INDICATE EXPERIENCE LEVEL:
Competitors are required to wear the designated belt.❏
BEGINNER—UP TO ONE YEAR
❏ NOVICE—ONE TO TWO YEARS
❏ INTERMEDIATE—TWO TO FOUR YEARS
❏ ADVANCED—4+ YEARS
EVENTS:
Please check each event in which you wish to compete❏ KATA ❏
WEAPONS
❏ KUMITE ❏ TEAM KATA
COST:
One Event ...................... $50
Two Events .................... $55
Three Events ................. $60
Four Events ................... $65
Applications received after 5/7/12 must include a $25late fee.
No applications will be accepted after 5/11/12.
No refunds will be given.
Total Amount enclosed _______________________________
TOURNAMENT RULES:
1. Divisions will be determined by the number of
entries.Tournament promoters have the right to refuse
admittance.
2. Kumite participants must use approved helmet, gloves and
amouthpiece. Groin protection is mandatory for males. Someequipment
will be available for purchase at the tournament.
3. Applications received after 5/7/12 must include a $25late
fee. No applications will be accepted after 5/11/12.No refunds will
be given.
DISCLAIMER:
I, the undersigned, hereby submit my attendance and
participationin Haley’s Spring Classic and hereby assume full
responsibilityfor any and all damages, injuries, or losses that I
may sustain orincur while attending or participating. I waive all
claims againstthe promotor or operators of said event individually
or otherwise.I fully understand that any medical treatment given to
me inconnection with this event will be first aid only. I have read
andunderstand the tournament rules and agree to abide by said
rules.
PRINT NAME
___________________________________________________________
SIGNATURE
____________________________________________________________
Parent must sign if competitor is under 18 years of age.
Haley’s Spring ClassicSaturday, May 12, 2012
Butte College GymnasiumDoors Open at 8:00 a.m. • Tournament
Begins at 9:30 a.m.
Contact Information: Pat Haley • 530-895-3114
Mail Registration forms with payment to: Haley’s Martial Arts
Center,260 Cohasset Road, Suite 150, Chico, CA 95926
Preregistration must be received by 5/7/12Make checks payable to
HMAC
Spectators: Adults, $5 • Children, 3–12 $3 • NO REFUNDS
INFORMATION:
FIRST & LAST NAME
__________________________________________________________________________________________________
❏ MALE ❏ FEMALE
PHONE (__________)
________________________________________________________ DATE OF
BIRTH _________________________ AGE AS OF MAY 12
_____________________
ADDRESS
___________________________________________________________________
CITY / STATE / ZIP
_____________________________________________________________
YEARS TRAINING
_____________________________________________________________ BELT
COLOR ____________________________
KYU / DAN
__________________________________________________________________
STYLE _________________________________ INSTRUCTOR’S NAME
__________________
DOJO NAME
_________________________________________________________________
DOJO ADDRESS
_______________________________________________________________
Spring Classic 2012 FlyerHMAC Map and Hotel
InfoSpring_Classic
DATE OF BIRTH: AGE AS OF MAY 12: ADDRESS: CITY STATE ZIP: YEARS
TRAINING: BELT COLOR: KYU DAN: STYLE: INSTRUCTORS NAME: DOJO NAME:
DOJO ADDRESS: BEGINNERUP TO ONE YEAR: OffNOVICEONE TO TWO YEARS:
OffINTERMEDIATETWO TO FOUR YEARS: OffADVANCED4 YEARS: OffKATA:
OffKUMITE: OffWEAPONS: OffTEAM KATA: OffPRINT NAME: Total Amount
enclosed: Phone Number: Sex: OffNAME:
