Aug 7, 2015 - and Business Administration to produce what you call the â21st century ... Tiger Kim's World Class Tae K
Welcome to all of the athletes from all over the world to the 7th Yong-in University Presidential Cup. In addition, I would also like to thank all the VIP guests, families, and volunteers who came to make this event special. And I would like to give a warm gratitude to the officers and officials who have put many hours and effort in preparing for today's tournament. The Yong-In University Presidential Cup International Tae Kwon Do Championship started in 2003, as a tournament to be held every two years and we celebrat the 7th this year. This tournament was able to continue the growth and development in scale and qualitative aspects over the years because of its alumni’s continuous effort, sweat, and dedication. In particular, the present competition has made a significant contribution in spreading Tae Kwon Do to not only in United States but too many countries around the globe as well. I want to ask all the Alumnus, please continue to support and work together for this great event to be well known amongst all Tae Kwon Do enthusiasts around the world. The school celebrates its 62nd anniversary of its alma mater. We are looking to a new leap forward with a new spirit. Just for the Tae Kwon Do department alone, many alumnus and current students have participated in the Olympics, Asian Games, and the World Tae Kwon Do Championships and performed well with great results. On top of that, the Tae Kwon Do demonstration team still now currently travels throughout the world in spreading Tae Kwon Do to the world of its culture and art. As a University that is well known to the world as a specialized school for martial arts, sports, and arts, we now have begun to focus on many other majors to create more opportunities for many international students. The school now is in all-out effort to focus on utilizing elements of Carl Jung and its practical education to develop in the areas such as Culture, Environment, Health Care and Welfare, and Business Administration to produce what you call the “21st century intellectuals”. In order for Yong-In University to continue to grow, we need the entire alumnus to continue to help and support your Alma Mater to become the most prestigious university in the world. Finally, to everyone that is here to compete in this event, I hope that you will give one hundred percent of what you have and bring out your best. I also hope that through this competition, we are able to bond and share the love of Tae Kwon Do to create relationships for the future. Furthermore, I want to send my deep thanks to those who have put a lot of time and effort in making this event possible. It is a great privilege to be here today, and I wish everyone the best of luck. Thank you very much. Sun Kyung Park President Yong-In University
Greetings Grandmasters, Masters, Coaches, Referees, Athletes and Guests, As president of the U.S. Yong In Alumni Association, it is my pleasure to bring to you the 7th Yong In University International Presidential Cup Tae Kwon Do Championships. On August 7th-8th, 2015, just outside the great city of Atlanta, Georgia, competitors from around the world will gather together to set a standard of competition like no other. I am certain this event will demonstrate the outstanding discipline of Taekwondo and help to promote a healthy lifestyle within this martial art. I am grateful for our U.S. Yong In Alumni’s efforts in providing you with a world class experience that represents our Yong In University and our nation of Korea with it’s rich cultural heritage. Our U.S. Yong In Alumni are commended for their promotion of Taekwondo within the United States and beyond it’s borders bringing us to where we are today. It is by their hard work that this year’s championship will bring together both young and old, beginner and experienced, athlete and spectator to embody the true spirit of Taekwondo. There is something for everyone who wishes to compete in this year’s event from Little Tigers Spirit to Team Sparring and Demo Competitions. I encourage all practitioners of Taekwondo to join us as we come together in one unified spirit to exemplify the enthusiasm that exudes from our passion for Taekwondo. I wish the best for all who will come together as our Taekwondo family along with Yong In University. Sincerely, Master Woo Sup Kim President of U.S. Yong In Alumni Association Tiger Kim’s World Class Tae Kwon Do Centers
GENERAL INFORMATION Dates:
Friday, 7 August and Saturday, 8 August
Location:
Duluth, GA USA Gwinnett Arena, Main Event Arena 6400 Sugarloaf Pkwy, Duluth, GA 30097 Website: www.gwinnettcenter.com
Tournament Host:
US Yong-‐In Alumni
Tournament Contact:
Jennifer Parlier Phone: 770.460.3356 Fax: 770.460.3357 Email:
[email protected] Website: atlantatkd.com
Registration:
All registration materials must be postmarked no later than Wednesday, 29 July 2015. Registration the day of the event will NOT be permitted. Mail registration(s) and payment to:
Yong-‐In University Presidential Cup C/O Master Shim’s WCTKD 834 Glynn St. S #200 Fayetteville, GA 30214 USA Payment:
All funds must be payable with certified check or money order to: “Yong-‐In Alumni” No personal checks or credit cards will be accepted.
Hotel/ Headquarters:
HOLIDAY INN GWINNETT CENTER Reservation D eadline: Saturday, 11 July 2015 $99 + tax/night, standard room Request “The 7th Yong-‐In Presidential Cup Tae Kwon Do Championship” rate 6310 Sugarloaf Parkway, Duluth, GA 3 0 0 9 7 Phone: 770.476.2022, Website: www.holidayinn.com/hotels/us/en/duluth/atldu/hoteldetail
Airports:
Atlanta International Airport (ATL), 44 miles
General Admission:
$10 Friday Demo Competition (Ages 5 and under, free admission). $20 Saturday All Day Admission (Ages 5 and under, free admission). $25 Two-‐Day Pass (Available at Individual TKD Schools)
Concessions:
Concessions available all day. No food or drink may be brought into the facility.
