FEDERACIÓN PUERTORRIQUEÑA DE JUDO
Dirección: A-C Comité Olímpico Apartado 8 San Juan, Puerto Rico 00902
Telefax  (787) 723-3890 - Fax: (787) 723-5558 Celular
787-548-0039
E-mail: ippon1@coqui.net

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PANAMERICAN JUVENILE AND JUNIOR CHAMPIONSHIPS
Carolina, Puerto Rico
March 24th - 29th, 200
4

NUMERIC REGISTRATION FORM

Send this form before February 09, 2004

NATIONAL FEDERATION FROM: __________________________________

Participating Crew (     )    
No Participating Crew (     )    
       
Number of  Competitors: (           )                = Male (        ) Female (        )
Number of Coaches: (           )    
Number of Referees: (           )    
Physicians: (           )    
Others: (           )    
TOTAL: (           )    
Transportation Medium: By Air (           ) By Earth   (        )  


Signature:
______________________________
Stick:
President of the National Federation

Pone number: _______________________    E-mail:________________________

Date:______________________

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FEDERACIÓN PUERTORRIQUEÑA DE JUDO
Dirección: A-C Comité Olímpico Apartado 8 San Juan, Puerto Rico 00902
Telefax  (787) 723-3890 - Fax: (787) 723-5558
Celular (57-3) 310/493 0252 – 315/552 3335 – 315/571 8464 - E-mail: ippon1@coqui.net

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PANAMERICAN JUVENILE AND JUNIOR CHAMPIONSHIPS
Carolina, Puerto Rico
March 24th - 31th, 200
4

NOMINAL AND FINAL REGISTRATION FORM.

Send this form before February 16, 2004

NATIONAL FEDERATION FROM: ______________________________

Junior 15 and 16 years old  (Born in 1988 and 1989)

Cat.( M )   First Name and Last Name                         Birth Date                             Belt:           

-51 kg       __________________________        ________________        _____________

-55 kg       __________________________        ________________        _____________

-60 kg       __________________________        ________________        _____________

-66  kg       __________________________        ________________       _____________

-73  kg       __________________________        ________________       _____________

-81 kg       __________________________        ________________        _____________

-90 kg       __________________________        ________________        _____________

+90 kg      __________________________        ________________        _____________

Cat.( F )   First Name and Last Name                         Birth Date                             Belt:           

-40 kg       __________________________        ________________        _____________

-44 kg       __________________________        ________________        _____________

-48 kg       __________________________        ________________        _____________

-52 kg       __________________________        ________________        _____________

-57 kg       __________________________        ________________        _____________

-63 kg       __________________________        ________________        _____________

-70 kg       __________________________        ________________        _____________

+ 70 kg    __________________________        ________________         _____________

Juvenile 17 to 19 years old, (Born in 1985, 1986, 1987)

Cat.( M )   First Name and Last Name                         Birth Date                             Belt:           

-55 kg       __________________________        ________________         _____________

-60 kg       __________________________        ________________         _____________

-66 kg       __________________________        ________________         _____________

-73  kg       __________________________        ________________        _____________

-81  kg       __________________________        ________________        _____________

-90 kg       __________________________        ________________         _____________

-100 kg     __________________________        ________________         _____________

+100 kg   __________________________        ________________          _____________

Cat.( F )   First Name and Last Name                         Birth Date                             Belt:           

-44 kg       __________________________        ________________          _____________

-48 kg       __________________________        ________________          _____________

-52 kg       __________________________        ________________          _____________

-57 kg       __________________________        ________________          _____________

-63 kg       __________________________        ________________          _____________

-70 kg       __________________________        ________________          _____________

-78 kg       __________________________        ________________          _____________

+ 78 kg    __________________________        ________________           _____________

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REFEREES:  (Show Classification)

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Coaches:

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Physician:

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Delegates - Officials – Others ( Specify Function or Role)

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TOTAL PARTICIPANTS IN THE TEAM:__________________________

Seal and Signature of the President of National Federation : _____________________ Stick

COMISIÓN DE MEDIOS

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TODO EL CONTENIDO ES COPYRIGHT© UNIÓN PANAMERICANA DE JUDO 1998

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