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2017 ISKFNATIONALS
11–12 November 2017 Hilton Los Angeles AirportHosted by ISKF Southwest RegionLOS ANGELES
Master Nakayama 33rd Memorial Service
ISKF US National Karate Championships 11–12 Nov 2017 Los Angeles
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Table of Contents3 General Information4 Timeline & Deadlines5 Competitor’s Checklist5 Dan & Judge Examinee’s Checklist5 iskf Passport Policy6 Schedule of Events8 Fees and Admission Prices9 Dan Examination Registration Information
10 Sample of Request for Dan Registration Form11 Application for Judge’s Exam12 Meritorious Service Award Form13 Selection of Judges Form14 Training Seminar Registration15 Medical Questionnaire16 Waiver/Release Agreement
Adult Competition 17 Adult Competition—General Information18 Black Belt Adult Individual Regional Representative Seeding Form19 Black Belt Young Adult & Adult Individual Registration Form20 Brown Belt Adult Individual Registration Form21 Colored Belt (6, 5, 4 kyu) Adult Individual Registration22 Adult Regional Team Registration Form23 Black & Brown Belt Senior Individual Registration Form24 Senior Team Kata Registration Form
Collegiate Competition 25 Collegiate Competition—General Information26 Collegiate Individual Registration Form27 Collegiate Team Registration Form
Youth Competition 28 Youth Competition—General Information29 Youth Individual Registration Form30 Youth Team Kata Registration Form31 Tournament Program Book Advertising Space Reservation Form 32 Banquet Reservation Form33 T-Shirt Order Form34 Memorial Service Transportation Reservation Form
ISKF US National Karate Championships 11–12 Nov 2017 Los Angeles
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General InformationWhat 2017 iskf/Us National Karate Tournament
National Collegiate Tournament National Youth Tournament National Senior Tournament
When November 11–12, 2017Tournament Venue/Hotel Hilton Los Angeles Airport
5711 West Century Boulevard • Los Angeles, California 90045 ISKF Group Rate $155/night, single/double occupancy.
ROOMs ARE LiMiTED, sO PLEAsE CALL EARLY. November 1, 2017 is the cut-off date for accepting hotel reservations into the iskf group guest room block. We hope that all our participants and their families will support the tournament/hosting region by staying at this hotel.
ISKF Group Code iskfOnline Reservations https://aws.passkey.com/e/49197902Phone Reservations 1-800-445-8667 (1-800-hiLTOns)
Parking Available at the Hilton Los Angeles Airport Special rates for tournament guests: self, $24; valet, $30
Car Rental Major rental agencies are located at Los Angeles International AirportHilton lax Shuttle Service Complimentary shuttle runs every 20–30 min. Please allow extra
30 min. of travel time due to lax construction. Hilton LAx shuttle is light blue and will pick-up/drop-off guests on lower level only.
Tournament Website iskfsm.comTournament Registration Regional Directors must submit all paperwork—all competitors &
examinees will register and pay fees to their Sensei or region.Each region will submit one payment (payable to ISKF Nationals) with all paperwork to: iskf Santa Monica, 1218 5th St, Santa Monica, CA 90401.
Tournament Director Holly Forsyth • (310) 486-4614 • [email protected]
ISKF US National Karate Championships 11–12 Nov 2017 Los Angeles
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Timeline & DeadlinesFriday, September 29, 2017 t to ISKF Santa Monica, 1218 5th St, Santa Monica, CA 90401
or electronic submission: [email protected] Advertising Space Reservation Form (page 30) & payment Ad artwork high-resolution print-ready digital file
t to ISKF Headquarters, 222 S. 45th Street, Philadelphia, PA 19104 or electronic submission: [email protected]
Meritorious Service Award Form (page 12) with photoFriday, October 13, 2017
all paperworK & FeeS dueRegional Directors must submit all paperwork—all competitors & examinees will register and pay fees to their Sensei or region.Each region will submit one payment (payable to ISKF Nationals) with all paperwork: t to ISKF Santa Monica, 1218 5th St, Santa Monica, CA 90401.
iskf Dan Registration Forms, with total fees (exam + registration) and one passport-sized photo (details on page 9)
Applications for Judges Exam (page 11) with exam fees Selection of Judges Form (page 13) Competitor Registration Forms with registration fees Competitor and Dan Examinee Medical Questionnaires (page 15) Competitor and Dan Examinee Waiver/Release Agreements (page 16) Training Seminar Registration (page 14) with training fees Banquet Reservation Form (page 31) with banquet fees T-shirt Order Form (page 32) with T-shirt fees
Wednesday, November 1, 2017 Cut-off date for accepting hotel reservations into the iskf group guest room block. See page 3 for tournament hotel information.t to ISKF Santa Monica, 1218 5th St, Santa Monica, CA 90401
or electronic submission: [email protected] Memorial Service Transportation Reservation Form (page 34)
Thursday, November 9, 2017 6 pm–9 pm
Competitors, examinees & judges check-in desk open Hilton LAx 2nd floor registration desk
Friday, November 10, 2017noon
Cut-off time for dan and judge’s examination registrants to check-in Hilton LAx 2nd floor registration desk
Friday, November 10, 201710 am–9 pm
Competitors, examinees & judges check-in desk open Hilton LAx 2nd floor registration desk
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ISKF US National Karate Championships 11–12 Nov 2017 Los Angeles
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Competitor’s ChecklistMouthpiece (approved by the iskf Technical Committee)White non-absorbent fist protectors (approved by the iskf Technical Committee)Standard white karate giiskf Passport (may be purchased at check-in—$70)Current 2017 iskf membership card (may be purchased at check-in—$50)Required for all collegiate events: Current semester full-time college student iD card
All competitors must check-in either Thursday, Nov 9, 6–9 PM or Friday, Nov 10, 10 AM–9 PM, Hilton LAx 2nd floor registration desk.
