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Individual Registration Form 2014 U.S. Taijiquan Team Trials | 5 th New England International Wushu Championships 2nd AllAmerica Taijiquan Cup | 2014 U.S. Traditional Team Trials July 26 and 27, 2014 At Manchester High School | 134 E. Middle Turnpike | Manchester, Connecticut 06040 FIRST DEADLINE (LATE FEES AFTER THIS DATE): June 20 FINAL DEADLINE (NO REGISTRATIONS ACCEPTED AFTER THIS DATE): July 1 PLEASE PRINT OR TYPE LAST NAME: __________________________ FIRST: ___________________________ MI: _____________ STREET: ______________________________________________________________________________________ CITY: ________________________ STATE: ________ ZIP: ________________ PHONE (PRIMARY): _____________________ PHONE (ALTERNATE): _____________________ EMAIL: _______________________________________________________________________________________ DATE OF BIRTH: M ______ / D ______ / Y ______ AGE: _____ SEX (CIRCLE ONE): M F YEARS EXPERIENCE: ______________ SCHOOL: ____________________________________________ PRIMARY INSTRUCTOR: __________________________________________________________________ SCHOOL ADDRESS: ________________________________________________________________________ CITY: ________________________ STATE: ________ ZIP: ________________ PHONE: ____________________________ EMAIL: ________________________________________________ FAX: _________________________ WAIVER I, the undersigned, knowingly and without duress, do voluntarily submit my entry to the 2014 U.S. Taijiquan Team Trials, the 5 th New England International Wushu Championships, and the 2014 AllAmerica Taijiquan Cup (hereinafter referred to collectively as “the Championships”). I hereby assume all risk of physical and mental injuries, disabilities, and losses which may result from or in connection with my participation in the Championships. Hereinafter the USA WushuKungfu Federation, USA National Tai Chi Chuan Federation, Malee’s School of Tai Chi & Kung Fu, and Manchester High School are collectively referred to as “the Organizing Committee.” Acting for myself, my heirs, personal representatives and assignees, I do hereby release the Organizing Committee, its officers, agents, representatives, servants, employees, volunteers, and all other members from liability due to any injuries incurred and any resulting legal claims, actions, suits or controversies. I also understand that there is risk of injury involved in all the competitive divisions, particularly in fighting events, and I assume full responsibility for all my actions, activities or omissions during and in connection with the Championships. I fully understand that any medical attention or treatment afforded me by the Organizing Committee, its officers, agents, representatives, servants, employees, volunteers, and all other related members will be of the first aid type only, and I hereby release the Organizing Committee, its officers, agents, representatives, servants, employees, volunteers, and all other related members from any liability for such aid. I have read, understand, and agree to abide by the rules of this event, and accept all responsibility and associated liability for infringement of such rules. Additionally, I am fully aware of my personal medical condition and hereby certify that I am mentally and physically fit to compete. I consent to the use of photographs and/or video recordings of my participation in this event for promotional purposes, and hereby waive my rights to any form of compensation or claim. Parent or legal guardian signature is required if participant is under eighteen (18) years of age ____________________________________________ ____________________________________________ _______________________ Signature of Participant Signature of Legal Guardian Date Please mail this form to: USA National Tai Chi Chuan Federation, 249 Broad St, Manchester, CT 06040 Contact: www.usantccf.org Phone (860) 6466818 [email protected] You may make copies of this form for personal use – You may also register online through our website. Organized by Hosted by Organized by

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Page 1: Individual Competition Registration Form copy - · PDF fileNAME:_____! Individual!Registration!Form! 2014U.S.!Taijiquan!Team!Trials! 5th!New!England!International!Wushu!Championships!

Individual  Registration  Form    

2014  U.S.  Taijiquan  Team  Trials  |  5th  New  England  International  Wushu  Championships  2nd  All-­‐America  Taijiquan  Cup  |  2014  U.S.  Traditional  Team  Trials  

 

July  26  and  27,  2014    

At  Manchester  High  School    |    134  E.  Middle  Turnpike    |    Manchester,  Connecticut    06040    

FIRST  DEADLINE  (LATE  FEES  AFTER  THIS  DATE):  June  20  FINAL  DEADLINE  (NO  REGISTRATIONS  ACCEPTED  AFTER  THIS  DATE):  July  1  

PLEASE  PRINT  OR  TYPE  LAST  NAME:  __________________________  FIRST:  ___________________________    MI:  _____________  STREET:  ______________________________________________________________________________________  CITY:  ________________________    STATE:  ________    ZIP:  ________________  PHONE  (PRIMARY):  _____________________    PHONE  (ALTERNATE):  _____________________  EMAIL:  _______________________________________________________________________________________  DATE  OF  BIRTH:  M  ______  /  D  ______  /  Y  ______      AGE:  _____    SEX  (CIRCLE  ONE):  M      F  YEARS  EXPERIENCE:  ______________    SCHOOL:  ____________________________________________  PRIMARY  INSTRUCTOR:  __________________________________________________________________  SCHOOL  ADDRESS:  ________________________________________________________________________  CITY:  ________________________    STATE:  ________    ZIP:  ________________  PHONE:  ____________________________    EMAIL:  ________________________________________________  FAX:  _________________________     WAIVER  