Parking:
Parking fees included in general admission.
EVENTS SCHEDULE
Friday, 7 August
4:00 PM -‐ 6:30 PM
Demo Team Preliminary Competition Gwinnett Arena, Main Event Arena 7:00 PM -‐ 8:30 PM Team Sparring Preliminary Competition Gwinnett Arena, Main Event Arena
Saturday, 8 July
Gwinnett Arena 6:30 AM
Volunteer Meeting.
7:00 AM
Doors Open.
7:00 AM -‐ 2:00 PM
Competitor Weigh-‐in, Pick Up Credentials.
7:30 AM
Referee & Coach Meeting.
7:45 AM
CALL TO HOLDING AREA, Forms Competitors By Age.
8:00 AM
Forms Competition Begins CALL TO HOLDING AREA, Breaking Competitors By Age. Breaking Competition Begins.
Competitor Weigh-‐In, Pick Up Credentials Gwinnett Arena
4:00 PM -‐ 9:00 PM
9:00 AM
CALL TO HOLDING AREA, World Class Sparring Competitors
11:00 AM 12:00 PM
Team Forms Competition followed by Team Sparring Final Match.
1:00 PM
Opening Ceremonies, Yong-‐In University Demonstration Team.
3:00 PM 3:15 PM 6:30 PM
CALL TO HOLDING AREA, Sparring Competitors By Age.
Demo Team Awards Presentation
Sparring Competition Begins Grand Champion Sparring Ages 15-‐17
All times are approximate and subject to change.
SPECIAL EVENT NOTES
All competitors in individual events will receive a medal and certificate. Individual Events: spirit, forms, board breaking, and sparring. School Demo Team Competition with cash prizes for top three schools. Team Forms Competition with Age Divisions 4-‐9, 10-‐14, and 15 & Up.
The Yong-‐In University Demonstration Team will perform at the opening ceremonies. All black belts ages 15 to 17 are eligible to compete for the title of “Grand Champion” in World Class sparring, if they place first in their individual sparring competition. o One male and one female will be crowned “Grand Champion of Sparring” in each of the five Junior World Class divisions. The top school in each of the following categories will be recognized at the opening ceremonies: Most Participants, Best Spirit/Enthusiasm, and Best Sportsmanship. Eleven mats will be used for competition with electronic scoring. All competitors must complete a w eigh-‐in on Friday, 7 August (4:00 PM to 9:00 PM at the Gwinnett Arena) or Saturday, 8 August (7:00 AM to 2:00 PM at the Gwinnett Arena). Competitors must wear a standard, white, V-‐neck (or Y-‐neck Poomsae) uniform in good condition. Black trim around the collar is allowed only for poom/black belts. Those competing in forms and board breaking should review the required form/technique for their belt color and must provide their own boards. Vision USA will be on the premises with boards for purchase. Competitors must provide their own safety/sparring equipment: head gear, mouth guard, forearm guards, chest protector, groin protector, shin and instep protector. World Class competitors will use KP&P E-‐Hogus. KP&P Sparring Socks will not be provided but will be available for purchase. Competitors will be grouped according to gender, age, belt, and weight. Masters/coaches/instructors should wear dress commensurate with the international level of this competition. World Class Division Coaches should wear suits while coaching on the floor. Coaches must be at least 16 years of age and a current tae kwon do student, instructor, or master. Those wishing to be a referee should contact Mrs. Jennifer Parlier. Referees must be 18 years of age and a black belt. Volunteers must be at least 14 years of age and able to work entire event. Previous tournament experience is preferred. Volunteers must wear khaki slacks.
GENERAL COMPETITION RULES
The World Tae Kwon Do Federation (WTF) rules and regulations will govern these championships for forms, breaking, and sparring competitions. The organizing committee reserves the right to adopt changes as they deem necessary. A. Competitors participating in individual events must wear a standard, white, V-‐neck uniform in good condition. Black trim around the collar is allowed only for poom/black belts. B. All competitors must weigh-‐in on Friday or Saturday during the designated times. This includes ALL who are competing individually in spirit, forms, board breaking, and/or sparring. C. Competitors must provide their own safety/sparring equipment. D. Competitors will be grouped according to gender, age, belt, and weight. E. Individual awards for spirit, forms, breaking, and sparring; 1. One 1st Place 2. One 2nd Place 3. Two 3rd Place F. All black belts ages 15 to 17 who finish in first place during the World Class sparring waves are eligible to compete for the m ale and female “Grand Champion” title in sparring.
“Come celebrate the spirit of Tae Kwon Do.”
