Alaska Judo, Inc.

41ST Annual Alaska Judo Championships

March 11, 2000

Male	Female	Age:	Weight:	Rank:

If competition in more than one division, please note which division:________________________________

Name:	Club:

Home Phone:	Emergency Phone:

USJI/AJI q	USJF q USJA q	Competitor Registration Number :

All competitors must enter their weight on this form, even though they will be weighed in the evening prior to the tournament.

I certify that the above named person is a student of Kodokan Judo under my instruction. I further certify that the registration, rank, age, and weight information listed above is accurate to the best of my knowledge.

Sensei Signature: _____________________________________ Date:__________________

NOTICE TO PARENTS AND COACHES: CONSENT TO MODIFY DIVISION ENTERED

An age and/or weight division will be dropped unless there are three (3) or more entries. If you consent to your child/student competing in a heavier or older weight division, please sign below. This decision should be discussed with the instructor. If you do not sign below, your child/student may be excluded from the competition. If this occurs, your entry fee will be refunded. AJI will not be responsible for transportation expenses to or from the tournament site, even if your child/student does not get to compete. Students should bring a current registration card to the competition site. Junior division are established on the basis of weight and age.

Parent/Guardian:	Date:

Location:	Palmer High School - 1170 West Arctic Avenue, Palmer, Alaska 99645

DEADLINE for ENTRIES: Tuesday, MARCH 7, 2000 - $25 (includes banquet)

DEADLINE - LATE ENTRIES at WEIGH-In @ Awards Banquet - Palmer

High School Cafeteria - Friday, MARCH 10, 2000 - $40 (banquet not included)

(NO APPLICATIONS WILL BE ACCEPTED THE DAY OP THE TOURNAMENT)

Date/Time	WEIGH-IN: Friday, March 10, 2000 - 6:00 PM TO 7:30 PM - Palmer High School Cafeteria

AWARDS BANQUET: Friday 7:00 PM - 9:00 PM - Palmer High School Cafeteria.

(Banquet in included in registration fee whether you eat or not.)

COMPETITION: Saturday, March 11, 2000 - Palmer High School Gym - 8:00 AM

Sanctioning Bodies	United States Judo, Inc/Alaska Judo, Inc. AJI, USJF, USJA

Rules	Standard International Judo Federation Contest Rules as modified by AJI.

Scoring	Pure double elimination. Winner may have lost once, all others will have lost twice.

THE RELEASE AND WAIVER ON THE BACK OF THIS FORM MUST BE CAREFULLY REVIEWED AND SIGNED BY THE PARTICIPANT AND THEIR PARENT(S) OR GUARDIAN(S), IF THE PARTICIPANT IS A MINOR. FAILURE TO SIGN THE WAIVER WILL RESULT IN EXPULSION FROM THE TOURNAMENT.

Continued on back

WARNING, WAIVER AND RELEASE OF LIABILITY AND AGREEMENT TO PARTICIPATE

(Including with USJF Sanction, Limited Co-ed Competition for Age 10 and Under)

IN CONSIDERATION OF BEING PERMITTED TO PARTICIPATE IN ANY WAY, INCLUDING TRAVEL TO AND FROM THE ALASKA JUDO, INC's ANNUAL STATE JUDO CHAMPIONSHIP, BUSINESS MEETING, PRACTICE, CLINIC, AND RELATED EVENTS AND ACTIVITIES OF UNITED STATES JUDO, INC., UNITED STATES JUDO FEDERATION INC., UNITED STATES JUDO ASSOCIATION, NORTHWEST YUDANSHAKAI, AND THEIR RESPECTIVE AFFILIATED CLUBS, AND THE MAT-SU SCHOOL DISTRICT,

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 for 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, instructor, or supervisor 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 not only to 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 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 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 United States Judo, Inc., United States Judo Federation, Inc., United States Judo Association, Northwest Yudanshakai, Alaska 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 in conducting the event, all of whom are hereinafter referred to as "releasees", from any and all claims, demands, losses, or damages on account of injury, negligence of the releasees or otherwise to the fullest extent permitted by law.

6.	Parents or legal guardians of minor participants (age 17 and below) additionally agree that they will instruct the minor participant tot he above warning and conditions and their ramifications, and that they consent to the minor's participation.

7.	Release, waive, discharge and covenant not to sue the Alaska Judo, Inc., United States Judo , Inc., the United States Judo Federation, the Northwest Judo Yudanshakai, the United States Judo Association, and the Mat-Su School District, 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 in conducting 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 or 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.

Participant ___________________________________	Signature _______________________________________
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Date:	______________

Parent /Guardian______________________________	Signature _______________________________________

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Date:	______________