FEBRUARY 25/26 2012
2138 S. 61st Ct Cicero, IL 60804
Registrations and Weigh Ins start @ 8:00am competition starts @ 10:30am for children 12:30 for teens and adults
WWW.COMBAT-DO.NET
E-mail COMBATDO@AOL.COM
DEADLINE FOR PRE-REGISTRATION 12/25/12
PLEASE CIRCLE YOUTH SMALL YOUTH MED YOUTH LARGE
ADULT SMALL ADULT MED ADULT LG ADULT XL ADULT 2X ADULT 3X ADULT 4X
Fees: Children $55.00 Teens & Adults $65.00
Spectator fee is $10.00
ADULT PRE-REGISTRATION FORM
Name_________________________________Phone__________________D.O.B___________Age
Address:______________________________City_____________State____Zip_________
E-mail________________________________Team__________________________
MEN’S ADULT NO-GI & GI GRAPPLING DIVISIONS:
MEN’S NO-GI EXPERIENCE LEVELS.
_____Men’s Novice 6 months experience ____ Fly weight 139 & under
No wrestling experience ______Feather weight 140 to 149.9
_____Men’s Beginner 6 months to 1 year ______Light weight 150 to 159.9
_____Men’s Intermediate 1year to 3 years ______Welter weight 160 to 169.9
_____Men’s Advanced 3 years + _____Middle weight 170 to 179.9
_____Expert Over 5 years Experience ______Light Heavy Weight 180 to 189.9
______Cruiser Weight 190 to 199.9
______Heavy Weight 200 to 224.9
______Super Heavy Weight 225 +
MEN’S GI DIVISIONS (WHITE & BLUE BELT)
_____MEN’S WHITE BELT (Use the weight divisions above)
_____MEN’S BLUE BELT (Use the weight divisions above)
MEN’S GI PURPLE; BROWN & BLACK BELT DIVISIONS
PURPLE BELT ____Lt. Wt. (154.9 lbs & under) ___Middle Wt. (155 to 174.9) __Cruiser (175 to 199.9)
_____Super Heavy (200 + )
EXPERT GI ______Lt. Wt. (154.9 lbs & under) ___Middle Wt. (155 to 174.9) ___Cruiser (175 to 199.9)
_____Super Heavy (200 + )
MEN’S MASTER GI & NO GI GRAPPLING DIVISIONS: .
MEN’S MASTERS DIVISIONS ( Ages 30 yrs & above) Circle one Weight Classes for MASTERS
___ MASTER NOVICE (Under 6 months experience) No Gi Only Masters Novice/Beginner & Int
___ MASTERS BEGINNER (6 months to 2 years exp) Gi Only divisions use the same 9 weight
___MASTERS INTERMEDIATE (2-5 YRS EXP) Both classes as the No-Gi Divisions
Above Masters Expert uses the
4 weight classes below.