Dan & Judge Examinee’s Checklistiskf Passport (may be purchased at check-in—$70)
All examinees must be checked-in by noon Friday, Nov 10, Hilton LAx 2nd floor registration desk.
ISKF Passport Policy• The International Shotokan Karate Federation (iskf) requires
that all members and clubs within the iskf follow the new iskf Passport Policy.
• Passports are required for: — All students (regardless of age) who will be testing for the rank
of 1st kyu (ikkyu) —All students who have already attained the rank of 1st kyu • Passports must be presented prior to any test, examination or
competition, otherwise participation will not be allowed.• This policy is mandatory. • Club Instructors and Regional Directors will not require passports
for those students who have not yet attained 1st kyu level.• Students are permitted to purchase a passport at the time they
become members of iskf. • Passports do not expire.
ISKF US National Karate Championships 11–12 Nov 2017 Los Angeles
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Schedule of EventsExcept for the Master Nakayama 33rd Memorial Service, all events will take place at the Hilton Los Angeles Airport. Refer to the hotel reader board for event room locations.
Thursday, November 9, 20176 pm–9 pm Check-in for all competitors, examinees & judges
8 pm Master Nakayama 33rd Memorial Service Venice Hongwanji Buddhist Temple 12371 Braddock Dr., Culver City 90230 (Memorial Service Transportation Reservation Form, see page 34)
Friday, November 10, 201710 am–9 pm Check-in for all competitors, examinees & judges9 am–10 am nCkA Board of Directors Meeting
10:15 am–11:45 am iskf Board of Directors and Board of Governors Meetingnoon–12:45 pm Directors and Governors Luncheon
1:30 pm–3 pm Judges Meeting, Judges Examinations (written & practical)3:30 pm–5:30 pm Dan Examinations
7 pm–8:30 pm Training SeminarsSaturday, November 11, 2017
8 am Doors Open—International Ballroom9 am Competition Eliminations and Finals
YouthCollegiate Color BeltsCollegiate AdvancedAdult Intermediate Color BeltsAdult Brown Belts
Competition EliminationsSenior Team KataSenior Individual Black & Brown BeltsYoung Adult Team KataYoung Adult Individual Black BeltsYoung Adult Team KumiteAdult Team KataAdult Individual Black BeltsAdult Team Kumite
ISKF US National Karate Championships 11–12 Nov 2017 Los Angeles
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Schedule of Events (continued)
Sunday, November 12, 201711 am Doors Open—International Ballroomnoon Opening Ceremony
Introduction of Honored Guests and Officials | Contestants’ OathsISKF National Seniors Final Events
Team Kata 3 finalistsWomen Individual Kata & KumiteMen Individual Kata & Kumite
ISKF National Young Adults Final Events
Team Kata Women, 3 finalistsMen, 3 finalists
Women Individual Kata & KumiteMen Individual Kata & Kumite
Team Kumite Women, 2 finalistsMen, 2 finalists
DemonstrationISKF National Adults Final Events
Team KataWomen, 3 finalistsMen, 3 finalists
Women Individual Kata & KumiteMen Individual Kata & Kumite
Team KumiteWomen, 2 finalistsMen, 2 finalists
5 pm Closing Ceremonies 7 pm Banquet, Cash Bar, and Entertainment— La Jolla Ballroom
ISKF US National Karate Championships 11–12 Nov 2017 Los Angeles
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Fees and Admission PricesISKF National Karate Tournament
Competitors’ Registration Fees Young Adult Division
$45 Individual, single event$55 Individual, both events$60 per Team
Adult Division$45 Individual, single event$55 Individual, both events$60 per Team
Youth Division$30 Individual, single event$45 Individual, both events$60 per Team Kata
Senior Division$45 Individual, single event$55 Individual, both events$60 per Team Kata
iskf National Collegiate
$30 Individual, single event$45 Individual, both events$60 per Team
Competitors’ Late Registration Fee (postmarked after October 13, 2017) $10 per competitor
Late registrants cannot be guaranteed a place on the tournament ladder. Absolutely no registrations postmarked after October 20 will be accepted.
Judge’s Examination Fee First time $80 Exam & registrationRanked judges $40 Exam
Training Seminars Fee All ranks $25 per personSpectator Admission Prices No charge Donations will be appreciated
ISKF US National Karate Championships 11–12 Nov 2017 Los Angeles
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Dan Examination Registration Information• All dan exam registrants must be checked-in by noon Friday, Nov 10,
Hilton LAx 2nd floor registration desk.• Each dan registrant must show an iskf Passport at check-in or will
have to purchase one for $70.Dan Registration Packet Checklist iskf Request for Dan Registration form. Download the form from
the iskf website: http://iskf.com/information/#examguidelines One passport-sized photo Medical Questionnaire (page 15) Waiver/Release Agreement (page 16) Total Fees (Examination + Registration)
Dan Fees ExAMinATiOn REgisTRATiOn TOTALShodan $ 80 $ 90 $ 170
Nidan 100 120 220Sandan 120 165 285Yondan 150 220 370Godan 200 270 470
Rokudan 275 575 850Shichidan 325 875 1,200Hachidan 325 975 1,300
Friday, October 13, 2017all paperworK & FeeS due
Regional Directors must submit all paperwork—all competitors & examinees will register and pay fees to their Sensei or region.Each region will submit one payment (payable to ISKF Nationals) with all paperwork to: iskf Santa Monica, 1218 5th St, Santa Monica, CA 90401.
ISKF US National Karate Championships 11–12 Nov 2017 Los Angeles
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Sample of Request for Dan Registration FormSample is shown smaller than actual size. Form can be downloaded from the iskf website: http://iskf.com/information/#examguidelines
REQUEST FOR DAN REGISTRATION
For purposes of clarity all information must be typewritten. Handwritten forms will be returned.
**All registration forms must be signed by the Chief Instructor of the examinee’s club to be accepted.**
Please send 1 photo with registration form by mail or email (attach photo).
No Dan Certificates will be issued without an ISKF Passport.
Name _________________________________________________________
Address _______________________________________________________ photo
_______________________________________________________
Telephone (_____) _________________________ E-mail_____________________________
Registering for ____________ Dan Date of Examination _________________
Examiner _________________________________ Instructor __________________________
**Instructor’s Signature_________________________________________________________**
Club Name ________________________ Country ____________ Region ________________
PERSONAL INFORMATION
Date of Birth _____/_____/_____ Sex M_____ F_____
Occupation ___________________________________________________________________________________
Last School or College __________________________________ Degree _________________________________
KARATE HISTORY
When did you begin karate practice? Year ______________ Month ______________
Previous Dan Registrations:
Date of Exam Reg. No. Date of Exam Reg. No.
Sho (1) Dan ____________ __________________ Go (5) Dan ____________ ___________________
Ni (2) Dan ____________ __________________ Roku (6) Dan ____________ ___________________
San (3) Dan ____________ __________________ Shichi (7) Dan ____________ ___________________
Yon (4) Dan ____________ __________________ Hachi (8) Dan ____________ ___________________
I REQUEST THAT MY RANK BE LISTED IN THE REGISTER OF THE INTERNATIONAL SHOTOKAN KARATE
FEDERATION. I PROMISE TO UPHOLD THE STANDARDS AND HONOR OF THE ISKF.
Student’s Signature __________________________________________________________________________
FOR EXAMINER’S USE ONLY
Rank Awarded _______________________ Examiner’s Signature ____________________________________________________
Promotion by: (circle one) EXAMINATION RECOMMENDATION HONORARY ISKF PASSPORT Y / N
Remarks:
ISKF US National Karate Championships 11–12 Nov 2017 Los Angeles
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Application for Judge’s Exam• All examinees must be checked-in by noon Friday, Nov 10,
Hilton LAx 2nd floor registration desk.• Each examinee who has a previous judge ranking must show an
iskf Passport at check-in or will have to purchase one for $70. Judges’ Requirements fOR jUDgE’s LEvEL YOUR RAnk MUsT bE AT LEAsT
D NidanC SandanB YondanA Shichidan
Examination Date Nov 10, 2017 Place 2017 Nationals, Los Angeles, CAPLEAsE PRinT LEgibLY
NameAddress
City State ZipTelephone E-Mail
Current Judge’s Rank (if any) Date Tested LocationCurrent Dan Rank
RegionPERsOnAL infORMATiOn
Date of Birth Gender f M Height WeightOccupation
Last School or College DegreeApplicant’s Signature
Judge’s Examination Fee $80, first time, exam & registration$40, ranked judges, exam
Friday, October 13, 2017all paperworK & FeeS due
Regional Directors must submit all paperwork—all competitors & examinees will register and pay fees to their Sensei or region.Each region will submit one payment (payable to ISKF Nationals) with all paperwork to: iskf Santa Monica, 1218 5th St, Santa Monica, CA 90401.
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Meritorious Service Award FormAwards Presentation Time & Date 7 PM Sunday, November 12, 2017
One individual from each region is selected to receive the Meritorious Service Award for his/her outstanding service and contribution in promoting the growth and goals of the International Shotokan Karate Federation (iskf). These awards are presented at the 2017 iskf/Us National Championships Banquet. This is to confirm that the following individual will receive the 2017 Meritorious Service Award:
NomineeRankClub
RegionBrief description of the
individual’s contribution (approximately 50 words or less)
Nominee’s Photo Please include a high-resolution, print-ready photo with nominee’s name and region written on the back (no action photos please; passport-style head shot only.)
Submit this form & photo by Friday, September 29, 2017
to iskf Headquarters, 222 S. 45th Street, Philadelphia, PA 19104 or electronic submission: [email protected]
ISKF US National Karate Championships 11–12 Nov 2017 Los Angeles
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Selection of Judges Form• Judges must meet the requirements as established by the
International Shotokan Karate Federation (iskf). • The iskf Technical Committee shall designate the Chief Judge
and Arbitrator. • A minimum of 3 judges is requested from each region,
2 of whom must be rated C or above.• Each participating judge must show an iskf Passport at check-in
or will have to purchase one for $70. Judge’s Uniform • Saturday: karate gi
• Sunday: White long-sleeved shirt with maroon tie, gray pants & navy blazer
Region
This is to confirm that the following persons will serve as Judges at the 2017 iskf/Us National Karate Championships:
nAMEDAn
RAnk
jUDgE’s RAnk
(A, b, C)iskf
CERTifiCATiOn nUMbER123456
Signature of Regional Director
Friday, October 13, 2017all paperworK & FeeS due
Regional Directors must submit all paperwork—all competitors & examinees will register and pay fees to their Sensei or region.Each region will submit one payment (payable to ISKF Nationals) with all paperwork to: iskf Santa Monica, 1218 5th St, Santa Monica, CA 90401.
ISKF US National Karate Championships 11–12 Nov 2017 Los Angeles
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Training Seminar RegistrationEvent Time & Date 7–8:30 PM Friday, November 10, 2017
RegionCLAss (ChECk OnE) C = COLORED bELTs; b = bLACk & bROwn bELTs; iT = insTRUCTOR TRAinEEs RAnk
C b iT nAME kYU DAn123456789
1011121314151617181920212223
Training Seminar Fee $25 per personTotal Amount Due $
Friday, October 13, 2017all paperworK & FeeS due
Regional Directors must submit all paperwork—all competitors & examinees will register and pay fees to their Sensei or region.Each region will submit one payment (payable to ISKF Nationals) with all paperwork to: iskf Santa Monica, 1218 5th St, Santa Monica, CA 90401.
