USA Judo Junior 2005

2005 Junior U.S. Open Judo Championships
(Formerly the U.S. Junior and Youth International)
Held under the Sanction of United States Judo, Inc.; Number 2005-006
August 5-7, 2005


Hosted by:	Hialeah/Budokan Judo Club
Sponsored:	Zebra Mats, Ft. Lauderdale Convention and Visitors Bureau
Tournament Headquarters:	The Embassy Suites-Fort Lauderdale 1100 SE 17th St, Ft Lauderdale Florida Tel: 954-527-2700 http://www.ftlauderdale.embsuites.com
Training Camp:	August 2, 3, 4, 2005
Competition Site:	Ft. Lauderdale Convention Center
Weigh-in:	August 5; 12-4 PM Junior (under 15) and Cadets (under 17) August 6; 1-4 PM Juvenile-1&2 (under 11 & 13) and Youth (under 20)
Competition Date:	August 6 Junior (under 15) and Cadets (under 17) August 7 Juvenile-1&2 (under 11 & 13) and Youth (under 20)
Tournament Co-Directors:	Gerry Navarro and John Miller Gerry: 16131 N.W. 12 Street; Pembroke Pines, FL; 33028; (954) 435-6976 / Fax: (954) 435-6976; gerrynavarro@aol.com John: 303-237-0063; jonmira@aol.com
Referee Commission:	Dr. Mel Applebaum, others to be announced


Category	Age in 2005	Year of birth
Juvenile – 1	under 11 years old	Born 1995 or later
Juvenile – 2	under 13 years old	Born 1993 or later
Junior	under 15 years old	Born 1991 or later
Cadet	under 17 years old	Born 1989 or later
Youth	under 20 years old	Born 1986 or later

A copy of this entry package can be found at: http://www.judonationals.com

Contact Zebra mats at: http://www.zebramats.com
for information on purchasing the mats used at this event at a substantial discount.

New Elimination System: A modified Double Elimination System will replace the Repechage system. This new system will insure that all athletes have at least two (2) matches. The Gold and Silver medals will be determined as in past years, by a single-elimination system (or round robin for divisions of 5 athletes or fewer.) All losers will compete in a loser’s pool. The final two matches will be between the last two remaining athletes in the loser’s pool and the losers of the semifinals. The two winners of those matches will be awarded third place; the two losers will be awarded fifth place. See “Method of Competition” section elsewhere in this package for a complete description.

Pan American Judo Union Membership Requirement: The Junior US Open has been designated an official Pan American Judo Union (PJU) Junior Circuit Event. As such, the Pan American Judo Union requires that all competitors and officials be members of the PJU. For membership requirements, Officials shall include: Coaches, Delegates, Doctors, Physiotherapists, etc., as well as the Federation members who appear in the Team’s Registration form. This is an annual requirement.

a. Competitors US $20 (Twenty American Dollars)
b. Officials US $30 (Thirty American Dollars)

PJU Dan Grade (Black Belt) registration requirement: Because the Junior US Open has been designated an official PJU Junior Circuit event, the PJU requires that all competitors who hold black belt rank, register that rank with the International Judo Federation (IJF) and the PJU. This is a one-time registration requirement.

The cost of the PJU Dan Grade Recognition as well as the request for application to the IJF level of Dan Grade Recognition will be US $60 (Sixty American dollars). The cost of PJU Recognition for those who already have the IJF Recognition will be US $20 (Twenty American dollars.)

These fees are IN ADDITION to the tournament entry fee and will be collected at the event by officials from the Pan American Judo Union.

If athletes and officials wish to pay these fees and receive membership and dan grade recognition in advance, forms and instructions can be obtained at USA Judo’s website: http://www.usjudo.org/forms

Athletes must compete for the country of which they are a citizen and must present a letter from their country’s federation stating that they are a member in good standing and have the Federation’s permission to compete. Proof of Citizenship must be presented at Tournament Check-in. Passports are mandatory for all citizens of countries other than the United States.

