The
Department of Parks and
Recreation
Central Area
James J. Burrell Memorial Senior Team Championship
In memory of a great player!
Tournament Site:
Glenn Dale, Md. 20769
(301) 352-8983
Registration & Weigh-in: 11:00a.m. – Noon for all teams
ALL MEMBERS OF A TEAM MUST WEIGH IN AT THE SAME TIME!
Failure to provide
a current USJF/JI/JA membership card will eliminate you from competition!
Membership
applications will be available on site.
Schedule: Competition will begin at 1 pm. Lightweight teams will compete first,
then heavyweight teams.
Eligibility: You must be a member of USJF, USJI, or USJA to participate. If you do not have a team
to compete with, please come anyway. There will be a ‘Swap Shop’ set up for teams missing
players and players looking for teams.
Sanction: Sanctioned by MJI #705
Entry Fees: Pre-registration-must be postmarked by 8/4/2007: Per team $30.00
On-Site (Late) Registration: Per team $35.00
Entries must be in writing only. No Phone or E-mail entries will be accepted.
Contest: Competition will be Round Robin: 4-minute matches
Note: In each team match, each team member will compete with the corresponding member from the opposing team. The team that obtains the most wins will advance. In the event of an equal number of wins a point scoring system will be used (Ippon=10pts.; Wazari=7pts.; Yuko=5pts.; Koka=3pts.) to determine the winner. There will be no flag wins. If there is no score, hiki-waki will be declared.
Contest Rules: Current IJF rules will govern the tournament:
· Players wear a white gi.
· Provide your own blue and white obis
Team Rules:
Awards: First, second, and third place
awards for each team competition division will be given. Each individual on the
winning teams will receive an award.
Tournament Director: Edwin
Y. Takemori: (410) 431-7360 or Takemorijudo@cs.com
Categories
Men’s: Total Team Weight: 550 lbs
Add 25 lbs per player over 35 years of age
Add 35 lbs per player over 45 years of age
Women’s: Total Team Weight: 400 lbs
Add 25 lbs per player over 30 years of age
Add 35 lbs per player over 40 years of age.
Teams MUST weigh-in together!.
Directions to
FROM 95/495 - THE BELTWAY: .
From the
Beltway, take exit 20 - Route 450 east towards Lanham. Watch directional signs
and stay on 450 east (towards
FROM ROUTE 50 WEST: (
Take exit 197 north towards
FROM THE
Take the exit for Route
193/Greenbelt Road. At the stop sign turn left. At the light turn left onto
Each team player must complete this form.
Name _________________________________________________
Gender ________
Home Address
__________________________________________ Rank* ________
__________________________________________Weight ________
Phone Numbers: (H)_________________(W)________________ Age:
______
Club Name:
_____________________________________________________________
REQUIRED:
USJI/USJF/USJA #
_________________________
Exp. Date._________
*For rank, please use the name of the rank (i.e. rokkyu,
gokyu, etc.) NOT the color of the belt.
Once you are
assigned to a team payment will be requested.
Make Checks or Money Orders payable to: “M-NCPPC”
Please
mail the completed entry forms, waivers, team roster
and entry fee to:
James J. Burrell Memorial Team Championship
Glenn Dale, Md. 20769
In memory of a great player!
Team
Name:_______________________________________ Club
Name:_________________________________
Check
all that apply: ______ Male ______Female
List
your team line up lightest person first (#1) and the heaviest person last (#3).
NAME RANK AGE WEIGHT
1._____________________________________________________ __________
______ ______lbs. (Lightest)
Address:_________________________________________________________________
USJI/USJF/USJA #:______________________ Club Name:_______________________
2.______________________________________________________ __________
______ ______lbs
Address:_________________________________________________________________
USJI/USJF/USJA #:______________________ Club Name:_______________________
3.______________________________________________________ __________
______ ______lbs.
Address:_________________________________________________________________
USJI/USJF/USJA #:______________________ Club Name:_______________________
Please make checks payable
to “MNCPPC”. VISA or MasterCard are also
accepted.
Enclosed
is a fee of $__________. VISA/MC
(Please circle one)
Card
number: ____________________________________________Exp. Date:_____________
Signature:
______________________________________
Make Checks or Money Orders payable to: “M-NCPPC”
Please mail the
completed entry forms, waivers, team roster and entry
fee to:
James J. Burrell Memorial Team Championship
Glenn Dale, Md. 20769
In consideration of
being permitted to participate in anyway, including travel to and from, in any
judo tournament, practice, clinic and other related event and activities of the
United States Judo Federation Inc.,
United States Judo, Inc., United States Judo Association, Inc., Shufu Judo Yudanshakai, Maryland
Judo Inc., Maryland-National Capitol Park and Planning Commission, Glenn Dale
Community Center, and the Prince George’s Judo Club, 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 condition and refuse to
participate.
3. Acknowledge and fully understand that I will
be engaging in a contact sport that might result in serious injury, including
permanent disability or death, and severe social and economic losses due to not
only my own actions, inactions, or negligence, but also the actions, inactions,
or 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 in the sport of Judo, I
assume all such risks and accept personnel responsibility for
the
damages following such injury, permanent disability, or death.
5. Release,
waive, discharge and covenant not to sue the United States Judo Federation Inc., United
States Judo Inc., United States Judo Association Inc., Shufu
Judo Yudanshakai, Maryland Judo Inc.,
Maryland-National Capitol Park and Planning Commission, Glenn Dale Community
Center, and the Prince George’s Judo Club, 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, coaches, sponsoring
agencies, sponsors, advertisers, and if applicable, owners, lessors,
lessees of the premises used to conducting the event, all of
whom are hereinafter referred to
as "Releasees", 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 Releasees or otherwise to the fullest extent permitted by
the law.
I HAVE READ THE ABOVE WARNING, WAIVER, AND RELEASE, UNDERSTAND THAT IF I GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND KNOWING THIS, SIGN IT VOLUNTARILY. I AGREE TO PARTICIPATE KNOWING THE RISK 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
Participant’s
Signature Date
FOR
PARENTS/GUARDIANS OF PARTICPANTS 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 to the above warnings and
conditions and their ramifications.
___________________________ ______________________________ _____________
Parent/Guardian Parent/Guardian’s
Signature Date
U.S. Judo Association, U.S. Judo Federation, Inc., U.S. Judo, Inc. © February 1998