Karate, Ju-Jitsu, & IAI-DONATIONALS

Saturday, August 19th, 2017Ohio University Chillicothe - Shoemaker Center Gym

101 University Drive • Chillicothe, Ohio 45601

OPEN TO ALL STYLESKarate • Kung-Fu • Tae Kwon Do • All styles of Ju-Jitsu • Grappling

* 1st Place winners become an AKJU ALL AMERICAN with Patch & Certificate (1 Patch Per Person)

“YOU QUALIFY TO COMPETE AT THE 22nd IRISH CUP” - DUBLIN, IRELAND

We must receive the form

and money order before

July 29, 2017

I, the undersigned, do hereby voluntarily submit my application for attendance & participation in the above said tournament andassume full responsibility of any and all damages, injuries or losses that I may sustain or incur while attending or participatingand I hereby wave for myself & executors all claims for injuries, damages or losses that I may sustain. I fully understand that ifany medical treatment is given to me, such treatment will be of first aid only, and I fully hold harmless any care giver of any claimfor injuries or damages which may result from such treatment whether given to me with or without my expressed consent. Fi-nally, I agree to allow without compensation the unrestricted use of any photographs, films or video tapes of myself.

Dear Competitor,

Notice: These are 3 separatetournaments.

Pre-register and save money! Send inearly and you don’t have to wait in lineas your card and T-Shirt will be wait-ing for you.

Also by pre-registration you pay only oneprice of $35.00 and that will cover all threeevents

(kata, kumite and weapons)or

ju-jitsu, (randori, grappling & duo)or

IAI-DO Sword Traditional & Non-Traditional

PLEASE MAIL IN!Don Madden

1101 Andersonville Road

Chillicothe, Ohio 45601

Email: akjumadden@horizonview.net

Please Print Neat (Your Email Address, Charge Card Code and Expiration Date is Very Important)

1ST PLACE WINNERbecomes anAKJU ALL AMERICANwith Patch & Certificate(Only one patch per person)

KARATE & JU-JITSU

WE TRAVEL, WE FIGHT, WE WIN!!®

H

H

H

Signature of Contestant:________________________________________________ Date:___________________

Signature of Parent or Guardian if under age 18:_____________________________ Date:___________________

AKJU TEAM AMERICA NATIONALS AUGUST 19, 2017

July 29, 2017

$35.00 Pre-registration

due by July 29, 2017

Registration at the door:$35 - 1 event, $40 2 & 3 events

$35.00 Pre-registration

due by July 29, 2017

Registration at the door:$35 - 1 event, $40 2 & 3 events

IMPORTANTEMAIL: _________________________________________________________

Don Madden, 1103 Andersonville Rd., Chillicothe, OH 45601

IAI-DO$35.00 q

H

H

Email:akjumadden@horizonview.net

NO DEBIT CARDS

ACCEPTED

AMERICA’S #1 FIGHTING SYSTEM

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Qual

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Cup

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Mail

to: D

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Email

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mad

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horiz

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We

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the

right

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xpel

any

one

or p

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fety

of t

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ompe

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nam

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SA

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FIR

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or th

e sa

fety

of a

ll co

mpe

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s, h

and

and

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will

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in a

ll ku

mite

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ns. P

ads

will

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on s

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men

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som

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cup

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7 GR

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PION

AW

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+1 F

or In

stru

ctor

With

The

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s• K

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ack

Belt

Men

Gra

nd C

ham

pion

• Ka

rate

Blac

k Be

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omen

Gra

nd C

ham

pion

• K

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Blac

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lt Gr

and

Cham

pion

• Ka

rate

Adu

lt un

der B

lack

Belt

Gran

d Ch

ampi

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• Kar

ate

Juni

or (a

ges

16 &

und

er) G

rand

Cha

mpi

on •

Ju-J

itsu

Blac

k Be

lt M

en G

rand

Cha

m-

pion

• Ju

-Jits

u Bl

ack

Belt

Ladi

es G

rand

Cha

mpi

on

TH

E M

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IN

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NA

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by AK

JU ®

Karat

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& IA

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are th

reese

parat

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rnam

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All

Amer

ican

Patc

h

HH

“This

year”

21st

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up w

on 48

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, 19 S

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8 Br

onze

.Bl

ack B

elt Fi

ghtin

g - G

old in

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& Hv

y. We

ights;

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- Gold

;Bl

ack B

elt Fi

ghtin

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KA

RA

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GH

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G &

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AM

tg. 1

1:45

am S

tart

s 12

Noo

nC

ompe

titor

Ent

ry:

1-2

even

ts: $

35, 3

Eve

nts

$40

(fig

hting, kata

, w

eapons)

Prec

isio

n K

ata:

$10

ext

ra2 p

eople

Spec

tato

rs:

Adults: $5 U

nder

12: $3

Un

der

6: F

ree

WEA

PON

S•

Men B

lack B

elt

1st –

3rd

• W

om

en B

lack B

elt

1st –

3rd

• M

en U

nder

Bla

ck B

elt

1st –

3rd

• W

om

en U

nder

Bla

ck B

elt

1st –

3rd

• Y

outh

(13-1

6)

Adva

nced

1st –

3rd

Novic

e1st –

3rd

• J

un

ior

(9-1

2)

Adva

nced

1st –

3rd

Novic

e1st –

3rd

• J

un

ior

(8 &

un

der)

1st –

3rd

• W

om

en &

Male

Senio

rs(3

5-6

4)

Ad

v

1st –

3rd

• W

om

en &

Male

Senio

rs(3

5-6

4)

No

v

1st –

3rd

• S

en

iors

(65 &

over)

1st –

3rd

PREC

ISIO

N KA

TA-

Tro

ph

y F

or

Eac

h

2 d

oin

g the s

am

e form

1st –

3rd

($10 e

xtr

a)

• A

du

lt

Adva

nced

1st –

3rd

Novic

e1st –

3rd

• Y

ou

th (

17 &

un

der)

Adva

nced

1st –

3rd

Novic

e1st –

3rd

IAI-

DO

• A

du

lt (

18 &

up

)

Tra

dit

ion

Advanced

1st –

3rd

Novic

e1st –

3rd

No

n-T

rad

itio

n

Adva

nced

1st –

3rd

Novic

e1st –

3rd

• J

un

iors

(17 &

un

der)

Tra

dit

ion

Adva

nced

1st –

3rd

Novic

e1st –

3rd

No

n-T

rad

itio

n

Adva

nced

1st –

3rd

Novic

e1st –

3rd

KA

RAT

E M

ENF

IGH

TIN

GK

ATA

Bla

ck B

elt

Lig

ht

1st –

3rd

Mid

dle

1st – 3

rd1st –

3rd

Heavy

1st – 3

rdB

row

n B

elt

1st – 3

rd1st –

3rd

Gre

en

Belt

1st – 3

rd1st –

3rd

Wh

ite B

elt

1st – 3

rd1st –

3rd

Yo

un

g M

en

(16-1

7)

Advanced

1st – 3

rd1st –

3rd

Novic

e1st – 3

rd1st –

3rd

Yo

un

g M

en

(14-1

5)

Advanced

1st – 3

rd1st –

3rd

Novic

e1st – 3

rd1st –

3rd

Yo

un

g M

en

(12-1

3)

Advanced

1st – 3

rd1st –

3rd

Novic

e1st – 3

rd1st –

3rd

Yo

un

g B

oys (

10-1

1)

Advanced

1st – 3

rd1st –

3rd

Novic

e1st – 3

rd1st –

3rd

Pee W

ee B

oys (

8-9

)A

dvanced

1st – 3

rd1st –

3rd

Novic

e1st – 3

rd1st –

3rd

Min

i P

ee W

ee B

oys (

6-7

)A

dvanced

1st – 3

rd1st –

3rd

Novic

e1st – 3

rd1st –

3rd

Min

i P

ee W

ee B

oys (

5 &

un

der)

KA

RAT

E LA

DIE

SFIG

HT

ING

/KA

TA

Bla

ck B

elt

Lig

ht

1st – 3

rdH

eavy

1st – 3

rdB

row

n B

elt

1st – 3

rd1st –

3rd

Gre

en

Belt

1st – 3

rd1st –

3rd

Wh

ite B

elt

1st – 3

rd1st –

3rd

Yo

un

g L

ad

ies (

16-1

7)

Advanced

1st – 3

rd1st –

3rd

Novic

e1st – 3

rd1st –

3rd

Ju

nio

r G

irls

(14-1

5)

Advanced

1st – 3

rd1st –

3rd

Novic

e1st – 3

rd1st –

3rd

Ju

nio

r G

irls

(12-1

3)