A U.S. Citizen may participate if he or she is a current member in good standing of United States Judo, Inc. United States citizens must present either a passport or a birth certificate.

Individuals who are not citizens of any country, but are authorized by the Department of Justice of the United States to remain in the United States, may participate by meeting the criteria listed above for U.S. Citizens.

All athletes must meet the age and weight requirements. Proof of age must be shown. All individuals must also submit all required documents and pay the appropriate entry fee.

U. S. Citizens having questions regarding eligibility should contact; Mr. Leo White; Chairman, National Coaching and Training Subcommittee; Leo White; 4371 Weston Drive; Lilburn, GA 30047-3168; 678-924-6960 H678-924-1161; email Leo209@mindspring.com

Cost: $90.00 per person. Cost DOES NOT include Hotel or Meals. Refer to camp entry form for details.

The Embassy Suites-Fort Lauderdale; 1100 SE 17th St; Ft Lauderdale Florida
Tel: 954-527-2700 http://www.ftlauderdale.embsuites.com/
The Hotel package includes: $93.00 plus 11% tax per night includes up to four people; Full breakfast for up to four people; Transportation to and from the airport; Transportation to and from the tournament venue; A happy 2-hour 5-7 pm free cocktails and drinks.

Reservations must be made by July 2, 2005. State you are with the Judo Championships.

Early Registration: The official entry form and all other required forms must be fully completed, properly signed, appropriate fees enclosed, and mailed to the address stated on the entry form, postmarked no later than July-05, 2005.

Entry Fee: Entry fee for early-registered contestants is $70.00. Personal Checks, Business Checks, Money Orders, Traveler’s Checks, Certified Checks, Cashier’s Checks only. Checks should be made payable to 2005 Jr. US Open Judo Championship. DO NOT MAIL CASH.

All contestants will receive a commemorative t-shirt free of charge.
Extra t-shirts can be obtained at a discount using the order form in this package.

Incomplete Entry Materials: Entries with incomplete or missing information will be considered late entries unless the required material is received before Tournament Check-in. See below for confirmation of registration.

Late Registration: Official entry forms postmarked between July 06, and July 28, 2005, inclusively, will be considered late entries. Late entries must pay an entry fee of $90.00. Absolutely no entries should be mailed after July 28, 2005. All other entries should be hand carried to the tournament for Friday or Saturday August 5 or 6, 2005 check-in, and will be considered walk-up registrations with an entry fee of $100.00.

Walk-Up Registration: Contestants who have not-registered early, may do so during Tournament Check-in. All forms must be properly completed and signed at that time and the walk-up registration fee of $100.00 will be expected. Cash, Money Orders, Traveler’s Checks, Certified Checks, Cashier’s Checks ONLY. Personal or Business Checks will not be accepted for walk-up registration.

Tournament Check-In: All Athletes must check-in with tournament officials, in person, at the tournament headquarters during one of the time periods listed in the schedule of events in order to confirm participation and competition categories. During Tournament Check-in, all late or incomplete registrations will be required to properly complete all forms and pay the appropriate fees.

All required forms must be properly completed and signed and the appropriate entry fees paid regardless of when the player registers. Refer to the checklist of required items listed elsewhere in this flyer.

Because of security concerns at the port of Ft. Lauderdale, the convention center is requiring a photo ID for all athletes. Athletes must enclose a passport sized photo for use on the Tournament Identification Card. This photo can be a standard passport photo or a paper print of a digital photo. Tournament ID cards will be ready at check-in. Those who do not send a photo will experience delays at Check-in and will be charged a $5.00 fee to have a photo taken.

The Championships will be conducted in accordance with the Contest Rules, Organization Code and Sporting Code of the International Judo Federation, as revised for the 2005 Jr. US Open Judo Championship. These rules include, but are not limited to draw, weigh-in, length of contests, and competition procedures.

· Determination of Weight Category: Athletes are asked to make a preliminary declaration of weight on the entry form or at check-in/registration. However, in this tournament the athlete’s actual weight at weigh-in will determine the category of competition, i.e. the athlete does not have to “make” the declared weight.