I,  the  undersigned,  knowingly  and  without  duress,  do  voluntarily  submit  my  entry  to  the  2014  U.S.  Taijiquan  Team  Trials,  the  5th  New  England  International  Wushu  Championships,  and  the  2014  All-­‐America  Taijiquan  Cup  (hereinafter  referred  to  collectively  as  “the  Championships”).  I  hereby  assume  all  risk  of  physical  and  mental  injuries,  disabilities,  and  losses  which  may  result  from  or  in  connection  with  my  participation  in  the  Championships.  Hereinafter  the  USA  Wushu-­‐Kungfu  Federation,  USA  National  Tai  Chi  Chuan  Federation,  Malee’s  School  of  Tai  Chi  &  Kung  Fu,  and  Manchester  High  School  are  collectively  referred  to  as  “the  Organizing  Committee.”  Acting  for  myself,  my  heirs,  personal  representatives  and  assignees,  I  do  hereby  release  the  Organizing  Committee,  its  officers,  agents,  representatives,  servants,  employees,  volunteers,  and  all  other  members  from  liability  due  to  any  injuries  incurred  and  any  resulting  legal  claims,  actions,  suits  or  controversies.  I  also  understand  that  there  is  risk  of  injury  involved  in  all  the  competitive  divisions,  particularly  in  fighting  events,  and  I  assume  full  responsibility  for  all  my  actions,  activities  or  omissions  during  and  in  connection  with  the  Championships.  I  fully  understand  that  any  medical  attention  or  treatment  afforded  me  by  the  Organizing  Committee,  its  officers,  agents,  representatives,  servants,  employees,  volunteers,  and  all  other  related  members  will  be  of  the  first  aid  type  only,  and  I  hereby  release  the  Organizing  Committee,  its  officers,  agents,  representatives,  servants,  employees,  volunteers,  and  all  other  related  members  from  any  liability  for  such  aid.  I  have  read,  understand,  and  agree  to  abide  by  the  rules  of  this  event,  and  accept  all  responsibility  and  associated  liability  for  infringement  of  such  rules.  Additionally,  I  am  fully  aware  of  my  personal  medical  condition  and  hereby  certify  that  I  am  mentally  and  physically  fit  to  compete.    I  consent  to  the  use  of  photographs  and/or  video  recordings  of  my  participation  in  this  event  for  promotional  purposes,  and  hereby  waive  my  rights  to  any  form  of  compensation  or  claim.  

Parent  or  legal  guardian  signature  is  required  if  participant  is  under  eighteen  (18)  years  of  age                          ____________________________________________              ____________________________________________          _______________________                                                        Signature  of  Participant                                                              Signature  of  Legal  Guardian                                                          Date    

Please  mail  this  form  to:  USA  National  Tai  Chi  Chuan  Federation,  249  Broad  St,  Manchester,  CT    06040  Contact:          www.usantccf.org            Phone  (860)  646-­‐6818            [email protected]  

 

You  may  make  copies  of  this  form  for  personal  use  –  You  may  also  register  online  through  our  website.  

Organized  by   Hosted  by   Organized  by  

Page 2: Individual Competition Registration Form copy - · PDF fileNAME:_____! Individual!Registration!Form! 2014U.S.!Taijiquan!Team!Trials! 5th!New!England!International!Wushu!Championships!

 NAME:  ___________________________________  

Individual  Registration  Form  2014  U.S.  Taijiquan  Team  Trials  

5th  New  England  International  Wushu  Championships  2nd  All-­‐America  Taijiquan  Cup  

Page  2  of  5  

FEES  –  PLEASE  FILL  OUT  CAREFULLY!  (1)  2014  U.S.  TAIJIQUAN  TEAM  TRIALS  FEES  Basic  Registration  Fee:  $120                                                          $________    

Each  event:  $30  x  _______  events                                              $________    

USAWKF  membership  no.  (REQUIRED):___________________    

$30  late  fee  (after  June  20)                                                                $________          (FINAL  DEADLINE:  JULY  1)    

                                                                                                           Total:                            $________     (2)  5th  New  England  INTERNATIONAL  

WUSHU  CHAMPIONSHIPS  FEES    

Basic  Registration  Fee:  $90                                                              $________    

Each  event:  $20  x  _______  events                                              $________    

USAWKF  membership  discount:  $5                                $________    

       USAWKF  membership  no.:  ________________    

USANTCCF  membership  discount:  $5                        $________    

       USANTCCF  membership  no.:  _____________    

Traditional  Team  Trials:  $50                                                        $________    

Grand  Champion  Trophy  Trial:  $35                                $________    

$20  late  fee  (after  June  20)                                                                $________          (FINAL  DEADLINE:  JULY  1)    

                                                                                                           Total:                            $________     (3)  2014  ALL-­‐AMERICA  TAIJIQUAN  CUP    

Basic  Registration  Fee:  $100                                                          $________    

Each  event:  $25  x  _______  events                                              $________    