SPIRIT AND FORMS COMPETITION RULES Spirit A. Eligibility 1. White belts, ages 4 and 5, who have just begun their taekwondo training. B. Directed by a m aster/instructor on the competition floor, the spirit participants will be judged on: 1. Focus and kihap; 2. Horse riding stance with basic punching; 3. Kicking stance; and, 4. Front snap kick (3 each leg).
Forms A. Eligibility 1. White belts age 6 and up. 2. Yellow/orange belts and higher of any age. B. Single elimination format. C. Competitors will be judged on ability to perform the form associated with their current rank, balance, rhythm, and manner. D. Official forms:
Black Belts 1 Dan – Koryo 2nd Dan – Keumgang 3rd Dan – Taebaek 4th Dan – Pyung Won 5th Dan – Sip Jin
Color Belts White – Basic Yellow/Orange – Taeguk & Palgwe 1 or 2 Green – Taeguk & Palgwe 3 or 4 Blue/Purple – Taeguk & Palgwe 5 or 6 Red/Brown – Taeguk & Palgwe 7 or 8
E. Forms weight divisions (ALL Belts-‐No weight divisions for ages 4-‐5):
ALL BELTS
st
Age 6 -‐ 7 8 -‐ 9 10 -‐ 11 12 -‐ 13
Male Female (lbs.) (lbs.) < 48 48 + < 64 64 + < 75 75 + < 90 < 77 90 + 77 +
Weight Class Light Heavy Light Heavy Light Heavy Light Heavy
ALL
Age 14 -‐ 15 16 -‐ 17 18 -‐ 32 33 and Up*
Male (lbs.) < 132 132 + < 139 139 + < 154 154 + < 150 150 +
Female (lbs.) < 119 119 + < 121 121 + < 134 134 + < 130 130 +
Weight Class Light Heavy Light Heavy Light Heavy Light Heavy
33 and Up will be divided into 33-‐40, 41-‐50, and 51+. *
“Courtesy”
BOARD BREAKING COMPETITION RULES
A. Eligibility 1. ALL participants. B. Ten point scoring system based on: 1. Required breaking technique based on belt color.
Belt Color White Yellow/Orange Green Blue/Purple Red/Brown Black Belts
# of Boards 1 2 2 2 2 3
Technique Any 1 Hand + Side Kick Any 1 Hand + Axe Kick Any 1 Hand + Back Kick Any 1 Hand + Spinning Kick Any 2 Hand and/or Kicking Techniques Any 3 Hand and/or Kicking Techniques
2. Presentation – balance, rhythm, manner, and kihap from entrance to completion. C. Board sizes (boards provided by tournament committee) 1. Ages 12 and less – ½ inch board 2. Ages 13 plus – 1 inch board D. No props allowed. Only the competitor and board holders are allowed on the mat. E. Weight Divisions (ALL Belts-‐No weight divisions for ages 4-‐5):
ALL BELTS
Age 6 -‐ 7 8 -‐ 9 10 -‐ 11 12 -‐ 13
Male Female (lbs.) (lbs.) < 48 48 + < 64 64 + < 75 75 + < 90 < 77 90 + 77 +
Weight Class Light Heavy Light Heavy Light Heavy Light Heavy
ALL
Age 14 -‐ 15 16 -‐ 17 18 -‐ 32 33 and Up*
Male (lbs.) < 132 132 + < 139 139 + < 154 154 + < 150 150 +
Female (lbs.) < 119 119 + < 121 121 + < 134 134 + < 130 130 +
Weight Class Light Heavy Light Heavy Light Heavy Light Heavy
* 33 and Up will be divided into 33-‐40, 41-‐50, and 51+.
“Integrity”
SPARRING COMPETITION RULES
A. Eligibility 1. Yellow/orange belts and higher of any age. B. Format 1. Random seeding. 2. Single elimination. C. Points 1. 1 point – valid punch or kick on chest protector. 2. 3 points – valid turning kick on chest protector. 3. 3 points – valid kick to the head. 4. 4 points – valid turning kick to the head. 5. At end of second round, 12 point difference rule will be in effect for black belts only. D. Application of head contact safety rules. 1. NO HEAD CONTACT – i. ALL color belts of any age ii. Black belts ages 7 and under. 2. LIGHT HEAD CONTACT -‐ Black belts ages 8-‐14. 3. HEAD CONTACT -‐ Black belts ages 15 and up. E. Rounds and duration
Belt ALL Color Belts ALL Black Belts World Class BB
# of Rounds 2 3 3
F. Weight divisions: See next page, please.
Round Duration 1 min. 1 min. 1 ½ min. min. min.
“Perseverance”
Rest Time 30 sec. 30 sec. 30 sec.