· Shime-waza rule: Shime-waza (choking) allowed in Junior, Cadet, and Youth categories only.

· Kansetsu-waza rule: Kansetsu-waza (arm locks) allowed in Youth (IJF-Junior) category only.

· Injury Rule: Decisions as to whether an athlete may continue if injured while on the mat, are to be resolved in accordance with IJF rules; such decisions occurring off the mat or not covered by the IJF rules, are to be made by the coach, the athlete, and the Team Doctor. If there is not a unanimous opinion among these three individuals, the athlete may not continue (Board-approved October 22, 1998.)

· Match lengths: Juvenile 1, 2, Junior 3 minutes
Cadet and Youth: 5 minutes

· Judo gi color: Although optional, USA Judo encourages the wearing of a Blue judo gi by the “blue” side competitor. The “white” side competitor must wear a white judo gi. Competitors are responsible for appearing in the correct color gi. Under no circumstances shall both competitors be allowed to compete in blue gis, nor will the blue and white competitors be allowed to switch positions. The gi jacket and pants must be the same color; no mixing of colors. In all matches where the both competitors are wearing white gis, both competitors will remove their grade belts and wear a blue or white belt to identify the contestant’s designated color for the match.

COMPETITORS AND THEIR COACHES ARE RESPONSIBLE FOR PROVIDING THEIR OWN BLUE AND WHITE BELTS FOR THIS COMPETITION. THIS RULE WILL INSURE THAT THE BELTS FIT PROPERLY. PLEASE MARK YOUR BELTS WITH YOUR NAME OR CLUB.

· Divisions will be posted for coach/player inspection as soon as possible after the close of weigh-ins on each day. 1 hour later, any necessary corrections will be made, the draw will be performed, and brackets, with match numbers will be posted.

· Authorized coaches will be given admission onto the venue floor. One coach per contestant.

· In the Youth (under 20 Yrs.) category ONLY, the top 4 athletes on the USA Judo IJF Junior National Roster will be seeded, according to the current USA Judo seeding procedures.

· The draw will be conducted by approved computer software and will be random with the provision that athletes from the same country will be separated as far apart in the pools as possible.

· The Texas Match Scheduling system will be used. Contestants will receive a card specifying their contest area number and match number. All contestants are expected to report to their assigned contest area 3 matches prior to their assigned match number

1. Categories having five (5) Competitors or less: Round Robin Pool (every competitor competes against every other competitor). The order of finish is determined by number of wins, then, if tied, by total points (Ippon=10, Waza-ari=7, Yuko=5, Koka=3, Decision=1). If tied in wins and points, the winner of the head-to-head competition between the two who are still tied determines the winner. If three or more are still tied in wins and points for any place (first, second, or third), those contestants involved must contest again to determine the order of finish.

2. Categories having six (6) competitors or greater: Modified Double Elimination. Players are divided into two pools, A and B by means of a draw (described above.)
Determination of 1st and 2nd place: The "knockout" (single elimination) system is used to produce two finalists, who will compete for 1st & 2nd place.
Determination of 3rd - 5th place: All contestants who were defeated before the semifinals will compete in a consolation bracket (referred to as a loser’s pool). Athletes will be placed in the losers pool in a way that attempts to keep those who met in the “winners” pool from meeting again, although depending on the size of the division, this will not always be possible. The losers of the semifinals will fight in the last two matches of the loser’s pool. The winners of those two matches (2) will be placed 3^rd, the losers (2) will be placed 5^th.

For the IJF Junior (Youth, under 20) Categories only, testing, in accordance with procedures of the U.S. Olympic Committee may be conducted by the United States Anti-Doping Agency (USADA) - the independent testing agency for Olympic sports in the United States. In the event there is a question concerning whether or not a substance is on the list, you may call the Drug Reference Hotline at 1-800-223-0393. If you prefer, you can send your correspondence and inquiries to: United States Anti-Doping Agency, 1265 Lake Plaza Dr., Colorado Springs, CO 80906. Other useful information can be found by visiting USADA's website: http://www.usantidoping.org/

Six (6) or more competitors: First, Second, and two (2) Third place medals will be awarded.
Five (5) or less competitors: First, Second, and one (1) Third place medals will be awarded.