USAWKF  membership  discount:  $5                                $________    

       USAWKF  membership  no.:  ____________________    

USANTCCF  membership  discount:  $5                        $________    

       USANTCCF  membership  no.:  ________________    

$25  late  fee  (after  June  20)                                                                $________          (FINAL  DEADLINE:  JULY  1)    

                                                                                                           Total:                            $________     (4)  SPECTATOR  TICKETS  Saturday  Tickets:  (does  NOT  include  Masters  Demo)                      $10  x  _____  people                                                                                            $________    

Sunday  Tickets:                      $10  x  _____  people                                                                                            $________    

Masters  Demo  (Saturday,  8  pm)                      $20  x  _____  people                                                                                            $________    

Both  Days  plus  Master  Demo:  $30                      $30  x  _____  people                                                                                            $________      

                                                                                                           Total:                    $________    

This  event  will  select  competitors  who  will  represent  the  U.S.  at  the  1st  World  Taijiquan  Championships,  to  be  held  November  1-­‐4,  2014,  in  Chengdu,  China.  (U.S.  citizens  only)  

This  event  is  an  open  competition  for  Chinese  martial  arts  practitioners  of  all  styles,  ages,  and  experience  levels.  

This  event  will  award  a  spot  on  the  2014  U.S.  Traditional  Team  for  any  competitor  who  finishes  third  in  any  traditional  event.  The  U.S.  team  will  go  on  to  compete  at  the  6th  World  Traditional  Wushu  Championships  in  Chizhou,  China,  October  23-­‐29,  2014.  

This  is  a  chance  for  competitors  to  go  home  with  a  beautiful  trophy  in  recognition  of  their  outstanding  achievement  at  the  event.  The  athlete  with  the  best  results  in  at  least  three  events  in  their  age  group  will  win  a  Grand  Champion  Trophy,  provided  he  or  she  signs  up  for  the  Trophy  event  and  competes  in  at  least  three  events,  including  at  least  one  weapon  and  one  barehand.  

This  is  a  Grand  Champion  event  for  advanced  taijiquan  competitors.  The  competition  is  divided  into  3  age  groups,  with  first,  second,  and  third  place  trophies  for  each  age  group,  male  and  female.  Champions  will  be  chosen  by  their  combined  highest  barehand  score  and  highest  weapon  score.  (U.S.  citizens  and  permanent  residents  only)  

(5)  TOTALS  FOR  (1)  THROUGH  (4)    

Each  competitor  will  receive  ONE  complimentary  ticket  (for  family/friends/etc.)  for  Saturday  and  Sunday  competitions  as  well  as  the  Masters  Demo.    

(1)  Taijiquan  Team  Trials  Fees                                                                    $________    (2)  N.E.  Int’l  Championships  Fees                                                            $________    (3)  All-­‐America  Cup                                                                                                              $________    (4)  Spectator  Tickets  Fees                                                                                      $________    

Total:                    $___________    

Payment  with  Check:  Please  make  checks  payable  to  USA  National  Tai  Chi  Chuan  Federation  and  mail  to  249  Broad  Street,  Manchester,  CT    06040    

Payment  with  credit  card:    

Cardholder  name:  _________________________________________________________    

Street  address:  _____________________________________________________________    City:  _______________________    State:  ______    Zip:  ____________    Card  number:  ________________________________    Exp  (MM/YY):  _______/_______    CVV  number:  _________  

PLEASE  NOTE:  There  will  be  a  $30  charge  for  each  event  change  after  your  initial  registration  is  accepted.  

Page 3: Individual Competition Registration Form copy - · PDF fileNAME:_____! Individual!Registration!Form! 2014U.S.!Taijiquan!Team!Trials! 5th!New!England!International!Wushu!Championships!

 NAME:  ___________________________________  

2014  U.S.  TAIJIQUAN  TEAM  TRIALS  REGISTRATION  

 U.S.  citizens  only  –  must  be  current  member  of  USAWKF  

 Please  make  a  check  mark  (√)  next  to  the  age  group  you  are  registering  in,  and  then  make  a  check  mark  in  the  space  provided  for  each  event  you  are  competing  in.    Registration  fee  (REQUIRED):  [    √    ]  $120.                    Events:  $30  x  _____  events  =  $________    Total:  $__________.    I.  Competition  Events  (at  least  one  barehand  and  one  weapon  required):    Age:  [        ]  16-­‐35    [        ]  Optional  Taijiquan  [        ]  Optional  Taijijian  [        ]  Compulsory  Yang  Style  Taijiquan  [        ]  Compulsory  Yang  Style  Taijijian  [        ]  Compulsory  Chen  Style  Taijiquan  [        ]  Compulsory  Chen  Style  Taijijian  [        ]  Compulsory  36  Form  Taijjiquan  (3rd  Set  Competition  Routine)  [        ]  Compulsory  39  Form  Taijijian  (3rd  Set  Competition  Routine)    II.  Demonstration  Events  (at  least  one  barehand  and  one  weapon  required):    Age:  [        ]  16-­‐35      [        ]  36-­‐60    [        ]  24  Form  Taijiquan  [        ]  42  Form  Taijiquan  [        ]  Yang  Style  Competition  Routine  [        ]  Chen  Style  Competition  Routine  [        ]  32  Form  Taijijian  [        ]  42  Form  Taijijian  [        ]  Trad.  Yang  Style  Taijiquan  [        ]  Trad.  Yang  Style  Taijijian  [        ]  Trad.  Chen  Style  Taijiquan  [        ]  Trad.  Chen  Style  Taijijian  [        ]  Trad.  Wu  Style  Taijiquan  [        ]  Trad.  Wu  Style  Taijijian  [        ]  Trad.  Sun  Style  Taijiquan  [        ]  Trad.  Sun  Style  Taijijian    III.  Group  competition  registration  for  the  Trials  is  in  the  Group  Registration  Form.  