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Medical QuestionnaireThis Medical Questionnaire must be completed, signed, and submitted to the proper iskf authority each year by any iskf member wishing to compete in a karate tournament, take a Dan Examination, or participate in any iskf event requiring this form.1. You must have had a complete physical examination by a physician or a health care facility dated no
longer than two years prior to the event in which you are expecting to participate.2. This Medical Questionnaire will be reviewed by the iskf event committee and will be kept confidential.
Contents may be reviewed by your instructor and the tournament medical staff.PLEASE PRINT OR TYPE
Name Last First
Birthdate Age Gender f M Rank
Address City State Zip
Instructor Club Region
Family Doctor Physician name Physician phone
Emergency Contact Name Phone Relationship to Competitor
Do you have a history of any of the following conditions? Please check all that apply to you:nO YEs if YEs, PLEAsE ExPLAin bELOw
Allergy to medication(s)? List all.
Have you ever been told in the last two years that you could not participate in a sport? Explain why.Hypertension (high blood pressure)
Heart murmur
Recent infection
Bone fracture in past 6 months
Concussion or severe head injury in past 6–12 months
Seizures
Eye injury
Severe bone bruises requiring padding
Kidney injury
Positive test for HIV
Positive test for Hepatitis C
Other surgeries/hospitalizations in the past 6–12 months. Explain.
Are you currently taking any medications? List all.
I attest that the above information is true and correct to the best of my knowledge. I further understand that this information is necessary to participate in iskf events.
Last complete physical exam
Date of exam Name of Physician Name of health care facility
I give permission to the above-named physician and/or health care facility to release any and all information regarding my last complete physical exam to the iskf National Committee for review, to medically qualify my participation in the karate competition on November 11–12, 2017.
Signatures
Competitor DateParent or Guardian
if competitor is under 18 years of age Date
Instructor Date
Coach Date
ISKF US National Karate Championships 11–12 Nov 2017 Los Angeles
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Waiver/Release AgreementEvery competitor and dan examinee must complete, sign and submit this Waiver/Release Agreement.
Event 2017 International Shotokan Karate Federation National Karate Tournament, National Collegiate Tournament, National Youth Tournament and National Senior Tournament; Hilton Los Angeles Airport, Los Angeles, California; November 10, 11, 12, 2017.I understand that there are risks and dangers inherent in participating and/or receiving instruction at the Dan & Judges exams, Clinics and the tournament (all of which will herein be referred to as the EvEnT). I also understand that in order to participate and/or receive instruction at the EvEnT, I must give up my rights to hold the Hilton Los Angeles Airport, the International Shotokan Karate Federation (iskf), the iskf Southwest Region, the International Shotokan Karate Federation Santa Monica (iskfsM) and all other clubs, schools, instructors, members, judges, officials and representatives (collectively the “Releases”) liable for any injury or damage which I may suffer while participating and/or receiving instruction at the EvEnT.Knowing this, and in consideration of being permitted to participate and/or receive instruction at the EvEnT, I hereby voluntarily release the Releases, and each of them, from any and all liability resulting from or arising out of my participation and/or receipt of instruction at the EvEnT.I understand and agree that I am releasing not only the entities and individuals set forth in the paragraph above, but also the officers, agents, principals, partners, shareholders, directors and employees of those entities or individuals.I understand and agree that this Waiver/Release will have the effect of releasing, discharging, waiving and forever relinquishing any and all actions or causes of action that I may have or have had, whether past, present or future, whether known or unknown, and whether anticipated or unanticipated by me, arising out of my participation and/or receipt of instruction at the EvEnT.I understand and agree that by signing this Waiver/Release, I am assuming full responsibility for any and all risk of death or personal injury or property damage suffered by me while participating and/or receiving instruction at the EvEnT. I expressly acknowledge and assume any and all risks that my participation in the EvEnT may subject me to personal injury or bodily harm.I understand and agree that this Waiver/Release will be binding on me, my spouse, my heirs, my personal representatives, my assigns, my children and any guardian ad litem for said children.I understand and agree that by signing this Waiver/Release, I am agreeing to release, indemnify and hold the above-named individuals or entities and their officers, agents, principals, partners, shareholders, directors and employees harmless from any and all liability or costs, including attorney fees, associated with or arising from my participating and/or receipt of instruction at the EvEnT. Any damage to the hotel or the tournament site that I cause are my full responsibility. Said damages are not the responsibility of the the International Shotokan Karate Federation (iskf), the iskf Southwest Region or the International Shotokan Karate Federation Santa Monica (iskfsM).I understand that if I am signing this Waiver/Release on behalf of my minor child, that I will be giving up the same rights for said minor, as I would be giving up if I signed this document on my own behalf.I acknowledge that I have read this Waiver/Release agreement and that I understand the words and language in it. I have been advised of the potential dangers incidental to participating and/or receiving instruction at the EvEnT.
Print Name Date
Sign Name Witness
Parent/Guardian Release I am the parent or legal guardian of the minor ___________________________________________________________
and am signing this Waiver/Release on behalf of said minor.
Print name of parent Date
Signature of parent
17
ISKF US National Karate Championships 11–12 Nov 2017 Los Angeles
Adult Competition—General InformationQualifications • The US National Karate Championship is open to International Shotokan Karate Federation
United States (iskf/Us) members only. • Any qualified member of the iskf who wishes to compete may do so by filling out the
appropriate forms and meeting the deadlines for registration.• There are no limits to the number of competitors from one region.• Young Adult Division competitors must be 18–21 years old.• Adult Division competitors must be 22–44 years old.• Individuals ages 45 and above must participate in the Senior Division.• Adult individuals may not compete in both the Adult Division and the Senior Division.• Competitors must show current iskf membership cards at check-in.• Competitors ranked 1st kyu (ikkyu) and above must show iskf Passports at check-in.