Special cash awards will be presented to the following special awards winners who will be selected from the Youth (under 20) Categories:

Listed below are the age and weight categories of competition. Please note that each age Category is based solely on the year in which the contestant was born. The contestant’s actual age on the day of competition is irrelevant. For each category, a contestant must be under the listed age, or younger, during the entire of 2005. Thus, a player who becomes 20 years of age anytime during 2005 is not eligible to compete in the “under 20 years” Category; a player who becomes 17 years of age anytime during 2005 is not eligible to compete in the “under 17 years” Category; etc.

All Weights listed below are in kilograms. For each weight division, the weight range will be over the next lower weight and up to and including the weight listed. Exception: PJU lightweight in the Youth Category (explained below).

Example: Under 13; Juvenile 2, 34 kg – over 31 kg and up to and including 34 kg.

The Tournament Director reserves the right to make changes in the highest and lowest weight classes in the Juvenile 1 and 2 divisions when it is in the best interest of the contestants to make these changes due to differences in weights.

Under 20 years (Youth)	M	55	60	66	73	81	90	100	+100 Kg
Born 1986 or later	F	44	48	52	57	63	70	78	+78 Kg
Under 17 (Cadet)	M	51	55	60	66	73	81	90	+90 Kg
Born 1989 or later	F	40	44	48	52	57	63	70	+70 Kg
Under 15 (Junior)	M	36	40	44	48	53	58	64	+64 Kg
Born 1991 or later	F	36	40	44	48	53	58	64	+64 Kg
Under 13 (Juvenile- 2)	M	28	31	34	38	42	48	53	+53 Kg
Born 1993 or later	F	28	31	34	38	42	48	53	+53 Kg
Under 11 (Juvenile – 1)	M	26	30	34	38	43	+43	Kg
Born 1995 or later	F	26	30	34	38	43	+43	Kg

The Youth Category is also referred to as the IJF-Junior Category and is equivalent to the International Judo Federation Junior-World Category. This means that there is no lower age limit. Athletes may enter if they are born in 1986 or later (1986, 1987, 1988, 1989, 1990, etc.).

1. The Pan American Judo Union (PJU) lightweight divisions, 44kg for women, and 55kg for men, will still be contested for PJU team selection purposes. Athletes whose weight would normally place them in these PJU divisions may elect to compete in the next higher weight divisions for Team selection purposes.

2. For some PJU events, eligibility is restricted to athletes born in 1986, 1987 or 1988 only. Therefore, athletes who are nationally ranked in the IJF-Junior Category but do not meet the PJU year of birth requirements, will not be eligible for USA team selection in such events.

The following is a general schedule of events. All dates and days of the week are final. However, the times listed are approximate and the Organizing Committee reserves the right to change these, if necessary. The final schedule will be provided to delegations, officials, and athletes upon arrival.

International Training Camp Final Training camp schedule will be provided upon arrival

Friday, August 5, 2005
      0930-1500 (9:30 am - 3:00 pm):   Tournament Check-in. All athletes must check-in with tournament officials, in person, at the tournament headquarters hotel to confirm participation and make a final declaration of weight Category.
     1200-1600 (12:00 pm - 4:00pm):  Official Weigh-in for Junior (under 15 years.) and Cadet (under 17 years.) Categories ONLY. Contestants may check weight as many times as desired prior to the start of the official weigh-in. During official weigh-in, a contestant is given only one chance on the scale.
      1700-1800 (5:00 pm - 6:00pm):     Referee meeting
      1800-1900 (6:00 pm - 7:00pm):     Technical (Coaches) Meeting
Saturday, August 6, 2005
      0930 (9:30 A.M.):                              Eliminations (all matches except medal matches)
                                                                 Junior (under 15 yrs.) and Cadets (under 17 yrs.)
     1300-1600 (1:00 pm - 4:00pm)   Official Weigh-in for Juvenile 1 & 2 (under 11 & 13 yrs.) and Youth (under 20 yrs.) Categories ONLY. Contestants may check weight as many times as desired prior to the start of the official weigh-in. During official weigh-in, a contestant is given only one chance on the scale.
      1600 (4:00 P.M.)                             Opening Ceremony
                                                                Medal matches follow Opening Ceremonies
                                                                Order of matches will be determined after preliminary rounds.

