PANAMERICAN JUDO UNION
USA JUDO

 

 

USA JUDO


 Miami, May 07 to 10, 2008

XXXII SENIOR PANAMERICAN CHAMPIONSHIPS MALES
XXI SENIOR PANAMERICAN CHAMPIONSHIPS FEMALES
IX JUDO PANAMERICAN CHAMPIONSHIPS TEAMS
IX KATAS PANAMERICAN CHAMPIONSHIPS
IPPON TROPHY
(Female and Male )

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FIRST NOTIFICATION
2008 Panamerican Judo Union Championships
 

Name of National Federation                                                                            

Signature of President of National Federation                                              

Total Number Attending                               

Number of Female Competitors                             

Number of Male Competitors                       

Number of Medical Staff                               

Number of VIP/Head of Delegation             

Number of Referees                                      

Number of Other Attendees                         

Telephone:                                                     

 

DUE APRIL 10, 2008!
FAX TO USA JUDO AT 719.866.4733
or
jose.h.rodriguez@usajudo.us

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2008 Panamerican Judo Union Championships

 Final Senior Shiai Roster

 

Name of National Federation:                                                                

Signature of President of National Federation                                    

List of Competitors

Given Name
(First Name)

Family Name (Surname, Last Name)

Date of Birth

Sex
(M/F)

Weight
(Kg)

City

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

List of Delegation Members & VIP’s

Given Name
(First Name)

Family Name (Surname, Last Name)

Date of Birth

Sex
(M/F)

Position (Coach, Referee, Physician, VIP, etc.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

You MUST return this form by Fax to: 719.866.4733 or jose.h.rodriguez@usajudo.us
No later than April 20, 2008

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Arrival/Departure Schedule Should Accompany this Form!
2008 Panamerican Judo Union Championships

Arrival/Departure Information

Name of National Federation:                                                                

Signature of President of National Federation                                    

Arrival Information

Date

 

Time

 

Airline

 

Flight No.

 

Number in Delegation

 

Departure Information

Date

 

Time

 

Airline

 

Flight No.

 

Number in Delegation

 

 You MUST return this form by Fax to: 719.866.4733
No later than April 10, 2008

 Please Confirm Entries With:

Mr. Frank Fullerton, Sports Director Panamerican Judo Union
Tel: 915.565.8754  FAX: 915.566.1668

or

Mr. Jose Rodriguez, CEO USA Judo
Tel: 719.866.4730 FAX: 719.866.4733 Email: jose.h.rodriguez@usajudo.us

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2008 Panamerican Judo Union Championships
Kata Competition

Katas Available for Competition:

Naga-No-Kata     Katame-no-Kata    Ju-no-Kata   

Please Mark Genders to Compete: Female (F) or Male (M).

Name of National Federation                                                  

Signature of President of National Federation                      

Tori’s Name (Last,First)

Uke’s Name (Last, First)

Kata

Gender (Male, Female)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

You MUST return this form by Fax to: 719.866.4733 or jose.h.rodriguez@usajudo.us
No later than April 20, 2008

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Accommodation Form

Hotel Room Rates: $136.00 per room per night if booked by April 1, 2008

$146.00 per room per night if booked between April 2-10, 2008

Rooms cannot be guaranteed after April 10, 2008.

NATIONAL FEDERATION:                                                                                          

SIGNATURE OF PRESIDENT OF NATIONAL FEDERATION:                                 

Room

Names

Arrival Date

Departure Date

Room #1

Name 1______________

Name 2______________

Name 3______________

Name 4______________

 

 

Room #2

Name 1______________

Name 2______________

Name 3______________

Name 4______________

 

 

Room #3

Name 1______________

Name 2______________

Name 3______________

Name 4______________

 

 

Room #4

Name 1______________

Name 2______________

Name 3______________

Name 4______________

 

 

Room #4

Name 1______________

Name 2______________

Name 3______________

Name 4______________

 

 

 Meal Request: Three Meals Per Day at $65

Number of Delegation Purchasing Meal Plan:___________

Date that meals will begin:__________

Date that meals will end:____________ 

All funds for rooms and meals must be paid to USA Judo no later than April 10, 2008 in order to guarantee these services.