Safety Precautions
• In kumite matches, mouthpiece and ISKF-approved white non-absorbent hand protectorsare required for all competitors, regardless of rank. No competitor will be permitted tocompete without both.
• No eye glasses or safety glasses will be permitted to be worn during kumite events.• Absolutely no jewelry of any type will be permitted to be worn by competitors or officials
(male or female).• Female competitors may wear white chest protectors, worn inside the gi jacket.
Kata Matches Shodan and above must perform any kata from The Best Karate series #5–#11.Nationals Young Adult, Adult and Senior Individual Events
Young Adult and Adult
Competition
• Each region of the iskf/Us may seed the top 4 competitors from its region in the followingevents: Women’s Kata, Men’s Kata, Women’s Kumite and Men’s Kumite.
• Brown and black belt ranks will compete in separate events.• Intermediate (6, 5, 4 kyu) ranks will have a color belt competition.• Brown and color belt events will conclude on Saturday, Nov 10, 2017.• Eliminations for all black belt individual events will be on Saturday; finalists from each
individual event will advance to the finals on Sunday, Nov 11.Senior
Competition• No competition for intermediate ranks.• Brown and black belt ranks will be combined.• Eliminations for all individual events will be on Saturday; finalists from each individual event
will advance to the finals on Sunday, Nov 11.Nationals Adult and Senior Team Events
Team Kata • Each iskf region may send one men’s team, one women’s team and one mixed senior team, chosen in competition at the regional eliminations.
• Senior kata team members may not also participate as members of an adult team.• Eliminations for kata teams will be on Saturday, Nov 10, 2017; the top three men’s, women’s
and senior teams will advance to the finals on Sunday, Nov 11, 2017.Team Kumite • Each iskf Region may send one men’s and one women’s, chosen in competition at the
regional eliminations. • Each men’s team will consist of five (5) members and one alternate.• Each women’s team will consist of three (3) members and one alternate.• Eliminations for kumite teams will be on Saturday, Nov 10, 2017; the top two teams will
advance to the finals on Sunday, Nov 11, 2017.Contest Rules Please refer to the official Tournament Rules & Regulations Booklet which can be downloaded at:
http://iskf.com/tournament-rules/
ISKF US National Karate Championships 11–12 Nov 2017 Los Angeles
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Black Belt Adult Individual Regional Representative Seeding Form• Each region may seed the top competitors from its elimination
tournament as “previously qualified” for the National Tournament. The maximum number of competitors is four (4) in each of these events: Women’s Kata, Women’s Kumite, Men’s Kata, Men’s Kumite.
• Each competitor must pre-register by October 13, 2017, and submit a Medical Questionnaire and a Waiver/Release Agreement.
• Competitors must be 22–44 years of age, shodan rank or higher• Competitors must show their iskf Passports and current iskf
membership cards at check-in.
Region
Regional Director’s Signature
nAME RAnkWomen’s Kata 1
234
Women’s Kumite 1234
Men’s Kata 1234
Men’s Kumite 1234
Friday, October 13, 2017all paperworK & FeeS due
Regional Directors must submit all paperwork—all competitors & examinees will register and pay fees to their Sensei or region.Each region will submit one payment (payable to ISKF Nationals) with all paperwork to: iskf Santa Monica, 1218 5th St, Santa Monica, CA 90401.
ISKF US National Karate Championships 11–12 Nov 2017 Los Angeles
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Black Belt Young Adult & Adult Individual Registration Form• Each competitor must pre-register by October 13, 2017, and submit a Medical
Questionnaire and a Waiver/Release Agreement. • Young Adult Division competitors must be 18–21 years of age.• Adult Division competitors must be 22–44 years of age.• Individuals ages 45 and above must participate in the Senior Division. • Adult individuals may not compete in both the Adult Division and the Senior Division.• Competitors must show their iskf Passports and current iskf membership cards
at check-in.• The number of participants in each category will determine if any adjustments will be
made to the categories.• There are no limits to the number of competitors from one region. • Registration fees are non-refundable, per competitor:
single event, $45; both events, $55.
Region
AgEnAME RAnk gEnDER 18–21 22–44 kATA kUMiTE fEE
1 f M2 f M3 f M4 f M5 f M6 f M7 f M8 f M9 f M
10 f M11 f M12 f M13 f M14 f M15 f M
Total Amount Due $Friday, October 13, 2017
all paperworK & FeeS dueRegional Directors must submit all paperwork—all competitors & examinees will register and pay fees to their Sensei or region.Each region will submit one payment (payable to ISKF Nationals) with all paperwork to: iskf Santa Monica, 1218 5th St, Santa Monica, CA 90401.
ISKF US National Karate Championships 11–12 Nov 2017 Los Angeles
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Brown Belt Adult Individual Registration Form• Each competitor must pre-register by October 13, 2017, and submit a Medical
Questionnaire and a Waiver/Release Agreement. • Competitors must be at least 18 years of age.• Individuals ages 45 and above must participate in the Senior Division. • Adult individuals may not compete in both the Adult Division and the Senior Division.• Competitors must show current iskf membership cards at check-in.• Competitors ranked 1st kyu (ikkyu) and above must show iskf Passports at check-in. • There are no limits to the number of competitors from one region. • Registration fees are non-refundable, per competitor:
single event, $45; both events, $55.
Region
nAME RAnk gEnDER AgE kATA kUMiTE fEE1 f M2 f M3 f M4 f M5 f M6 f M7 f M8 f M9 f M
10 f M11 f M12 f M13 f M14 f M15 f M16 f M17 f M18 f M
Total Amount Due $Friday, October 13, 2017
all paperworK & FeeS dueRegional Directors must submit all paperwork—all competitors & examinees will register and pay fees to their Sensei or region.Each region will submit one payment (payable to ISKF Nationals) with all paperwork to: iskf Santa Monica, 1218 5th St, Santa Monica, CA 90401.