0930 (9:30 A.M.):                            Eliminations (all matches except medal matches)
                                                          Juvenile 1&2 (under 11 & 13 yrs.) and Youth (under 20 yrs.)
Medal matches will occur 1 hour following the end of the eliminations.
Order of matches will be determined after preliminary rounds.
Awards:                                            Following the medal matches.
Closing ceremonies:                      Following the awards.
Social Function:                              A party will follow the closing ceremony for athletes, coaches, and officials at no cost.

To assure the requirements for participation in the Championships have been fulfilled, the following forms must be completed and Postmarked by July 05, 2005 at the address printed at the bottom of this page.

q Official Entry Form and $70.00 Entry Fee ($90 if postmarked between July 06, 2005 and July 28, 2005, inclusively; $100.00 walk-up entry fee; DO NOT mail entries after July 28, 2005)

q Copy of current USA JUDO membership card. If membership is not current, circle at the bottom of the entry form “Will bring current membership card to event” or “Will purchase membership at event.”

q Passport size photo for use on Tournament Identification Card (required by the convention center). Standard photo or print of digital photo. If no photo is enclosed, you will experience a delay at check-in and will be charged $5.00 to have a photo taken.

q Proof of Age: Copy of birth certificate, passport, or USA JUDO membership card having the verification symbol “(V)” printed following the birthdate. A driver’s license is not proof of age!

q Power of Attorney: Required for participants under the age of 18 years whose parent/guardian will not be attending the championships.

Copy of rank certificate, OR,
Certificate Regarding Non-Black Belt Contestants

NOTE: A copy of your current USA JUDO membership card having the rank verification symbol “(V)” printed following the rank will serve as proof. In addition, rank cards issued by the USJF or USJA National Offices will serve as proof.

NOTE: Don’t forget to include your check, money order or cashier’s check in the amount of $70.00 made to: 2005 Jr. US Open Judo Championship, postmarked by July 05, 2005 ($90 if postmarked between July 06, and July 28, 2005, inclusively). DO NOT mail entries after July 28, 2005.

NOTE: A self-addressed, stamped envelope must be included to receive confirmation of Entry Form received and notification of any missing items.

Forward all forms and fees to:

Gerry Navarro;16131 N.W. 12 Street; Pembroke Pines, FL 33028-1206
Voice: 954-435-6976 / Fax: 954-435-6976
Email: Gerrynavarro@aol.com

Last Name (Family Name, Surname):

First Name:

Street Address:

City::

State

Zip Code:

Country:

Judo Club:

Coach’s Name:

Telephone (Voice):

Fax:

USA Judo (USJI) Membership Number (U.S. Athletes): ***

Date of Birth (month/day/year):

Circle the category in which you wish to compete. Circle One Category and One Weight only!

Mr. Leo White; Chairman, National Coaching and Training Subcommittee

4371 Weston Drive; Lilburn, GA 30047-3168; 678-924-6960 H678-924-1161; Leo209@mindspring.com

IMPORTANT! Do not forget to include proof of age (birth certificate or passport; a driver’s license is NOT acceptable), proof of rank, and signature of parent/guardian if under 18 years of age. These items can be very difficult to obtain, once you arrive at the event.

Will bring current membership card to event Will purchase membership at event

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 2005 JUNIOR US OPEN Judo Championships and related events and activities of United States Judo, Inc. (USA Judo), Greater Fort Lauderdale Convention & Visitors Bureau, Embassy Suites-Fort Lauderdale, Zebra Mats, Tournament Director, Tournament Organizers, Tournament Staff, Florida Judo, Inc., 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 conditions 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 to the actions, inactions, or negligence of others, the rules 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. Release, waive, discharge and covenant not to sue the United States Judo, Inc., the United States Olympic Committee, United States Judo Federation, United States Judo Association, Greater Fort Lauderdale Convention & Visitors Bureau, Embassy Suites-Ft. Lauderdale, Tournament Director, Tournament Organizers, Tournament Staff, Zebra Mats, Florida Judo, Inc., together with their 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, 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.

