CAMPEONATOS
PANAMERICANOS DE JUDO SENIORS
Isla de
Margarita, Venezuela
24 al 29 de Marzo del 2004
NUMERIC REGISTRATION
This form must be sent before March 15th, 2004
NATIONAL FEDERATION: __________________________________
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Participating Crew |
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Not Participating Crew |
( ) |
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Number of competitors: |
( ) = |
Male ( ) |
Female ( ) |
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Number of coaches: |
( ) |
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Number of referees: |
( ) |
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Physicians: |
( ) |
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Others: |
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TOTAL: |
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Transportation medium: |
By Air ( ) |
By Land ( ) |
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Signature:______________________________
President of National
Federation.
Pone Number: _______________________
E-mail:________________________
Date:______________________
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CAMPEONATOS
PANAMERICANOS DE JUDO SENIORS
Isla de
Margarita, Venezuela
24 al 29 de Marzo del 2004
NOMINAL INSCRPTION, final.
This form must be sent before March 26th, 2004
NATIONAL FEDERATION OF: ______________________________
Cat.( M ) First Name and Last Name Date of Birth Belt:
-55 kg _________________________ ________________ ____________
-60 kg _________________________ ________________ ____________
-66 kg _________________________ ________________ ____________
-73 kg _________________________ ________________ ____________
-81 kg _________________________ ________________ ____________
-90 kg _________________________ ________________ ____________
-100 kg _________________________ ________________ ____________
+100 kg _________________________ ________________ ____________
Cat.( F ) First Name and Last Name Date of Birth Belt:
-44 kg _________________________ ________________ ____________
-48 kg _________________________ ________________ ____________
-52 kg _________________________ ________________ ____________
-57 kg _________________________ ________________ ____________
-63 kg _________________________ ________________ ____________
-70 kg _________________________ ________________ ____________
-78 kg _________________________ ________________ ____________
+78 kg _________________________ ________________ ____________
Participating
in the Team Competition:
___ Yes ___ No Male:___ Female:___
Participating in the Kata Competition:
Female:
Nage No Kata_____ Katame no Kata ____ Ju No kata___
Male:
Nage No Kata_____ Katame no Kata ______ Ju No kata_____
REFEREES: (Show Classification)
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Coaches:
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Physician: --------------------------------- ------------------------------------------------
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 : ______________
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TODO EL CONTENIDO ES
COPYRIGHT© UNIÓN PANAMERICANA DE JUDO 1998
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