Email:___________________________________
Phone:__________________
Rank & Belt Color: ___________________________________
JUDO
CLUB:______________________________________________________
1st. Entry Division:
Check One: Master __ Junior
___ Senior ____
Additional entry
divisions:_____________________________________________
AFFILIATION: (USJA, USJF, USJI Required*) number:__________________
IF applying for national affiliation today, circle appropriate
organization, attach application and note method of payment (check, cash or
charge card)
MUST
COMPLETE WARNING WAIVER
KATA TEAM COMPETITION ENTRY FORM
Kata name: ______________________________________________
Tori’s Name:______________________________________________
Street Address/P.O.
Box_____________________________________
City__________________ State_______ Zip Code________________
Email:___________________________________
Phone:__________________
Rank & Belt Color: ___________________________________
JUDO CLUB:______________________________________________________
Uke’s Name _______________________________________________________
Street Address/P.O.
Box_____________________________________
City__________________ State_______ Zip Code________________
Email:___________________________________
Phone:__________________
Rank & Belt Color: ___________________________________
JUDO CLUB:______________________________________________________
AFFILIATION: (USJA, USJF, USJI Required*) number:__________________
IF applying for national affiliation today, circle appropriate
organization, attach application and note method of payment (check, cash or
charge card)
MUST
COMPLETE WARNING WAIVER
WARNING, WAIVER AND RELEASE OF LIABILITY, AGREEMENT TO PARTICIPATE
IN LENNY LEBLANC MEMORIAL OPEN JUDO CHAMPIONSHIPS
In consideration
of being permitted to participate in any way, including travel to and from the Lenny
LeBlanc Memorial Open Judo Championships, and related events and activities of
United States Judo, Inc., United States Judo Federation, United States Judo
Association, Kazoku Judo Dojo, the City of Norwich Departments of Education and
Recreation and all tournament staff and referees, 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
conditions and
refuse to participate.
3. Acknowledge and
fully understand that I will be engaging in a contact sport that might results
in serious
injury, including
permanent disability or death, and severe social and economic losses due not
only to my
own actions,
inactions or neglect, but also to the action, inactions 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,
discharge and covenant not to sue the United States Judo, Inc., United States
Judo
Federation, United
State Judo Association, Kazoku Judo Dojo, the City of Norwich Departments of
Education and Recreation and all tournament staff and referees, 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, guardians, supervisors and
coaches, sponsoring agencies, sponsors, advertisers,
and if applicable,
owners, lessors and lessees of premises used in conducting the event, all of
whom are
hereinafter
referred to as “releasee”, from any and all claims, demands, losses, or damages
on account of
injury, including
permanent disability and 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
OF 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 (print
name) 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 Releasees, 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
(print name) Parent/Guardian Signature Date