Funds may be wired in US Dollars to: 
 
It count NameUSA Judo
Bank Name: Chase Bank
It count Number: 635 39 8984
Swift Code:  CHASUS33

PLEASE FAX THIS FORM TO USA JUDO AT 719.866.4733 or jose.h.rodriguez@usajudo.us

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PANAMERICAN JUDO UNION

Agreement between the Panamerican Judo Union and ____________________________

Agreement between the Panamerican Judo Union, hereinafter referred to as the PJU, and (name of competitor) , concerning the use of personal data, UF rules concerning advertisement on judogi, respect of protocol during awards ceremony, behavior off tatami and fundamental principle.

1. Personal data: I,                                                           , a competitor from _____________ , grant to the PJU the right to use the name, likeness, photograph, image, sketch, voice, recorded image and/or voice, televised image and/or voice, radio broadcast voice, signature, endorsement and performance record of the competition for promotional purposes, for the purpose of raising revenues to support PJU objectives as well as for the training, education, development of competitors, coaches and technical officials. I also grant to the PJU the right to assign such rights to such persons, firms, corporations or parties as the PJU at its sole discretion shall determine.

2. Advertisement of judogis: I, the competitor from _____________, realize and agree that I am prohibited from using advertisement on my judogi that does not meet the requirements of the International Judo Federation or utilizing a judogi that does not conform to the regulations of the International Judo Federation.

I realize that information may be received regarding the advertisement and other judogi requirements by visiting:

 

I fully understand that if my judogi is found to be in violation of the requirements of the PJU, its use will be prohibited in competition.

3. Protocol at awards ceremony and behavior on and off tatami:

I, __________________________ , the competitor from ___________________________agree that any actions, demeanor and reactions will be in accordance with the regulations and procedures of the PJU concerning the Code of Conduct on the tatami and alongside of the tatami, approved and adopted by the Governing Congress of the PJU on November 10. 2004. I understand that the following behavior will not be permitted:

a)     Non-acceptance of referee's decision by not leaving the tatami after the contest.

b)    Aggressive behavior towards referees after the contest.

c)     Refusing to receive medal/certification at the Awards Ceremony.

d)     Displaying or attempting to display a national flag or other items (such as wearing a capor displaying propaganda) at the Awards Ceremony.

e)     Designated areas to be respected.

f)      Appropriate behavior concerning food/beverages.

g)     Coaching from the coach's chair.

h)    Showing disrespect to fellow competitors.

i)      Removing the judogi, or any part thereof, and throwing on tatami or onto floor once off the tatami.

j)      Making gestures and uttering loud noise.

I understand that I may be disqualified from future competition in this tournament where prohibited act was committed, as well as in future tournaments or activities of the PJU.

4. Fundamental principle: I will respect and accept the authority of the PJU officials, the statutes, the sports and organization rules and the refereeing rules of the PJU related to the 2008 Panamerican Judo Union Championships.

 

In the event it is deemed that I have acted against the PJU, its principles or purpose, I understand that I shall be subject to suspension and/or expulsion from the 2008 Panamerican Championships and/ or cancellation of my accreditation card.

This agreement will terminate at the end of the 2008 Panamerican Championships.


 

                                         _____________________________                            _____________________________
                                                         Competitor                                                             Panamerican Judo Unión

                                                                                   Date: ___________________

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Panamerican Judo Union

Name of Event:                                                                         

Place of Event:                                                                          

Date:                                                                                      

 WARNING, WAIVER AND RELEASE OF LIABILITY AND AGREEMENT TO PARTICIPATE

In consideration of being permitted to participate in any way, including travel to and from the                                           related events and activities of the PJU, National Federation and others (add name of organization)                                         I hereby:

1. Acknowledge that I am familiar with the sport of Judo and understand the rules governing the sport of Judo.

 2. Agree that prior to participating, I will inspect the mats, equipment, facilities, competition pools or divisions and the elimination or scoring system to be used, and if I believe anything is unsafe or beyond my capability, I will immediately advise my coach, supervisor, and/or a tournament official of such condition and refuse to participate.