Tournament Sparring Weight Divisions
(No weight divisions for ages 4-‐5, excludes Grand Champions Sparring Divisions)
Age
6 -‐ 7
8 -‐ 9
Belt
ALL BELTS
10 -‐ 11
12 – 14
15-‐17
15 -‐ 17
18 -‐ 32
BLACK BELTS
COLOR BELTS
COLOR BELTS
18 – 32
33 – 40, 41 – 50, 51+
BLACK BELTS
ALL BELTS
Male (lbs.)
Female (lbs.)
< 42 42–51 51.1–59 > 59 < 46 46.1–55 55.1–66 > 66 < 66 66.1–77 77.1–88 > 88 143.4 < 106 106–121 121.1–139 139.1–161 > 161 < 99.2 99.3 – 105.8 105.9 – 112.4 112.5 – 121.3 121.4 – 130.0 130.1 – 138.9 139.1 – 149.9 150.1 – 160.9 161.0 – 172.0 >172 < 128 128–150 150.1–176 > 176 < 112 112–128 128.1–139 139.1–150 150.1–163 163.1–176 176.1–192 > 192 < 128 128–150 150.1–176 > 176
130.2 < 97 97–108 108.1–121 121.1–139 > 139 < 92.6 92.7 – 97 97.1 – 101.4 101.5 – 108.0 108.0 – 114.6 114.7 – 121.3 121.4 – 130.0 130.1 – 138.9 139.0 – 149.9 > 150 < 108 108–126 126.1–148 > 148 < 101 101–108 108.1–117 117.1–126 126.1–137 137.1–148 148.1–161 > 161 < 108 108–126 126.1–148 > 148
Weight Class FIN LIGHT MIDDLE HEAVY FIN LIGHT MIDDLE HEAVY FIN LIGHT MIDDLE HEAVY FIN FLY BANTAM FEATHER LIGHT WELTER L. MIDDLE MIDDLE L. HEAVY HEAVY FIN/FLY BANTAM/FEATHER LIGHT/WELTER L.MIDDLE/MIDDLE L. HEAVY/HEAVY FIN FLY BANTAM FEATHER LIGHT WELTER L. MIDDLE MIDDLE L. HEAVY HEAVY FLY FEATHER WELTER HEAVY FIN FLY BANTAM FEATHER LIGHT WELTER MIDDLE HEAVY FLY FEATHER WELTER HEAVY
Team FORMS COMPETITION RULES
A. Eligibility: 1. All team members must be within the same age division (4-‐9, 10-‐14, or 15&Up). 2. Must have at least three team members, but no more than five. B. Divisions 1. Color belt division i. All members of the performing team must be color belts (do not have to be the same color belts). ii. Team may perform any one form from the following list: Color Belts White – Basic Yellow/Orange – Taeguk & Palgwe 1 or 2 Green – Taeguk & Palgwe 3 or 4 Blue/Purple – Taeguk & Palgwe 5 or 6 Red/Brown – Taeguk & Palgwe 7 or 8 2. Black belt division i. All members of the performing team must be black belts (do not have to be the same Dan level). ii. Team may perform any one form from the following list: Black Belts 1 Dan – Koryo 2nd Dan – Keumgang 3rd Dan – Taebaek 4th Dan – Pyung Won 5th Dan – Sip Jin st
C. Scoring based on: a. Kihap/spirit/enthusiasm, originality in performing the form, synchronization, balance/rhythm, and performance of form. D. The top three teams from each division will be competing for a team trophy.
“Self Control”
Team Sparring COMPETITION RULES
A. Eligibility: 1. All team members must be between ages 12-‐14. 2. Each have at least three team members. 3. All members must be from the same school. 4. No chief instructors may be a part of any team. B. Divisions 1. Black belt division i. All members of the team must be World Class Black belts (do not have to be the same Dan level). ii. The combined weight for the entire team must not exceed 350lbs. C. Match Rules Based On: 1. Team Sparring shall follow the same rules and protocols as World Class sparring with the following exceptions. 2. Before a match the team with the highest ranking member shall call a coin toss. 3. The team that wins the coin toss may choose to select their first competitor or let the other team select first. 4. Each round will be 1 ½ minutes. 5. After all three rounds have been completed all points and warnings will be tabulated. 6. In the event of a tie each team will select one member for a sudden victory match. 7. If a competitor is DQ and the team only has three members the team is DQ. 8. If a competitor is DQ and the team has four members the round is over, any points that person has scored are void and his team is issued a warning. 9. If another match is required the 3rd alternate will take the place of the DQ competitor. 10. If a competitor is injured and cannot continue and the team has only three members the team is DQ. 11. If a competitor is injured and cannot continue and the team has four members, the round is over, any points or warnings will still be counted. 12. If another match is required the 3rd alternate will take the place of the injured competitor.