Individual  Registration  Form  2014  U.S.  Taijiquan  Team  Trials  

5th  New  England  International  Wushu  Championships  2nd  All-­‐America  Taijiquan  Cup  

Page  3  of  5  

Page 4: Individual Competition Registration Form copy - · PDF fileNAME:_____! Individual!Registration!Form! 2014U.S.!Taijiquan!Team!Trials! 5th!New!England!International!Wushu!Championships!

5th  NEW  ENGLAND  INTERNATIONAL  WUSHU  CHAMPIONSHIPS  REGISTRATION  Circle  all  events  you  wish  to  register  for  

Experience  Levels  –  Beginner,  0-­‐2  years  –  Intermediate,  2-­‐4  years  –  Advanced,  4+  years  You  may  register  in  only  one  experience  level  for  all  external  events,  one  for  all  internal  events,  and  one  for  all  contact  events    At  the  sole  discretion  of  the  Organizing  Committee,  

events  and  divisions  may  be  combined  or  divided  at  any  time  prior  to  competition.  nt  

A.  Youth  External  Events    

100.  Traditional  Kung  Fu  -­‐  Barehand    

[        ]  101.  Children  6  &  under,  beginner  [        ]  102.  Children  6  &  under,  int-­‐adv  [        ]  103.  Children  7-­‐9,  beginner  [        ]  104.  Children  7-­‐9,  int-­‐adv  [        ]  105.  Children  10-­‐12,  beginner  [        ]  106.  Children  10-­‐12,  int-­‐adv  [        ]  107.  Children  13-­‐15,  beginner  [        ]  108.  Children  13-­‐15,  int-­‐adv  [        ]  109.  Teen  boys,  16-­‐18,  beginner  [        ]  110.  Teen  boys,  16-­‐18,  int-­‐adv  [        ]  111.  Teen  girls,  16-­‐18,  beginner  [        ]  112.  Teen  girls,  16-­‐18,  int-­‐adv    

200.  Traditional  Kung  Fu  –  Weapons    

[        ]  201.  Children  6  &  under,  beginner  [        ]  202.  Children  6  &  under,  int-­‐adv  [        ]  203.  Children  7-­‐9,  beginner  [        ]  204.  Children  7-­‐9,  int-­‐adv  [        ]  205.  Children  10-­‐12,  beginner  [        ]  206.  Children  10-­‐12,  int-­‐adv  [        ]  207.  Children  13-­‐15,  short/other,  beginner  [        ]  208.  Children  13-­‐15,  short/other,  int-­‐adv  [        ]  209.  Children  13-­‐15,  long,  beginner  [        ]  210.  Children  13-­‐15,  long,  int-­‐adv  [        ]  211.  Teen  boys,  16-­‐18,  short/other,  beginner  [        ]  212.  Teen  boys,  16-­‐18,  short/other,  int-­‐adv  [        ]  213.  Teen  boys,  16-­‐18,  long,  beginner  [        ]  214.  Teen  boys,  16-­‐18,  long,  int-­‐adv  [        ]  215.  Teen  girls,  16-­‐18  short/other,  beginner  [        ]  216.  Teen  girls,  16-­‐18,  short/other,  int-­‐adv  [        ]  217.  Teen  girls,  16-­‐18,  long,  beginner  [        ]  218.  Teen  girls,  16-­‐18,  long,  int-­‐adv    

300.  Contemporary  Wushu  -­‐  Barehand    

[        ]  301.  Children  6  &  under,  beginner  [        ]  302.  Children  6  &  under,  int-­‐adv  [        ]  303.  Children  7-­‐9,  beginner  [        ]  304.  Children  7-­‐9,  int-­‐adv  [        ]  305.  Children  10-­‐12,  beginner  [        ]  306.  Children  10-­‐12,  int-­‐adv  [        ]  307.  Children  13-­‐15,  beginner  [        ]  308.  Children  13-­‐15,  int-­‐adv  [        ]  309.  Teen  boys,  16-­‐18,  beginner  [        ]  310.  Teen  boys,  16-­‐18,  intermediate  [        ]  311.  Teen  boys,  16-­‐18,  changquan,  advanced  [        ]  312.  Teen  boys,  16-­‐18,  nanquan,  advanced  [        ]  313.  Teen  boys,  16-­‐18,  other,  advanced  [        ]  314.  Teen  girls,  16-­‐18,  beginner  [        ]  315.  Teen  girls,  16-­‐18,  intermediate  [        ]  316.  Teen  girls,  16-­‐18,  changquan,  advanced  [        ]  317.  Teen  girls,  16-­‐18,  nanquan,  advanced  [        ]  318.  Teen  girls,  16-­‐18,  other,  advanced    