3.  Acknowledge and fully understand that I will be engaging in a contact sport that might result in serious injury, including permanent disability or death, and severe social and economic losses due to not only my own actions, inactions, or negligence, but also the actions, inactions or negligence of others, the roles of the sport of judo, or conditions of the premises or of any equipment used. Further, I acknowledge that there may be other risks not known to me or not reasonably foreseeable at this time.

4.  Knowing the risks involved in the sport of Judo, I assume all such risks and accept personal responsibility for the damages following such injury, permanent disability or death.

5.   Affirm that I am in good physical condition and have no injury, disease or disability nor have I injected or ingested anything that would impair my performance or physical condition or increase the likelihood of injury in competing or participating in this event

6.   Release, waive, discharge, covenant not to sue and agree to indemnify and hold harmless the PJU, together with its affiliated clubs, their respective administrators, directors, agents, coaches and other employees or volunteers of the organization, event officials, medical personnel, other participants, their parents, guardians, supervisors and coaches, sponsoring agencies, sponsors, advertisers, and if applicable, owners, lessors, and lessees of premises used to conduct the event, all of whom are hereinafter referred to as "releasee,” from any and all claims, demands, losses, actions, cost, expense and demand, or damages on account of injury, including permanent disability and death and damage to property, caused or alleged to be caused in whole or in part by the negligence of the releasee or otherwise to the fullest extent permitted by law, arising out of or in connection with my competing or participating in this event. No physician, nurse therapist, trainer, manager or other person has advised me not to compete or participate in a body contact sport or in this event.

I HAVE READ THE ABOVE WARNING, WAIVER AND RELEASE OF LIABILITY AND AGREEMENT TO PARTICIPATE, UNDERSTAND THAT I GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND KNOWING THIS, SIGN IT VOLUNTARILY. I AGREE TO PARTICIPATE KNOWING THE RISK AND CONDITIONS INVOLVED AND DO SO ENTIRELY OF MY OWN FREE WILL.

                                                                                                                                                                       
                                               Participant's Printed Name
                                  Participant's Signature

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FOR PARENTS/GUADIANS OF PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT TIME OF REGISTRATION)

 

This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release, as provided above, of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child's involvement or participation in these programs as provided above, even if arising from their negligence, to the fullest extent permitted by law. I have instructed the minor participant as to the above warnings and conditions and their ramifications.

Parent / Guardian__________________________

Date____________________________________

Witness__________________________________

Date___________________________________

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PANAMERICAN JUDO UNION

POWER OF AITORNEY

Name of event: _______________________

Place of event: _____________________________________________________________

Date of event: ___________________________________

If competitor is under the age of 18 years, this document must be completed by the competitor's parent or legal guardian if the parent or legal guardian is not attending the Championships.

                                                                                                                                                                        I certify that I am the parent or legal guardian of _________________________________________    

who is a minor. I will not be in attendance at the Championships and do hereby designate __ _____________ _________who is over 21 years of age, to be my true and lawful attorney, to act in my name, place and stead, to do any and every act and exercise any power that I might or could do or exercise through any other person and that he/she shall deem proper or advisable, intending hereby to vest in the person acting for me full power and authority to do and perform all and every act and thing.


Signature of parent or legal guardian                                                                 Date                                                      

Witness
                                                                              Date                            

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    Ing. Jaime Casanova M.
             President
    Cr. Oscar O Cassineri
    General Secretary

COMISIÓN DE MEDIOS

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Si tiene alguna pregunta o comentario, por favor envíe su e-mail 
TODO EL CONTENIDO ES COPYRIGHT© UNIÓN PANAMERICANA DE JUDO 1998

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