I HAVE READ THE ABOVE WARNING, WAIVER AND RELEASE, 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. . I AGREE TO PARTICIPATE KNOWING THE RISK AND CONDITIONS INVOLVED AND DO SO ENTIRELY OF MY OWN FREE WILL. I AFFIRM THAT I AM AT LEAST 18 YEARS OF AGE, OR, IF I AM UNDER 18 YEARS OF AGE, I HAVE OBTAINED THE REQUIRED CONSENT OF MY PARENT/GUARDIAN AS EVIDENCED BY THEIR SIGNATURE BELOW.


Participant's Printed Name	Participant's Signature	Date

FOR PARENTS/GUARDIANS 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 Releases, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releases 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's Printed Name	Parent/Guardian's Signature	Date
Participant's Printed Name	Participant's Signature	Date

CERTIFICATE REGARDING NON BLACK BELT CONTESTANTS

I, ____________________________________________, a Judo Instructor, who has been

………..(Name of Instructor)

awarded the Judo rank of Shodan or higher, recognized by United States Judo, Inc., hereby certify that,

____________________________________________________, although not

having been awarded the Judo rank of Shodan or higher, is of sufficient aptitude and skill in

Judo to compete in these Championships.

____________________________________________________

Signature of Judo Instructor

A copy of my proof of rank (rank certificate, USA JUDO membership card having the verification symbol “(V)” printed following my rank or rank cards issued by the USJF or USJA National Offices) is attached. MUST BE INCLUDED WITH ENTRY FORM!!!

CERTIFICATE UNITED STATES CITIZENSHIP AND AGE

I certify that I am a citizen of the United States of America and ______ years of age as of August 6, 2005.

A copy of my birth certificate, military identification, passport, voter registration card, or my USA JUDO membership card having the verification symbol “(V)” printed following my date of birth is attached. MUST BE INCLUDED WITH ENTRY FORM!!!

_________________________________…..__________________________________

Signature of parent or guardian if contestant…………….Signature of Contestant
is under 18 years of age.

POWER OF ATTORNEY

If contestant if under the age of 18 years on the day of competition, this document must completed by the contestant’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 ___________________________________

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

NOTE: If you have submitted one of these forms within the past year, please check the update box after your name and only provide any updated information that you feel is necessary. Otherwise, please complete this form as completely as is possible. This information is kept by USA Judo as a career record of elite athletes.

Name:

q UPDATE

Address:

City:

State:

Zip:

Phone: ( )

USA JUDO #:

Email Address:

Age:

Birth date:

Sex:

Current weight category:

Judo Club Name:

Club Address:

City:

State:

Zip:

Coach’s Name:

Phone: ( )

Coach’s Address:

City:

State:

Zip:

Education:

Grade (1-8)___ Fr. So. Jun. Sen.

College: Fr. So. Jun. Sen. Grad.

Degrees earned/Institutions:

Judo Rank:

Year started Judo:

Favorite Food:

Favorite Music:

Other sports, hobbies, etc.:

Name of your local newspaper:

Paper’s sports fax: ( )

Paper’s sports phone: ( )

Newspaper email address:

International Teams/Years/Wt. (Jr. PanAm, Jr. World, PanAm, World, Olympics):

Best Finishes in Recent National Competition:

Place

Year

Event

Age/Weight Division

COACH CREDENTIALS APPLICATION FORM

Attach a photocopy of your coach certification credential (certificate or badge).

Because of security concerns at the port of Ft. Lauderdale, the convention center is requiring a photo ID for all coaches.