SCHOOL DEMO TEAM COMPETITION RULES
A. No coaching or instruction from coaches allowed during the demonstration. Masters/coaches/instructors can assist with music. B. All demo team participants must be less than 18 years of age as of 7 August 2015. C. Number of team participants 1. Minimum number of team competitors is 10. 2. Maximum number of team competitors is 18. D. Time permitted 1. One minute for set up. 2. Six minutes for demonstration. E. Technical requirements: 1. Forms 2. Board breaking 3. Self defense F. Miscellaneous: 1. Equipment and costumes can be chosen by school demo team. 2. Any weapons used must be imitations. G. Scoring based on: 1. Team spirit. 2. Originality. 3. Organization of set-‐up and performance. 4. Technical requirements. 5. Deductions for exceeding 6 minute time limit will be assessed. H. The top three school demo teams will be competing for a school banner, individual medals, and the following prizes for their sponsoring schools: 1. 1st Place -‐ $1,000 2. 2nd Place -‐ $500 3. 3rd Place -‐ $300
“Indomitable Spirit”
GRAND CHAMPIONS COMPETITION RULES
Sparring A. Those black belts in the 15 to 17 divisions who place first in their respective sparring weight class will
be eligible to compete for the title of Grand Champion of Sparring. Grand Champions (One male and one female in each of the five below weight classes) will be awarded a 10 day Training Trip at Yong In University (Airfare not included.) C. Single elimination format. 1. 3 – 1.5 minute rounds with one minute rest periods. 2. Twelve point difference rule will be in effect from end of second round. 3. Competitors will be randomly seeded in their respective weight class. D. The weight classes for the Grand Champions of Sparring are: 1. 15-‐17 age division B.
Male (lbs.) Female (lbs.) < 105.8 < 97.0 105.9-‐121.3 97.1-‐108.0 121.4-‐138.9 108.0-‐121.3 139.0-‐160.9 121.4-‐138.9 >161.0 >139.0
Weight Class FLY FEATHER WELTER MIDDLE HEAVY
Courtesy │ Integrity │ Perseverance │ Self-‐Control │ Indomitable Spirit
REFEREE, COACH, AND VOLUNTEER REQUIREMENTS
Referees
Eligibility § Contact Mrs. Jennifer Parlier if interested. § Must be 18 years of age AND a black Belt (any Dan level). § Must be able to control your assigned mat and work efficiently. § Able to judge forms, board breaking, and sparring. § Must commit to work the entire tournament on Saturday, 8 August 2015. Dress requirements § Dark slacks § Soft sole shoes § All referees will be provided a tournament shirt.
Coaching Eligibility § Must be 16 years of age or older AND a current taekwondo student, instructor, o r master. § Completed Coaching Registration Form AND $40 coaching fee. § World Class Division Coaches must wear a suit while coaching on the floor § Must attend the Saturday morning coaches meeting at the tournament location. Coaches will not be permitted on the competition floor without proper credentials.
Volunteers Eligibility § Contact Mrs. Jennifer Parlier if interested. § Must be 14 years of age or older. § Must be able to work the entire event. § Must attend the volunteer m eeting on Saturday morning at the tournament location. § Previous tournament experience preferred. Dress requirements § Khaki slacks. § Soft sole shoes. § All volunteers will be provided a tournament shirt, credentials, and meal ticket. Volunteers not assigned to work within the competition area are NOT allowed to enter this area without permission from the tournament director/coordinator.
THE 7 TH YONG-IN UNIVERSITY PRESIDENTIAL CUP
International TaeKwonDo Championship
Friday, 7 August 2015 and Saturday, 8 August 2015, Duluth, G A
COMPETITOR REGISTRATION FORM
Registration must be postmarked no later than Wednesday, 29 July 2015.
Payments must be in form of certified check or money order payable to “Yong-In 15" (no personal checks).
Mail to:
Did you include:
D Medical Questionnaire D Registration Form D Payment
Yong-ln University Presidential Cup C/0 Master Shim’s WCTKD 834 Glynn St. S #200 Fayetteville, GA 30214 USA
Turn in form and payment to school instructor. For any registration questions, please contact M r s . J e n n i f e r P a r l i e r at a t l a n t a t k d @ h o t m a i l . c o m o r 7 7 0 . 4 6 0 . 3 3 5 6 .
PLEASE PRINT ALL INFORMATION
Last Name:
First Name:
Middle Initial:
Address:
City:
State:
Zip:
Home Phone: ( )
Applications with missing information will not be processed. Please fill in all information completely! Date of Birth:
Age:
Circle One: MALE FEMALE Height: _______ Weight: _______
Belt Color: ______________________ (Black Belts must indicate Dan Rank) (Little Tigers should indicate “White Belt LT”) EVENTS: ___Spirit (Little Tigers & New White Belts)
___Forms Tae Kwon Do School: _____________________________ ___Breaking School Phone #:_________________________________ ___Sparring (or) Master Name: __________________________________ ___World Class Sparring: 10-‐32 year old Black Belts Only (KP&P Foot Protectors required and are not provided)
One Event $90 Two Events $100 Three Events $110
Total Amount Enclosed: $
(no refunds on entry fees)
PAYABLE BY: CERTIFIED CHECK OR MONEY ORDER ONLY-‐ NO EXCEPTIONS
LIABILITY WAIVER In consideration of your acceptance of my registration, I do hereby, for myself, heirs, executors, and administrators waive, release, and forever discharge any and all rights claims for damages which I may have, or which may accrue to me, against 2015 Yong-ln University International Tournament and for its state and district associations, 2015Yong-l n University International Tournament, or their respective officers, agents, representatives, successors, and/or assi g ns, and against any competitors for any and all damages which may be sustained by me in connection with my association with my participation in or entry in the above athletic meet and competition, and in connection with any medical service I may be provided in connection with any such injury or illness. I understand Tae Kwon Do is a body contact sport and I further understand all contents of the 2015 rules and regulations and genera l information which was published by the sponsors and I agree with them in their entirety. I further understand that I may be dismissed from the premises without compensation of refund if my conduct is not courteous and cooperative for the successful operations of the championships.
Contestant's Signature:.
Date:
Parent/Legal Guardian Signature
Date:
I I
I I
Friday, 7 A u g u s t 2015 and Saturday, 8 A u g u s t 2015, Duluth, G A
MEDICAL QUESTIONNAIRE FORM
(This form is mandatory for all competitors)
Please circle the (Y) for yes or (N) for no. 1. Do you have any allergies to any medications?
Y
N
If you answered yes, please indicate which medications: ________________________________________________
2. Do you take any medications regularly?
Y
N
If you answered yes, please indicate which medications:
3. Do you wear contact lenses?
Y
_
N
4. Do you have a history of any of the following conditions?
Epilepsy (seizures)
Y
Lung disease
Y
N
Heart disease
Y
N
Diabetes
Y
N
High blood pressure
Y
N
N
If you answered YES to any part of question four, please complete question five. 5. I hereby state that I am under the care of a physician for the treatment of
_
and that I have been medically cleared by that physician to participate in this tournament.
Please read carefully: I hereby certify that the above information is true and accurate to the best of my knowledge and hereby agree that I WILL NOT be permitted to participate in this tournament if this MEDICAL QUESTIONNAIRE FORM is not completed and returned prior to the 2015 U.S.YONG-IN UNIVERSITY PRESIDENTIAL CUP INTERNATIONAL TOURNAMENT. COMPE TITOR'SSIGNATURE:
PARENT/LEGAL GUARDIAN SIGNATURE:
DATE:
_
CERTIFICATION: Competitor's Name:
AGE:
_
Home Phone: _______
Home Address:
_
If you are a minor (under 18 years old) and will be at the tournament without a parent, the statement below must be read and signed by a parent or legal guardian and returned prior to participating in any competition or event. The undersigned competitor (parent or legal guardian of the competing minor) represents that he has the authority to consent to the medical care and treatment of such a competitor (or competing minor) by the designees of 2015 U.S. YONG-IN UNIVERS ITY PRESIDENTIAL CUP CHA MPIONSHIP. PARENT/LEGAL GUARDIAN NAME: PARENT/LEGAL GUARDIAN SIGNATURE:
_
If competitor is under age 18, this must be signed by parent or legal guardian.
Parent's Name:
DATE:
_ DATE:
_
Friday, 7 August 2015 and Saturday, 8 August 2015, Duluth, G A
TEAM FORMS REGISTRATION FORM ($100 per team)
Registration must be postmarked no later than Wednesday, 29 July 2015.
NOTE: All participants must complete a COMPETITOR REGISTRATION FORM and MEDICAL QUESTIONNAIRE to complete their registration and receive credentials.
Payments must be in form of certified check or money order payable to "Yong-ln 15" (no personal checks).
Mail to:
Did you include:
C/O Master Shim’s WCTKD
D Team Registration Form D Payment ($ 100 per team)
834 Glynn St. S #200
Turn in form and payment to school instructor.
Yong-ln University Presidential Cup
Fayetteville, GA 30214 USA For any registration questions, please contact M r s . J e n n i f e r P a r l i e r at a t l a n t a t k d @ h o t m a i l . c o m o r 770.460.3356
Coach/Instructor name: ___________________________________________________ School Name: __________________________________________________________ Address: _______________________________________________________________ City: ______________________________ State: ___________ Zip: ________________ Country: ____________________ Phone: ____________________________________ Email: _________________________________________________________________ Please read Team Forms competition rules and requirements before submitting your Team's registration form and payment. Minimum of 3 and maximum of 5 per team. Name
Belt Color
1.
2.
3.
4.
5.
LIABILITY WAIVER In consideration of your acceptance of my registration, I do hereby, for myself, heirs, executors, and administrators waive, rel ease, and forever discharge any and all rights cl aims for damages which I may have, or which may accrue to me, against 2015 Yong-ln University International Tournament and for its state and district associations, 2015 Yong-l n University International Tournament, or their respective officers, agents, representatives, successors, and/or assigns, and against any competitors for any and all damages which may be sustained by me in connection with my association with my participation in or entry in the above athletic meet and competition, and in connection with any medical service I may be provided in connection with any such injury or illness. I understand Tae Kwon Do is a body contact sport and I further understand all contents of the 2015 rules and relations and general information which was published by the sponsors and I agree wi th them in their entirety. I further understand that I may be dismissed from the premises Wi thout compensation of refund if my conduct is not courteous and cooperative for the successful operations of the championshi ps.
Friday, 7 August 2015 and Saturday, 8 August 2015, Duluth, G A
TEAM SPARRING REGISTRATION FORM ($150 per team)
Registration must be postmarked no later than Wednesday, 29 July 2015.
NOTE: All participants must complete a COMPETITOR REGISTRATION FORM and MEDICAL QUESTIONNAIRE to complete their registration and receive credentials.
Payments must be in form of certified check or money order payable to "Yong-ln 15" (no personal checks).
Mail to:
Did you include:
C/O Master Shim’s WCTKD
D Team Registration Form D Payment ($ 150 per team)
834 Glynn St. S #200
Turn in form and payment to school instructor.
Yong-ln University Presidential Cup
Fayetteville, GA 30214 USA For any registration questions, please contact M r s . J e n n i f e r P a r l i e r at a t l a n t a t k d @ h o t m a i l . c o m o r 770.460.3356
Coach/Instructor name: ___________________________________________________ School Name: __________________________________________________________ Address: _______________________________________________________________ City: ______________________________ State: ___________ Zip: ________________ Country: ____________________ Phone: ____________________________________ Email: _________________________________________________________________ Please read Team Forms competition rules and requirements before submitting your Team's registration form and payment. Minimum of 3 and maximum of 5 per team. Name
Weight
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LIABILITY WAIVER In consideration of your acceptance of my registration, I do hereby, for myself, heirs, executors, and administrators waive, rel ease, and forever discharge any and all rights cl aims for damages which I may have, or which may accrue to me, against 2015 Yong-ln University International Tournament and for its state and district associations, 2015 Yong-l n University International Tournament, or their respective officers, agents, representatives, successors, and/or assigns, and against any competitors for any and all damages which may be sustained by me in connection with my association with my participation in or entry in the above athletic meet and competition, and in connection with any medical service I may be provided in connection with any such injury or illness. I understand Tae Kwon Do is a body contact sport and I further understand all contents of the 2015 rules and relations and general information which was published by the sponsors and I agree wi th them in their entirety. I further understand that I may be dismissed from the premises Wi thout compensation of refund if my conduct is not courteous and cooperative for the successful operations of the championshi ps.
Friday, 7 August 2015 and Saturday, 8 August 2015, Duluth, G A
SCHOOL DEMO TEAM REGISTRATION FORM (Team coach must complete this form, requires minimum of 10 students and maximum of 18 students, ages less than 18}
Registration must be postmarked no later than Wednesday, 29 August 2015. NOTE: All participants and coaches must complete their appropriate REGISTRATION FORM and MEDICAL QUESTIONNAIRE to complete their registration and receive credentials.
Payments must be in form of certified check or money order payable to "Yong-ln 15" (no personal checks).
Mail to:
Did you include:
Yong-ln University Presidential Cup
D Demonstration Team Registration Form D Payment ($300 per team)
C/O Master Shim’s WCTKD
834 Glynn St. S #200
Fayetteville, GA 30214 USA For any registration questions, please contact Mrs. Jennifer Parlier at
[email protected] or 770.460.3356. IMPORTANT: IF ANY INFORMATION IS MISSING APPLICATION WILL NOT BE PROCESSED.
Coach/Instructor name: ___________________________________________________ School Name: __________________________________________________________ Address: _______________________________________________________________ City: ______________________________ State: ___________ Zip: ________________ Country: ____________________ Phone: ____________________________________
Email: _________________________________________________________________
Name
Birthday
Name
Birthday
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LIABILITY WAIVER In consideration of your acceptance of my registration, I do hereby, for myself, hei rs, executors, and administrators waive, release, and forever discharge any and all rights clai ms for damages which I may have, or which may accrue to me, against 2015 Yong·I n University International Tournament and for its state and district associations, 2015 Yong·In Uni v ersity International Tournament, or their respective officers, agents, representatives , successors, and/or assigns, and against any competitors for any and all damages which may be sus· tained by me in connection with my association with my participation in or entry in t h e above athletic meet and competition, and in connection wit h any medical service I may be provided in connection w it h any such injury or illness. I understand TaeKwonDo is a body contact sport and I further understand all contents of the 2015 rules and regulations and general information which was published by the sponsors and I agree with them in their entirety. I further understand that I may be dismissed from the premi s es without compensation of refund if my conduct i s not courteous and cooperative for the successful operations of the championships.
THE 7 TH YONG-IN UNIVERSITY PRESIDENTIAL CUP
International TaeKwonDo Championship
Friday, 7 August 2015 and Saturday, 8 August 2015, Duluth, G A
COACHING REGISTRATION FORM
Registration must be postmarked no later than Wednesday, 29 July 2015.