ISKF US National Karate Championships 11–12 Nov 2017 Los Angeles
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Colored Belt (6, 5, 4 kyu) Adult Individual Registration Form• Each competitor must pre-register by October 13, 2017, and submit a
Medical Questionnaire and a Waiver/Release Agreement. • Competitors must be 18–44 years of age.• Competitors must show current iskf membership cards at check-in.• There are no limits to the number of competitors from one region. • Registration fees are non-refundable, per competitor:
single event, $45; both events, $55.
Region
nAME RAnk gEnDER AgE kATA kUMiTE fEE1 f M2 f M3 f M4 f M5 f M6 f M7 f M8 f M9 f M
10 f M11 f M12 f M13 f M14 f M15 f M16 f M17 f M18 f M19 f M20 f M
Total Amount Due $Friday, October 13, 2017
all paperworK & FeeS dueRegional Directors must submit all paperwork—all competitors & examinees will register and pay fees to their Sensei or region.Each region will submit one payment (payable to ISKF Nationals) with all paperwork to: iskf Santa Monica, 1218 5th St, Santa Monica, CA 90401.
ISKF US National Karate Championships 11–12 Nov 2017 Los Angeles
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Adult Regional Team Registration Form• Each region may send one team for each of the following team events:
Women’s Team Kata, Women’s Team Kumite, Men’s Team Kata, Men’s Team Kumite.• All teams must pre-register by October 13, 2017. • Competitors must submit a Medical Questionnaire and a Waiver/Release Agreement.• Competitors must be at least 18 years of age, 3 kyu or higher• Competitors must show current iskf membership cards at check-in.• Competitors ranked 1st kyu (ikkyu) and above must show iskf Passports at check-in. • Registration fees are non-refundable, per team: $60.
RegionRegional Director’s Signature
nAME RAnkWomen’s Kata Team 1 (CAPTAin)
234 (ALTERnATE)
Women’s Kumite Team 1 (CAPTAin)
234 (ALTERnATE)
Men’s Kata Team 1 (CAPTAin)
234 (ALTERnATE)
Men’s Kumite Team 1 (CAPTAin)
23456 (ALTERnATE)
Total Amount Due $Friday, October 13, 2017
all paperworK & FeeS dueRegional Directors must submit all paperwork—all competitors & examinees will register and pay fees to their Sensei or region.Each region will submit one payment (payable to ISKF Nationals) with all paperwork to: iskf Santa Monica, 1218 5th St, Santa Monica, CA 90401.
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Black & Brown Belt Senior Individual Registration Form • Each competitor must pre-register by October 13, 2017, and submit a Medical
Questionnaire and a Waiver/Release Agreement. • Individuals ages 45–64 must participate in this division. • Adult individuals may not compete in both the Adult Division and the Senior Division.• Competitors must show current iskf membership cards at check-in.• Competitors ranked 1st kyu (ikkyu) and above must show iskf Passports at check-in. • There are no limits to the number of competitors from one region. • Registration fees are non-refundable, per competitor:
single event, $45; both events, $55.Senior Division
Kumite• Method of kumite competition for ages 55–64 will be jiyu ippon.• Competitors over the age of 65 will not compete in kumite.
Region
nAME RAnk gEnDER AgE kATA kUMiTE fEE1 f M2 f M3 f M4 f M5 f M6 f M7 f M8 f M9 f M
10 f M11 f M12 f M13 f M14 f M15 f M16 f M17 f M
Total Amount Due $Friday, October 13, 2017
all paperworK & FeeS dueRegional Directors must submit all paperwork—all competitors & examinees will register and pay fees to their Sensei or region.Each region will submit one payment (payable to ISKF Nationals) with all paperwork to: iskf Santa Monica, 1218 5th St, Santa Monica, CA 90401.
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Senior Team Kata Registration Form• Each region may send one kata team for the Senior Team Kata Event. • Teams may be a mix of male and female.• Senior kata team members may not also participate as members of an
adult team.• All teams must pre-register by October 13, 2017. • Each team member must submit a Medical Questionnaire and a
Waiver/Release Agreement.• Competitors must be 45 years of age and above.• Competitors must show current iskf membership cards at check-in.• Competitors ranked 1st kyu (ikkyu) and above must show their
iskf Passports at check-in.• Registration fees are non-refundable, per team: $60.
Region
Regional Director’s Signature
nAME RAnkSenior Kata Team 1 (CAPTAin)
234 (ALTERnATE)
Total Amount Due $60Friday, October 13, 2017
all paperworK & FeeS dueRegional Directors must submit all paperwork—all competitors & examinees will register and pay fees to their Sensei or region.Each region will submit one payment (payable to ISKF Nationals) with all paperwork to: iskf Santa Monica, 1218 5th St, Santa Monica, CA 90401.
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Collegiate Competition—General InformationQualifications • The National Collegiate Karate Tournament is open to International Shotokan
Karate Federation United States (iskf/Us) members who are full-time undergraduate or graduate students in good standing enrolled at a college, university or junior college in the United States.
• Competitors must be at least 18 years old. • A student may compete in the Collegiate Competition for a total of 4 years.• Competitors must show valid proof of current semester full-time student status
at check-in.• Competitors must show current iskf membership cards at check-in.• Competitors ranked 1st kyu (ikkyu) and above must show iskf Passports at check-in. • There is no limit to the number of contestants from one school.
Safety Precautions • In kumite matches, mouthpiece and ISKF-approved white non-absorbent hand protectors are required for all competitors, regardless of rank. No competitor will be permitted to compete without both.
• No eye glasses or safety glasses will be permitted to be worn during kumite events. • Absolutely no jewelry of any type will be permitted to be worn by competitors or
officials (male or female).• Female competitors may wear white chest protectors, worn inside the gi jacket.