MASTERS EXPERT__ Lt. Wt.(154.9 lbs & Under)___Middle Wt. (155 to 174.9)___Cruiser(175 to 199.9)
___Super Heavy Wt. (200 +)
MEN’S DIRECTOR’S (40 YRS +) & EXECUTIVE (50 YRS +) GRAPPLING DIVISIONS
MEN’S DIRECTORS & EXECUTIVES SKILL LEVEL CHECK ONE WEIGHT CLASSES & AGE GROUP
____NOVICE Under 6 Months Exp No wrestlers ___ No-Gi ___Directors (Ages 40 to 49 yrs)
____BEGINNER 6 Months to 2 yrs exp ___Gi Only ___Executives (Ages 50 & above)
____INTERMEDIATE 2 to 5 yrs exp ____Both Directors and Executives will be
____EXPERT 5 years exp & above broken up into weight classes
____ABSOULTE DIVISION
WOMEN’S ADULT GRAPPLING DIVISIONS: Circle No-Gi Gi only Both Gi & No Gi
_____Women’s Novice/WHITE(Under 6 months exp) ___Light Wt. (139.9 lbs & Under)
_____Women’s Beginner/WHITE Under 1 Year exp ____Middle Wt. (135. & Above)
_____women’s Intermediate 1 to 3 years exp ____Light Heavy Wt. (145 to 154.9)
_____Women’s Advanced 3 years + ____155 -164.9
____175-184.9
____185 – 194.9
KIDS/TEEN PRE-REGISTRATION FORM
Name____________________________Phone_________________D.O.B______Age____
Address_______________________________City________________State_______Zip__
E-Mail__________________________________Team________________________________
CHILDREN’S NO-GI & GI GRAPPLING DIVISIONS (13 YEARS OF AGE & UNDER)
CHILDREN’S EXPERIENCE LEVELS AGE & GENDER WEIGHT CLASSES
KIDS NOVICE=6 Months exp or less ____Boy____Girl _____49.9 & under
_____Kids Novice No-Gi (without sub) ____Age _____50 to 59.9
_____Kids Novice Gi (without sub) _____60 to 69.9
No wrestlers in the Novice Div _____70 to 79.9
KIDS BEGINNER=Less than 1 year exp _____80 to 89.9
_____Kids Beginner No-Gi (with submissions) _____90 to 99.9
_____Kids Beginner Gi (with submissions) ______100 to 114.9
No wrestlers in the beginner Division ______115 to 129.9
_____KIDS INTERMEDIATE NO-GI (with submissions) ______130 to 179.9
_____KIDS INTERMEDIATE GI (With submissions) All Children 13 & under that
Weigh over 180 lbs. will need to
KIDS EXPERT=More than 2 yrs exp compete with the teens.
_____KIDS EXPERT NO-GI (with submissions) Please note, if you placed 1st in a
_____KIDS EXPERT GI (With submissions) prior event you MUST move up
A skill level!
TEENS NO-GI & GI GRAPPLING DIVISIONS.
Circle
Teens 14 &15 16 & 17
TEENS NOVICE =6 Months Exp ___Male____Female______
_____TEENS NOVICE NO-GI ____Bantam Wt (114.9 & Under)
_____TEENS NOVICE GI ____Fly Wt (115 to 129.9)
TEENS BEGINNER = 1 Yr Exp ____Light Wt (130 to 149.9)
_____TEENS BEGINNER NO-GI ____Middle Wt (150 to 169.99)
_____TEENS BEGINNER GI ____Heavy Wt (170 to 199.9)
No Wrestlers allowed in Novice ____Super Heavy Wt (200 + )
Or Beginner.
_____TEENS INTERMEDIATE GI
_____TEENS INTERMEDIATE NO-GI
_____TEENS ADVANCE GI
_____TEENS ADVANCE NO-GI
_____TEENS EXPERT NO-GI
_____TEENS EXPERT GI
TEENS OVER 200 LBS WILL COMPETE WITH ADULTS. Please note we reserve the right to either subdivide or combine the above weight classes the day of the event depending on the turnout.
Please note if you placed 1st in a prior Combat-Do Event you must move up a skill level.
We will match kids based on age and weight to make each division as fair as possible. Girls will be paired up with other girls whenever possible if there are 2 or more girls in a division, we will create a separate division for those girls.
WAIVER OF LIABILITY
In consideration of services to be received as a competitor on these premises, the undersigned herby releases and forever discharges the school, its heirs successors, administrators and assigns from any and all actions, cause of actions, liability, claims and demands upon or by reason of any damage, loss injury, or suffering known and unknown which may be sustained by ___________
On these premises, from the instructor or instructors, staff, official, or employees of this school or any fellow students on the premises in connection there with and within the course of taking training or competition for the purpose designed on this application, He/She herby waives all his/her rights to the claims, actions, and cause of action, demand or suit for loss injury, damage, of suffering sustained as a result of anything other than gross negligence on the part of this school. The undersigned assumes all the risks inherent and incident to this type of sports activities as a condition for competing to this school for the purpose Herein above stipulated.
____________________________________ _____________________________________________
Signature of Applicant Date Signature of Parent, if applicant is under 18