400.  Contemporary  Wushu  -­‐  Weapons    

[        ]  401.  Children  9  &  under,  beginner  [        ]  402.  Children  9  &  under,  int-­‐adv  [        ]  403.  Children  10-­‐12,  short/other,  beginner  [        ]  404.  Children  10-­‐12,  short/other,  int-­‐adv  [        ]  405.  Children  10-­‐12,  long,  beginner  [        ]  406.  Children  10-­‐12,  long,  int-­‐adv  [        ]  407.  Children  13-­‐15,  short/other,  beginner  [        ]  408.  Children  13-­‐15,  short/other,  int-­‐adv  [        ]  409.  Children  13-­‐15,  long,  beginner  [        ]  410.  Children  13-­‐15,  long,  int-­‐adv  [        ]  411.  Teen  boys,  16-­‐18,  broadsword,  beg  [        ]  412.  Teen  boys,  16-­‐18,  broadsword,  int-­‐adv  [        ]  413.  Teen  boys,  16-­‐18,  str.  sword,  beg  [        ]  414.  Teen  boys,  16-­‐18,  str.  sword,  int-­‐adv  [        ]  415.  Teen  boys,  16-­‐18,  staff,  beginner  

400.  Contemporary  Wushu  –  Weapons  (cont.)    

[        ]  416.  Teen  boys,  16-­‐18,  staff,  int-­‐adv  [        ]  417.  Teen  boys,  16-­‐18,  spear,  beginner  [        ]  418.  Teen  boys,  16-­‐18,  spear,  int-­‐adv    [        ]  419.  Teen  girls,  16-­‐18,  broadsword,  beg  [        ]  420.  Teen  girls,  16-­‐18,  broadsword,  int-­‐adv  [        ]  421.  Teen  girls,  16-­‐18,  str.  sword,  beg  [        ]  422.  Teen  girls,  16-­‐18,  str.  sword,  int-­‐adv  [        ]  423.  Teen  girls,  16-­‐18,  staff,  beginner  [        ]  424.  Teen  girls,  16-­‐18,  staff,  int-­‐adv  [        ]  425.  Teen  girls,  16-­‐18,  spear,  beginner  [        ]  426.  Teen  girls,  16-­‐18,  spear,  int-­‐adv    

B.  Adult  External  Events    

500.  Traditional  Kung  Fu  –  Barehand    

[        ]  501.  Men’s,  18-­‐35,  Northern,  beginner  [        ]  502.  Men’s,  18-­‐35,  Southern,  beginner  [        ]  503.  Men’s,  18-­‐35,  Northern,  intermediate  [        ]  504.  Men’s,  18-­‐35,  Southern,  intermediate  [        ]  505.  Men’s,  18-­‐35,  Northern,  advanced  [        ]  506.  Men’s,  18-­‐35,  Southern,  advanced  [        ]  507.  Men’s,  36+,  All  Styles,  beginner  [        ]  508.  Men’s  ,36+,  All  Styles,  int-­‐adv  [        ]  509.  Women’s  18-­‐35,  Northern,  beginner  [        ]  510.  Women’s  18-­‐35,  Southern,  beginner  [        ]  511.  Women’s  18-­‐35,  Northern,  int  [        ]  512.  Women’s  18-­‐35,  Southern,  int  [        ]  513.  Women’s  18-­‐35,  Northern,  advanced  [        ]  514.  Women’s  18-­‐35,  Southern,  advanced  [        ]  515.  Women’s,  36+,  All  Styles,  beginner  [        ]  516.  Women’s,  36+,  All  Styles,  int-­‐adv    

600.  Traditional  Kung  Fu  –  Weapons    

[        ]  601.  Men’s,  18-­‐35,  short/other,  beginner  [        ]  602.  Men’s,  18-­‐35,  long,  beginner  [        ]  603.  Men’s,  18-­‐35,  short/other,  int  [        ]  604.  Men’s,  18-­‐35,  long,  intermediate  [        ]  605.  Men’s,  18-­‐35,  short,  advanced  [        ]  606.  Men’s,  18-­‐35,  long,  advanced  [        ]  607.  Men’s,  36+,  All  Weapons,  beginner  [        ]  608,  Men’s,  36+,  All  Weapons,  int-­‐adv  [        ]  509.  Women’s,  18-­‐35,  short/other,  beginner  [        ]  610.  Women’s,  18-­‐35,  long,  beginner  [        ]  611.  Women’s,  18-­‐35,  short/other,  int  [        ]  612.  Women’s,  18-­‐35,  long,  intermediate  [        ]  613.  Women’s,  18-­‐35,  short,  advanced  [        ]  614.  Women’s,  18-­‐35,  long,  advanced  [        ]  615.  Women’s,  36+,  All  Weapons,  beginner  [        ]  616.  Women’s,  36+,  All  Weapons,  int-­‐adv    