Collegiate Individual EventsbEginnERs (UnRAnkED TO 7 kYU)
inTERMEDiATE (6, 5, 4 kYU)
ADvAnCED (3 kYU AnD AbOvE)
• Combined Kata• Women’s Kumite• Men’s Kumite
• Combined Kata• Women’s Kumite• Men’s Kumite
• Women’s Kata• Men’s Kata• Women’s Kumite• Men’s Kumite
Collegiate Team Events• All members of a collegiate team must be from the same college/university. • Only one team per school is allowed in each team event.• A team consists of three members and one alternate.
Team Kata Teams may be composed of any combination of ranks for the men’s team and for the women’s team.
Team Kumite Teams may be composed of any combination of ranks for the men’s team and for the women’s team.
Collegiate Contest RulesPlease refer to the official Tournament Rules & Regulations Booklet which can be downloaded at: http://iskf.com/tournament-rules/
Finals All Collegiate divisions will conclude on Saturday, November 11, 2017.
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Collegiate Individual Registration Form• Each competitor must pre-register by October 13, 2017, and submit a Medical
Questionnaire and a Waiver/Release Agreement. • Competitors must be at least 18 years of age.• Competitors must be full-time undergraduate or graduate students in good standing
enrolled at a college, university or junior college in the United States. • No part-time students will be allowed to compete. • A student may compete in the Collegiate Competition for a total of 4 years.• Competitors must show valid proof of current semester full-time student status at check-in. • Competitors must show current iskf membership cards at check-in.• Competitors ranked 1st kyu (ikkyu) and above must show iskf Passports at check-in.• There is no limit to the number of contestants from one school.• Registration fees are non-refundable, per competitor:
single event, $30; both events, $45.
SchoolCity State
CoachRegion
Ranking Categories bEginnERunranked to 7 kyu
inTERMEDiATE6 kyu to 4 kyu
ADvAnCED3 kyu and above
nAME RAnk gEnDER AgE kATA kUMiTE fEE1 f M2 f M3 f M4 f M5 f M6 f M7 f M8 f M9 f M
10 f M11 f M12 f M
Total Amount Due $Friday, October 13, 2017
all paperworK & FeeS dueRegional Directors must submit all paperwork—all competitors & examinees will register and pay fees to their Sensei or region.Each region will submit one payment (payable to ISKF Nationals) with all paperwork to: iskf Santa Monica, 1218 5th St, Santa Monica, CA 90401.
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Collegiate Team Registration Form• Each team member must pre-register by October 13, 2017, and submit a Medical
Questionnaire and a Waiver/Release Agreement. • Competitors must be at least 18 years of age.• Competitors must be full-time undergraduate or graduate students in good standing
enrolled at a college, university or junior college in the United States. • No part-time students will be allowed to compete. • Competitors must show valid proof of current semester full-time student status at check-in. • Competitors must show current iskf membership cards at check-in.• Competitors ranked 1st kyu (ikkyu) and above must show iskf Passports at check-in.• Only one team per event, per school. • Teams may be composed of any combination of rank.• All members of a team must be from the same school.• Registration fees are non-refundable, per team: $60.
CollegeCity State
CoachRegion
nAME RAnkTeam Kata
(Kata team may be any gender combination)
1 (CAPTAin)
234 (ALTERnATE)
Women’s Team Kumite 1 (CAPTAin)
234 (ALTERnATE)
Men’s Team Kumite 1 (CAPTAin)
234 (ALTERnATE)
Total Amount Due $Friday, October 13, 2017
all paperworK & FeeS dueRegional Directors must submit all paperwork—all competitors & examinees will register and pay fees to their Sensei or region.Each region will submit one payment (payable to ISKF Nationals) with all paperwork to: iskf Santa Monica, 1218 5th St, Santa Monica, CA 90401.
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Youth Competition—General InformationAge-Rank Qualifications
and Rules• All eligible youth competitors must be a member in good standing
with the International Shotokan Karate Federation. • Youth competitors must be between the ages of 7 and 17 years old.• The number of participants in each category will determine if
adjustments will need to be made, if any, to their categories. • If any division has fewer than 5 competitors, we reserve the right to
combine divisions.Youth Individual Events The competition is open to both male and female competitors and will
include five age categories as follows. AgEs 7–9 • 10–11 bOYs AnD giRLs wiLL bE combIned in ThE fOLLOwing gROUPs:
Unranked to 7 kyu kata kumite6 kyu to 4 kyu kata kumite3 kyu and above kata kumite
AgEs 12–13 bOYs AnD giRLs wiLL bE combIned in ThE fOLLOwing gROUPs:Unranked to 7 kyu kata kumite6 kyu to 4 kyu kata kumite3 kyu and above kata —
bOYs AnD giRLs wiLL bE Separate in ThE fOLLOwing gROUPs:3 kyu and above — kumite
AgEs 14–15 • 16–17 bOYs AnD giRLs wiLL bE combIned in ThE fOLLOwing gROUPs:Unranked to 7 kyu kata kumite6 kyu to 4 kyu kata kumite
bOYs AnD giRLs wiLL bE Separate in ThE fOLLOwing gROUPs:3 kyu and above kata kumite
Youth Team Kata • Team kata will be open to all ages, ranks and any gender.• The number of youth teams per region is not limited.
Youth Contest Rules Please refer to the official Tournament Rules & Regulations Booklet which can be downloaded at: http://iskf.com/tournament-rules/
Finals All Youth divisions will conclude on Saturday, November 11, 2017.
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Youth Individual Registration FormDivisions bEginnERs
unranked to 7 kyuinTERMEDiATE 6 kyu to 4 kyu
ADvAnCED 3 kyu and above
Age Groups 7–9 10–11 12–13 14–15 16–17• Each region may send an unlimited number of competitors in each of
the three divisions in each of the five age groups.• Each competitor must pre-register by October 13, 2017, and submit
a Medical Questionnaire and a Waiver/Release Agreement. Parents who do not accompany their minor children must assure that these forms are submitted.