Competition Floor Pass Credentials will be provided at no cost to nationally certified coaches who are coaching an athlete at this event, provided that this coach credential application is postmarked by July 28, 2005. Application forms postmarked after that date and coaches who register as “walk-ups” will be charged a $10.00 processing fee. Coaches MUST check-in on Friday, August 05, 2005 between 11:00 a.m. and 3:00 p.m. to obtain their credential. Do not send any applications after July 28, 2005.

Coaches admitted to the floor of the event are expected to dress appropriately for a National Championship: (i.e. dress slacks and golf shirts or warmup suits (track suits) preferred). No tank tops, cut-offs, etc.

For each Club, coach credentials will be distributed based on the following allocation:

1. If # of players are less than # of contest areas, then max # of coaches = max # of players.

Special benefit for Coaches this year! Coaches who bring at least five (5) players and send in their registration form postmarked by July 5, 2005 will receive a FREE tournament Polo Shirt. If you qualify for this benefit, please indicate your size below:

This contract will stipulate the points of agreement between Gerry Navarro and _________________________ on the handling, distribution and sales of merchandise at the 2005 Jr. US Open Judo Championships to be held August 6-7, 2005 at The Ft. Lauderdale Convention Center, Ft. Lauderdale, FL

1. All merchandise or items for sale must be “Judo” oriented. All items must not have political statements, racial or ethnic slurs, lewd or indecent pictures or representations and must be in keeping with the aims of Judo, USJI interests, and/or the goals of the Olympic Sport movement.

Post Tournament Party

As always, there will be a great party following the tournament!

This party will be free of charge to all Athletes, Coaches, Referees, and Tournament Officials.

Parents and family of the athletes are also invited, but we can only offer free admission to 500 total attendees. After that number we will be charging $8.00 at the door.

To help us in planning and to insure your admission to the party, please enclose this form with your athlete’s application.

INTERNATIONAL TRAINING CAMP

----------------------------------------------------------------------------------------------------

After July 14, participation in the camp is not guaranteed
but may be allowed based on available space.

Hotel Registration Form The Ft. Lauderdale Convention and Visitors Bureau is interested in tracking the hotel use in the area by the participants in the Junior US Open. Please indicate where you intend to stay during the tournament.
q I Live in the local area and will not be staying at a hotel
q Tournament Headquarters: The Embassy Suites
q Hotel other than headquarters (Hotel Name):
Number of rooms reserved:	Number of nights:

Printed Name:
Club:
State:
Coach certification level:		q A	q B	q C	q D	q E
Certified by	q USA Judo	q USJF	q USJA		Number:

Size:	S	M	L	X	XXL	Total #
Quantity:

Gerry Navarro and John Miller

Gerry: 16131 N.W. 12 Street; Pembroke Pines, FL;

33028; (954) 435-6976 / Fax: (954) 435-6976; gerrynavarro@aol.com John: 303-237-0063; jonmira@aol.com

Under 17 (Cadet)

M

51

55

60

66

73

81

90

+90 Kg

Under 15 (Junior)

M

36

40

44

48

53

58

64

+64 Kg

36

40

44

48

53

58

64

+64 Kg

Under 13 (Juvenile- 2)

M

28

31

34

38

42

48

53

+53 Kg

28

31

34

38

42

48

53

+53 Kg

Forward all forms and fees to:

Gerry Navarro;16131 N.W. 12 Street; Pembroke Pines, FL 33028-1206 Voice: 954-435-6976 / Fax: 954-435-6976 Email: Gerrynavarro@aol.com

Under 17 (Cadet)

M

51

55

60

66

73

81

90

+90 Kg

Under 15 (Junior)

M

36

40

44

48

53

58

64

+64 Kg

36

40

44

48

53

58

64

+64 Kg

Under 13 (Juvenile- 2)

33028; (954) 435-6976 / Fax: (954) 435-6976; gerrynavarro@aol.com
John: 303-237-0063; jonmira@aol.com

Gerry Navarro;16131 N.W. 12 Street; Pembroke Pines, FL 33028-1206
Voice: 954-435-6976 / Fax: 954-435-6976
Email: Gerrynavarro@aol.com