700.  Contemporary  Wushu  –  Barehand    

[        ]  701.  Men’s,  18+,  beginner  [        ]  702.  Men’s,  18+,  changquan/other,  int  [        ]  703.  Men’s,  18+,  nanquan,  intermediate  [        ]  704.  Men’s,  18+,  changquan,  advanced  [        ]  705.  Men’s,  18+,  nanquan,  advanced  [        ]  706.  Men’s,  18+,  other,  advanced  [        ]  707.  Women’s,  18+,  beginner  [        ]  708.  Women’s,  18+,  changquan/other,  int  [        ]  709.  Women’s,  18+,  nanquan,  intermediate  [        ]  710.  Women’s,  18+,  changquan,  advanced  [        ]  711.  Women’s,  18+,  nanquan,  advanced  [        ]  712.  Women’s,  18+,  other,  advanced    

800.  Contemporary  Wushu  –  Weapons    

[        ]  801.  Men’s,  18+,  All  Weapons,  beginner  [        ]  802.  Men’s,  18+,  short/other,  intermediate  

800.  Contemporary  Wushu  –  Weapons  (cont.)    

[        ]  803.  Men’s,  18+,  long,  intermediate  [        ]  804.  Men’s,  18+,  short,  advanced  [        ]  805.  Men’s,  18+,  long,  advanced  [        ]  806.  Men’s,  18+,  other,  advanced  [        ]  807.  Women’s,  18+,  beginner  [        ]  808.  Women’s,  18+,  short/other,  intermediate  [        ]  809.  Women’s,  18+,  long,  intermediate  [        ]  810.  Women’s,  18+,  short,  advanced  [        ]  811.  Women’s,  18+,  long,  advanced  [        ]  812.  Women’s  18+,  other,  advanced    

C.  Internal  Events    

900.  Taijiquan    

[        ]  901.  Men’s,  45  &  under,  all  styles,  beginner  [        ]  902.  Men’s,  45  &  under,  all  styles,  intermediate  [        ]  902.1.  Men’s,  45  &  under,  42  Form  Taijiquan,  adv  [        ]  903.  Men’s,  45  &  under,  Yang  style,  advanced  [        ]  904.  Men’s,  45  &  under,  Chen  style,  advanced  [        ]  905.  Men’s,  45  &  under,  Wu  style,  advanced  [        ]  906.  Men’s,  45  &  under,  Wu/Hao  style,  adv  [        ]  907.  Men’s,  45  &  under,  Sun  style,  advanced  [        ]  907.1.  Men’s,  45  &  under,  Zhaobao  style,  advanced  [        ]  908.  Men’s,  45  &  under,  Other  styles,  advanced  [        ]  909.  Women’s,  45  &  under,  all  styles,  beginner  [        ]  910.  Women’s,  45  &  under,  all  styles,  int  [        ]  910.1.  Women’s,  45  &  under,  42  Form  Taiji,  adv  [        ]  911.  Women’s,  45  &  under,  Yang  style,  adv  [        ]  912.  Women’s,  45  &  under,  Chen  style,  adv  [        ]  913.  Women’s,  45  &  under,  Wu  style,  advanced  [        ]  914.  Women’s,  45  &  under,  Wu/Hao  style,  adv  [        ]  915.  Women’s,  45  &  under,  Sun  style,  advanced  [        ]  915.1.  Women’s,  45  &  under,  Zhaobao  style,  adv  [        ]  916.  Women’s,  45  &  under,  Other  styles,  adv  [        ]  917.  Men’s/Women’s,  46-­‐65,  all  styles,  beginner  [        ]  918.  Men’s/Women’s,  46-­‐65,  all  styles,  int-­‐adv  [        ]  919.  Men’s/Women’s,  66+,  all  styles,  beginner  [        ]  920.  Men’s/Women’s,  66+,  all  styles,  int-­‐adv    

1000.  Other  Internal  Barehand    

[        ]  1001.  Men’s/Women’s  45  &  under,  All  other,  beg  [        ]  1002.  Men’s/Women’s  45  &  under,  Bagua,  int  [        ]  1003.  Men’s/Women’s  45  &  under,  Xingyi,  int  [        ]  1004.  Men’s/Women’s  45  &  under,  Other,  int  [        ]  1005.  Men’s  45  &  under,  Baguazhang,  advanced  [        ]  1006.  Men’s  45  &  under,  Xingyiquan,  advanced  [        ]  1007.  Men’s  45  &  under,  Other,  advanced  [        ]  1008.  Women’s  45  &  under,  Baguazhang,  adv  [        ]  1009.  Women’s  45  &  under,  Xingyiquan,  adv  [        ]  1010.  Women’s  45  &  under,  Other,  advanced  [        ]  1011.  Men’s/Women’s  46+,  All  other,  beginner  [        ]  1012.  Men’s/Women’s  46+,  All  other,  int  [        ]  1013.  Men’s/Women’s  46+,  All  other,  advanced    

