UNIÓN PANAMERICANA DE JUDO

UNIÃO PANAMERICANA DE JUDÔ

PANAMERICAN JUDO UNION

UNION PANAMERICAINE DE JUDO


 

7th PANAMERICAN INFANTILE JUDO CHAMPIONSHIPS
November 21th to 25th, 2007

Cali, Colombia

 

 ¡ NUMERIC INSCRIPTION ¡
Will have to be send before october 10, 2007

NATIONAL FEDERATION: __________________________________

To Participate  (     )    
Not Participate (     )    
Number of Competitors: (           )        = Male (    ) Female (           )
Number of Coach (           )        = Male (    ) Female (           )
Number of Referee    (           )        = Male (    ) Female (           )
Doctors:                                             (           )        = Male (    ) Female (           )
Others: (           )        = Male (    ) Female (           )
TOTAL: (           )        = Male (    ) Female (           )
Transportation:  By   Air (           )    By earth (          )

Signature:____________________________
National President Federation

Phone: _______________________

Date: _________________________


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7th PANAMERICAN INFANTILE JUDO CHAMPIONSHIPS
November 21th to 25th, 2007

Cali, Colombia


NOMINAL INSCRIPTION , final.
Will have to be send before October 27, 2007

NATIONAL FEDERATION: _________________________________________

                                                            (SHIAI)

MALE: (INFANTILE 11 A 12 YEARS OLD ) (Born in 1995 y 19965)

Number

Category

Last name and Name

Date of Birdth

1

-28 Kg.

    

2

-31 Kg.

    

3

-34 Kg.

    

4

-38 Kg.

    

5

-42 Kg.

    

6

-48 Kg.

    

7

-53 Kg.

    

8

+53 Kg.

    

FEMALE: (INFANTILE 11 A 12 YEARS OLD ) (Born in 1995 y 1996)
Number Category Last name and Name Date of Birdth

1

-28 Kg.

    

2

-31 Kg.

    

3

-34Kg.

    

4

-38 Kg.

    

5

-42 Kg.

    

6

-48 Kg.

    

7

-53 Kg.

    

8

+53 Kg.

    

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MALE: (INFANTILE 13 A 14 YEARS OLD ) (Born in 1993, 1994)
Number Category Last name and Name Date of Birdth

1

-36 Kg.

    

2

-40 Kg.

    

3

-44 Kg.

    

4

-48 Kg.

    

5

-53 Kg.

    

6

-58 Kg.

    

7

-64 Kg.

    

8

+64 Kg.

    

FEMALE: (INFANTILE 11 A 12 YEARS OLD ) (Born in 1993, 1994)
Number Category Last name and Name Date of Birdth

1

-36 Kg.

    

2

-40 Kg.

    

3

-44 Kg.

    

4

-48 Kg.

    

5

-53 Kg.

    

6

-58 Kg.

    

7

-64 Kg.

    

8

+64 Kg.

    

Official: (Referee, Coach, Doctor and Other)

  Name Name Name
REFEREE:      
COACH:      
DOCTORS      
OTHERS      
TOTAL MEMBERS OF THE NATIONAL TEAM      

President  Signature of the national judo federation:______________________________

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¡2007 Annual Membership and Dan Grade Form¡

(How to get the 2007 PJU Annual Membership Card)

This form must be hand in before the Technical Congress by all Federations, with no exceptions, in order to get the PJU Card:

Annual Membership and Dan Grade Form

 PJU:______      IJF:___

National Federation: ____________________

Photo No._________

 

For PJU Use Only

Certificate No. _________________   Book No. ______________________

Date: _______________________________________________________ 

Date of Form Issuance: Day________ Month_____________ Year_______  Please print or write down in clear and esay to understand hand writing. Remember that this is the data that will appear in your Memebership Card and Diplomas.

Name (Only one name allowed):____________________________________________

Last Name(Only one last name allowed):______________________________________

Place of birth: ______________________ Nationality:___________________________

Date of Birth: dd/mm/yyyy:______/_____/________ Blood Type:__________________

ID Number ___________________ (Passport)_____________       (C.I)_____________

Room Number:______________________________E-mail:_________________

Country: _________________________ Phone: _____________

Proffession:__________Academic Level in Education:________

Languages you speak: English: ____ Spanish:_____French:____Portuguese ____

Belt in Judo: __________________________ (please specify your black belt grade in numbers : 1st, 2 nd, 3 rd etc., if you are not a black belt, please specify the color of your belt). Last Date you got your Belt Recognition: ___/___/____(dd/mm/yyyy)  

Year when he started Judo: _______ Competitor_______          No competidor_________

Role: Competitor:______, Official:_______, Referee_______, Coach:_______,

           Physician______President of NF:______ NF General Secretary:________  

 

_____________________________________ 

President of Federation
(Seal of Federation and Signature of the President)

________________

Applicant’s Signature

______________________

PJU Director Signature     (PJU Seal)

 

        
 Ing. Jaime Casanova
      PJU President       		            Cr. Oscar Cassineri
     PJU General Secretary

COMISIÓN DE MEDIOS

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TODO EL CONTENIDO ES COPYRIGHT© UNIÓN PANAMERICANA DE JUDO 1998

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