Advanced

1st – 3

rd1st –

3rd

Novic

e1st – 3

rd1st –

3rd

Pee W

ee G

irls

(10-1

1)

Advanced

1st – 3

rd1st –

3rd

Novic

e1st – 3

rd1st –

3rd

Pee W

ee G

irls

(8-9

)A

dvanced

1st – 3

rd1st –

3rd

Novic

e1st – 3

rd1st –

3rd

Min

i P

ee W

ee G

irls

(6-7

)A

dvanced

1st – 3

rd1st –

3rd

Novic

e1st – 3

rd1st –

3rd

Min

i P

ee W

ee G

irls

(5 &

un

der)

KA

RAT

E SE

NIO

RS

FIG

HT

ING

/KA

TA

• 35 &

over

Men A

dvanced

1st – 3

rd1st –

3rd

Men N

ovic

e1st – 3

rd1st –

3rd

Wom

en A

dv.

1st – 3

rd1st –

3rd

Wom

en N

ovic

e1st – 3

rd1st –

3rd

• 50 &

over

Men A

dvanced

1st – 3

rd1st –

3rd

Men N

ovic

e1st – 3

rd1st –

3rd

Wom

en A

dv.

1st – 3

rd1st –

3rd

Wom

en N

ovic

e1st – 3

rd1st –

3rd

• 65 &

over

Men A

dvanced

1st – 3

rd1st –

3rd

Men N

ovic

e1st – 3

rd1st –

3rd

} 1st –

3rd

}

JU-J

ITSU

Mtg

. 9:4

5am

Sta

rts

10:0

0am

Com

petit

or E

ntry

: Ju-

Jits

u O

nly

1-2

even

ts: $

35, 3

Eve

nts

$40

Spec

tato

rs:

Adults

: $5 U

nder

12: $3 U

nder

6: F

ree

MEN

RA

ND

OR

I•

Bla

ck B

elt

Lig

ht

1st –

3rd

Mid

dle

1st –

3rd

Heavy

1st –

3rd

• In

term

ed

iate

Lig

ht

1st –

3rd

Heavy

1st –

3rd

• N

ovic

eLig

ht

1st –

3rd

Heavy

1st –

3rd

• P

eeW

ee B

oys (

8 &

under)

1st –

3rd

• Junio

r B

oys (

9-1

0)

1st –

3rd

• Junio

r B

oys (

11-1

2)

1st –

3rd

• Y

oung M

en (

13-1

4)

1st –

3rd

• Y

oung M

en (

14-1

6)

1st –

3rd

• Y

oung M

en (

16-1

7)

1st –

3rd

WO

MEN

RA

ND

OR

I•

Bla

ck B

elt

Lig

ht

1st –

3rd

Heavy

1st –

3rd

• U

nd

er

Bla

ck B

elt

Lig

ht

1st –

3rd

Heavy

1st –

3rd

• Junio

r G

irls

(8 &

Under)

1st –

3rd

• Junio

r G

irls

(9-1

2)

1st –

3rd

• Y

oung L

adie

s (

13-1

6)

1st –

3rd

DU

O J

U-J

ITSU

Bla

ck B

elt

1st –

3rd

Un

der

Bla

ck B

elt

1st –

3rd

Gra

pplin

g•

Men

Ad

van

ced

Lig

ht

1st –

3rd

Mid

dle

1st –

3rd

Heavy

1st –

3rd

• M

en

In

term

ed

iate

Lig

ht

1st –

3rd

Mid

dle

1st –

3rd

Heavy

1st –

3rd

• M

en

No

vic

eLig

ht

1st –

3rd

Mid

dle

1st –

3rd

Heavy

1st –

3rd

• P

eeW

ee B

oys (

7-8

)1st –

3rd

• Junio

r B

oys (

9-1

0)

1st –

3rd

• Junio

r B

oys (

11-1

2)

1st –

3rd

• Y

oung M

en (

13-1

4)

1st –

3rd

• Y

oung M

en (

15-1

6)

1st –

3rd

• W

om

en A

dvanced

1st –

3rd

• W

om

en Inte

rmedia

te1st –

3rd

• W

om

en N

ovic

e1st –

3rd

• Junio

r G

irls

(8 &

under)

1st –

3rd

• Junio

r G

irls

(9-1

2)

1st –

3rd

• Y

oung L

adie

s (

13-1

6)

1st –

3rd