• Competitors must be 7–17 years of age on the date of the event. • Competitors must show current iskf membership cards at check-in.• Competitors ranked 1st kyu (ikkyu) and above must show their
iskf Passports at check-in. • Registration fees are non-refundable, per competitor:
single event, $30; both events, $45.Region
RAnknAME kYU DAn gEnDER AgE kATA kUMiTE fEE
1 f M2 f M3 f M4 f M5 f M6 f M7 f M8 f M9 f M
10 f M11 f M12 f M13 f M14 f M
Total Amount Due $Friday, October 13, 2017
all paperworK & FeeS dueRegional Directors must submit all paperwork—all competitors & examinees will register and pay fees to their Sensei or region.Each region will submit one payment (payable to ISKF Nationals) with all paperwork to: iskf Santa Monica, 1218 5th St, Santa Monica, CA 90401.
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Youth Team Kata Registration Form• Each region may send an unlimited number of kata teams for the
Youth Team Kata Event. • Teams may be made up of any combination of age, rank and gender.• Competitors must be 7–17 years of age on the date of the event. • All teams must pre-register by October 13, 2017. • Each team member must submit a Medical Questionnaire and a
Waiver/Release Agreement. Parents who do not accompany their minor children must assure that these forms are submitted.
• Competitors must show current iskf membership cards at check-in.• Competitors ranked 1st kyu (ikkyu) and above must show their
iskf Passports at check-in. • Registration fees are non-refundable, per team: $60.
Region
Regional Director’s Signature
nAME RAnk1 (CAPTAin)
234 (ALTERnATE)
1 (CAPTAin)
234 (ALTERnATE)
1 (CAPTAin)
234 (ALTERnATE)
Total Amount Due $Friday, October 13, 2017
all paperworK & FeeS dueRegional Directors must submit all paperwork—all competitors & examinees will register and pay fees to their Sensei or region.Each region will submit one payment (payable to ISKF Nationals) with all paperwork to: iskf Santa Monica, 1218 5th St, Santa Monica, CA 90401.
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Tournament Program Book Advertising Space Reservation Form
MEChAniCAL sPECifiCATiOns• 300 dpi• CMYk or grayscale• fonts embedded• Preferred format: PDf,
saved as “high quality print” or “press quality”
• Any copy not already typeset must be typed, not handwritten
• Business cards are acceptable, those in color will be converted to black & white
• Only cover ads may be in color; all other ads are black & white
71/2" x 10" fULL PAgEOUTsiDE bACk COvER
$ 600insiDE fROnT/bACk COvER
$ 500fULL insiDE PAgE
$ 350
71/2" x 5"hALf PAgE
$ 180
33/4" x 5"qUARTER
PAgE$ 100
33/4" x 21/2"1/8 PAgE/bC
$ 75
Company NameCompany Address
City State ZipPhone E-mail address
Company RepresentativeSignature Date
Please check one $ 600 Outside Back Cover (may be in color) $ 500 Inside Front/Back Cover (may be in color) $ 350 Full Inside Page (black & white only) $ 180 Half Page (black & white only) $ 100 Quarter Page (black & white only) $ 75 Eighth Page/Business Card (black & white only)
Total amount due $Checks/money orders payable to ISKF Nationals
Send this form, payment & artwork to
iskf Santa Monica, 1218 5th St, Santa Monica, CA 90401
or electronic submission: [email protected] Postmarked by Friday, September 29, 2017
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Banquet Reservation Form Event Time & Date 7:00 PM Sunday, November 12, 2017
Location Hilton Los Angeles Airport, La Jolla BallroomThe banquet is open to all participants, family and friends. Please plan to attend with others from your region. Banquet fees are non-refundable. There will be a cash bar.
Buffet $70 per personSpecial dietary needs can
be accommodated upon request. Please specify.
Chicken & vegetable soup • Kale salad with yam, celery, garlic croutons, Japanese vegetable dressing • California herb marinated sirloin • Citrus marinated chicken breast • Roasted salmon with pepper coulis • Roasted garlic potatoes • Roasted brussel sprouts • Individual tarts
Region
nAMEsPECifY if
sPECiAL DiET qTY fEE123456789
10111213141516
Total amount due $Friday, October 13, 2017
all paperworK & FeeS dueRegional Directors must submit all paperwork—all competitors & examinees will register and pay fees to their Sensei or region.Each region will submit one payment (payable to ISKF Nationals) with all paperwork to: iskf Santa Monica, 1218 5th St, Santa Monica, CA 90401.
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T-Shirt Order FormOrder your 2017 iskf Tournament T-Shirt now—it will be available for you when you check-in at the tournament. Style: Short-Sleeve—$25Sizes: Adult—s, M, L, xL, xxL • Youth—s, M, L
Region
nAMEADULT
sizEYOUTh
sizE qTY fEE123456789
101112131415161718
Total amount due $Friday, October 13, 2017
all paperworK & FeeS dueRegional Directors must submit all paperwork—all competitors & examinees will register and pay fees to their Sensei or region.Each region will submit one payment (payable to ISKF Nationals) with all paperwork to: iskf Santa Monica, 1218 5th St, Santa Monica, CA 90401.
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Memorial Service Transportation Reservation FormFor those staying at the Hilton, sign-up here for round-trip transportation. This tally will help us determine the type of transport to hire.
Event Master Nakayama 33rd Memorial ServiceTime & Date 8:00 PM Thursday, November 9, 2017
Location Venice Hongwanji Buddhist Temple 12371 Braddock Dr., Culver City 90230
nAME CELL PhOnE #123456789
10111213141516
Send this form to iskf Santa Monica, 1218 5th St, Santa Monica, CA 90401
or electronic submission: [email protected] by Wednesday, November 1, 2017