Payments must be in form of certified check or money order payable to "Yong-ln 15" (no personal checks).
Mail to:
Did you include:
Yong-ln University Presidential Cup C/0 Master Shim’s WCTKD 834 Glynn St. S #200 Fayetteville, GA 30214 USA
D Registration Form D Payment $40
Turn in form and payment to school instructor.
For any registration questions, please contact M r s . J e n n i f e r P a r l i e r at a t l a n t a t k d @ h o t m a i l . c o m o r 7 7 0 . 4 6 0 . 3 3 5 6 .
PLEASE PRINT ALL INFORMATION
Last Name:
First Name:
Middle Initial:
Address:
City:
State:
Zip:
Home Phone: ( )
Age: Email Address: TKD School Name:
Gender:
Belt Rank:
_____________________________
________________
Address:
City:
State:
Zip:
Phone: ( ) ________
Instructor or Master: School Website:
_____________________________
_____________________________________
School Email:
All coaches must leave the competition floor immediately after completion of his/her competitor’s match. The organizing committee reserves the right to suspend the coach’s pass for failure to abide by the rules. .
LIABILITY WAIVER In consideration of your acceptance of my registration, I do hereby, for myself, heirs, executors, and administrators waive, rel ease, and forever discharge any and all rights cl aims for damages which I may have, or which may accrue to me, against 2015 Yong-ln University International Tournament and for its state and district associations, 2015 Yongl n University International Tournament, or their respective officers, agents, representatives, successors, and/or assigns, and against any competitors for any and all damages which may be sustained by me in connection with my association with my participation in or entry in the above athletic meet and competition, and in connection with any medical service I may be provided in connection with any such injury or illness. I understand Tae Kwon Do is a body contact sport and I further understand all contents of the 2015 rules and relations and general information which was published by the sponsors and I agree wi th them in their entirety. I further understand that I may be dismissed from the premises Wi thout compensation of refund if my conduct is not courteous and cooperative for the successful operations of the championshi ps.
Coach’s Signature: _________________________________________________________ Date: / / Parent/Legal Guardian Signature: _____________________________________________ Date: / / (if coach’s age under 18)
The Official Headquarters Hotel Holiday Inn at Gwinnett Center
Welcome to Holiday Inn Gwinnett Center Hotel, located on the campus of the Gwinnett Center and the Arena at Gwinnett Center, home of the Gwinnett Gladiators and many other Gwinnett Arena Events. The Holiday Inn Gwinnett Center, a Duluth GA hotel is located NE of Downtown Atlanta via I-‐85, 7 miles from the Mall of Georgia, close to the Gwinnett Civic Center, Gwinnett Convention Center and 3 miles from the Gwinnett Place Mall. Gwinnett County offers a wide variety of recreational activities such as golf and tennis, which are located within 2 miles of the Holiday Inn Gwinnett Center, a Lawrenceville GA hotel. The hotel is also close to the University of Georgia (UGA) Bulldogs Stadium. Each one of our 143 beautifully appointed guest rooms was designed to make your stay comfortable and productive whether it be for business of pleasure. We are proud to offer complimentary high-‐speed Internet access. During your stay at the Holiday Inn Gwinnett Center you can relax with a refreshing dip in our indoor pool or work out in our poolside fitness center
Standard Rooms $99 Reservations can be made by calling 888-‐269-‐9585 and using “TWD” as your group name.
6010 Sugarloaf Parkway Lawrenceville, GA 30043 (678)407-‐4223 Double Rooms $89 Complimentary Full Hot Breakfast Included
Atlanta I-‐85 Lawrenceville / Duluth
The Homewood Suites Atlanta I-‐85 Lawrenceville/Duluth is located in North East Atlanta off Interstate 85. The hotel is across the street from Discover Mills Mall, Dave & Buster’s and Medieval Times and across the highway from Gwinnett Civic Center and Arena. The hotel offers complimentary shuttle service within a three mile radius of the hotel to local businesses and attractions. Queen/Queen suite w/ sleeper sofa -‐ $89 King one bedroom suite w/ sleeper sofa -‐ $89 For registration call: 770-‐277-‐1243 and use group Master Shim’s Tae Kwon Do
1948 Day Drive Duluth, GA 30096 (770)814-‐2800 King Rooms with Pullout Sofa $89 Double Queen Rooms $89 Complimentary Full Hot Breakfast Included
$95 King or Double Room Complimentary wireless high-‐speed internet access Refrigerator, microwave, coffee maker, hair dryer, iron and ironing board Reservations can be made by calling (770)495-‐7600 Use: Yong In University Presidential Cup
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A Mission you can Believe in…. …A Charity you can Trust
99.3% of all Donations to Midwest Food Bank goes to support those in need. Charity Navigator’s Highest rated Food Bank in the U.S. (770) 486-1103 peachtree.midwestfoodbank.org