1100.  Internal  Weapons    

[        ]  1101.  Men’s/Women’s,  60  &  under,  Taiji  sword,  beg  [        ]  1102.  Men’s/Women’s,  60  &  under,  Other,  beg  [        ]  1102.1.  Men’s/Women’s,  60  &  under,  42  Taiji  sword,  int-­‐adv  [        ]  1103.  Men’s/Women’s,  60  &  under,  Taiji  sword,  int-­‐adv  [        ]  1104.  Men’s/Women’s,  60  &  under,  Other  short,  int-­‐adv  [        ]  1105.  Men’s/Women’s,  60  &  under,  Long,  int-­‐adv  [        ]  1106.  Men’s/Women’s,  61+,  Taiji  sword,  beg  [        ]  1107.  Men’s/Women’s,  61+,  Other,  beg  [        ]  1107.1.  Men’s/Women’s,  61+,  42  Form  Taiji  sword,  int-­‐adv  [        ]  1108.  Men’s/Women’s,  61+,  Taiji  sword,  int-­‐adv  [        ]  1109.  Men’s/Women’s,  61+,  Other  short,  int-­‐adv  [        ]  1110.  Men’s/Women’s,  61+,  Long,  int-­‐adv  

 

 NAME:  ___________________________________  

Individual  Registration  Form  2014  U.S.  Taijiquan  Team  Trials  

5th  New  England  International  Wushu  Championships  2nd  All-­‐America  Taijiquan  Cup  

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Page 5: Individual Competition Registration Form copy - · PDF fileNAME:_____! Individual!Registration!Form! 2014U.S.!Taijiquan!Team!Trials! 5th!New!England!International!Wushu!Championships!

 

At  the  sole  discretion  of  the  Organizing  Committee,  events  and  divisions  may  be  combined  or  divided  at  any  time  prior  to  competition.    D.  Contact  Events    1200.  Push  Hands  –  Restricted  Step    [        ]  1201.  Men’s  45  &  under,  0-­‐160  lbs.,  beginner  [        ]  1202.  Men’s  45  &  under,  0-­‐160  lbs.,  int-­‐adv  [        ]  1203.  Men’s  45  &  under,  161+  lbs.,  beginner  [        ]  1204.  Men’s  45  &  under,  161+  lbs.,  int-­‐adv  [        ]  1205.  Men’s  46+,  0-­‐160  lbs.,  beginner  [        ]  1206.  Men’s  46+,  0-­‐160  lbs.,  int-­‐adv  [        ]  1207.  Men’s  46+,  161+  lbs.,  beginner  [        ]  1208.  Men’s  46+,  161+  lbs.,  int-­‐adv  [        ]  1209.  Women’s  45  &  under,  0-­‐130  lbs.,  beg  [        ]  1210.  Women’s  45  &  under,  0-­‐130  lbs.,  int-­‐adv  [        ]  1211.  Women’s  45  &  under,  131+  lbs.,  beginner  [        ]  1212.  Women’s  45  &  under,  131+  lbs.,  int-­‐adv  [        ]  1213.  Women’s  46+,  0-­‐130  lbs.,  beginner  [        ]  1214.  Women’s  46+,  0-­‐130  lbs.,  int-­‐adv  [        ]  1215.  Women’s  46+,  131+  lbs.,  beginner  [        ]  1216.  Women’s  46+,  131+  lbs.,  int-­‐adv  

1300.  Push  Hands  –  Moving  Step    [        ]  1301.  Men’s  45  &  under,  0-­‐160  lbs.,  beginner  [        ]  1302.  Men’s  45  &  under,  0-­‐160  lbs.,  int-­‐adv  [        ]  1303.  Men’s  45  &  under,  161+  lbs.,  beginner  [        ]  1304.  Men’s  45  &  under,  161+  lbs.,  int-­‐adv  [        ]  1305.  Men’s  46+,  0-­‐160  lbs.,  beginner  [        ]  1306.  Men’s  46+,  0-­‐160  lbs.,  int-­‐adv  [        ]  1307.  Men’s  46+,  161+  lbs.,  beginner  [        ]  1308.  Men’s  46+,  161+  lbs.,  int-­‐adv  [        ]  1309.  Women’s  45  &  under,  0-­‐130  lbs.,  beg  [        ]  1310.  Women’s  45  &  under,  0-­‐130  lbs.,  int-­‐adv  [        ]  1311.  Women’s  45  &  under,  131+  lbs.,  beg  [        ]  1312.  Women’s  45  &  under,  131+  lbs.,  int-­‐adv  [        ]  1313.  Women’s  46+,  0-­‐130  lbs.,  beginner  [        ]  1314.  Women’s  46+,  0-­‐130  lbs.,  int-­‐adv  [        ]  1315.  Women’s  46+,  131+  lbs.,  beginner  [        ]  1316.  Women’s  46+,  131+  lbs.,  int-­‐adv  

1400.  Continuous  Light  Contact  Sparring  –  Youth    [        ]  1401.  Children,  8  &  under,  beginner  [        ]  1402.  Children,  8  &  under,  int-­‐adv  [        ]  1403.  Children,  9-­‐11,  beginner  [        ]  1404.  Children,  9-­‐11,  int-­‐adv  [        ]  1405.  Children,  12-­‐14,  beginner  [        ]  1406.  Children,  12-­‐14,  int-­‐adv  [        ]  1407.  Teen  Boys,  15-­‐17,  0-­‐145  lbs.,  beginner  [        ]  1408.  Teen  Boys  ,  15-­‐17,  0-­‐145  lbs.,  int-­‐adv  [        ]  1409.  Teen  Boys,  15-­‐17,  146+  lbs.,  beginner  [        ]  1410.  Teen  Boys  ,  15-­‐17,  146+  lbs.,  int-­‐adv  [        ]  1411.  Teen  Girls,  15-­‐17,  0-­‐120  lbs.,  beginner  [        ]  1412.  Teen  Girls  ,  15-­‐17,  0-­‐120  lbs.,  int-­‐adv  [        ]  1413.  Teen  Girls,  15-­‐17,  121+  lbs.,  beginner  [        ]  1414.  Teen  Girls  ,  115-­‐17,  21+  lbs.,  int-­‐adv    1500.  Continuous  Light  Contact  Sparring  –  Adult    [        ]  1501.  Men’s,  0-­‐160  lbs.,  beginner  [        ]  1502.  Men’s,  0-­‐160  lbs.,  int-­‐adv  [        ]  1503.  Men’s,  161+  lbs.,  beginner  [        ]  1504.  Men’s,  161+  lbs.,  int-­‐adv  [        ]  1505.  Women’s,  0-­‐130  lbs.,  beginner  [        ]  1506.  Women’s,  0-­‐130  lbs.,  int-­‐adv  [        ]  1507.  Women’s,  131+  lbs.,  beginner  [        ]  1508.  Women’s,  131+  lbs.,  int-­‐adv  

 

 NAME:  ___________________________________  

5th  NEW  ENGLAND  INTERNATIONAL  WUSHU  CHAMPIONSHIPS  REGISTRATION  (CONTINUED)  Circle  all  events  you  wish  to  register  for  

Experience  Levels  –  Beginner,  0-­‐2  years  –  Intermediate,  2-­‐4  years  –  Advanced,  4+  years  You  may  register  in  only  one  experience  level  for  all  external  events,  one  for  all  internal  events,  and  one  for  all  contact  events    

Individual  Registration  Form  2014  U.S.  Taijiquan  Team  Trials  

5th  New  England  International  Wushu  Championships  2nd  All-­‐America  Taijiquan  Cup  

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2014  ALL-­‐AMERICA  TAIJIQUAN  CUP  REGISTRATION  Circle  all  events  you  wish  to  register  for  

Experience  Levels  –  Advanced  Only  –  At  least  one  barehand  and  one  weapon  form  required    At  the  sole  discretion  of  the  Organizing  Committee,  events  and  divisions  may  be  combined  or  divided  at  any  time  prior  to  competition.    A.  Contact  Events    1600.  Ages  35  and  under.    Men’s  [        ]        Women’s  [        ]    [        ]  1601.  42  Form  Taijiquan  [        ]  1602.  42  Form  Taijijian  [        ]  1603.  Yang  Style  Taijiquan  [        ]  1604.  Chen  Style  Taijiquan  [        ]  1605.  Wu  Style  Taijiquan  [        ]  1606.  Wu/Hao  Style  Taijiquan  [        ]  1607.  Other  Styles  Taijiquan  [        ]  1608.  Sun  Style  Taijijquan  [        ]  1609.  Zhaobao  Taijiquan  [        ]  1610.  Yang  Style  Taijijian  [        ]  1611.  Chen  Style  Taijijian  [        ]  1612.  Other  Styles  Taijijian  [        ]  1613.  Other  Short  Weapon  [        ]  1614.  Long  Weapon    

1700.  Ages  36-­‐60    Men’s  [        ]        Women’s  [        ]    [        ]  1701.  42  Form  Taijiquan  [        ]  1702.  42  Form  Taijijian  [        ]  1703.  Yang  Style  Taijiquan  [        ]  1704.  Chen  Style  Taijiquan  [        ]  1705.  Wu  Style  Taijiquan  [        ]  1706.  Wu/Hao  Style  Taijiquan  [        ]  1707.  Sun  Style  Taijijquan  [        ]  1708.  Zhaobao  Taijiquan  [        ]  1709.  Other  Styles  Taijiquan  [        ]  1710.  Yang  Style  Taijijian  [        ]  1711.  Chen  Style  Taijijian  [        ]  1712.  Other  Styles  Taijijian  [        ]  1713.  Other  Short  Weapon  [        ]  1714.  Long  Weapon    

1800.  Ages  61+    Men’s  [        ]        Women’s  [        ]    [        ]  1801.  42  Form  Taijiquan  [        ]  1802.  42  Form  Taijijian  [        ]  1803.  Yang  Style  Taijiquan  [        ]  1804.  Chen  Style  Taijiquan  [        ]  1805.  Wu  Style  Taijiquan  [        ]  1806.  Wu/Hao  Style  Taijiquan  [        ]  1807.  Sun  Style  Taijijquan  [        ]  1808.  Zhaobao  Taijiquan  [        ]  1809.  Other  Styles  Taijiquan  [        ]  1810.  Yang  Style  Taijijian  [        ]  1811.  Chen  Style  Taijijian  [        ]  1812.  Other  Styles  Taijijian  [        ]  1813.  Other  Short  Weapon  [        ]  1814.  Long  Weapon