Host:              New York State Judo Inc.
Date:              Sunday November  7th, 2021Place:             SALESIAN HIGH SCHOOL
                       148 EAST MAIN STREET
                      NEW ROCHELLE NY 10801Tournament Hotel: 1 Radisson Plaza, New Rochelle, NY 10801Weigh-ins: 12-4pm        
San Yama-Bushi Dojo
612 Main St UNIT 2,
New Rochelle, NY 10801
   
Satellite Weigh-ins:
Darfight  3100 Brighton 4th St 2nd floor, Brooklyn, NY 11235
Generation Judo 275 Avenue U, Brooklyn, NY 11223

COMPETITION START TIME: Venue will open doors at 8am
                                                              8:30AM Coaches Meeting
                                                              9AM  Competition for Bantam-1 Bantam-2 Bantam-3
                                                              11AM  Competition for Intermediate-1  and Cadets
                                                              12PM Competition for IJF Junior
                                                              1PM START ALL SENIORS AND VETERANS

Tournament  Co-Directors: Leo Lopes                          914-439-7532  
                                                          Oleksandr Semenenko   914-420-5678Tournament Co-Coordinators: Jon Silveri
                                                                 Parnel LegrosRegistration Co-Coordinators: Wisler Jacques
                                                                  Ana Lopes 914-439-7532  NYSjudo@gmail.comChief Referee : Bill Gugino      Tournament Laissons: Reggie Van ErrSanction:      #00073Entry Fee: Make checks payable to: NYSTATE JUDO INC.
Must be Received by by Nov 4th,  2021
Mail-in Form to:
TotalFormFitness
250 East Hartsdale ave  
Hartsdale, NY 10530Early Registration
$60.00 per person. Must be done Online by Nov 4th,  2021Late Registration
$70.00 per person After Nov. 4th Thru Saturday November 6th.
Absolutely no registration on tournament day.
             
Spectator:                
$5.00 Adult,   National Champions & Olympians free
Event Website:Eligibility:
- Ages 5 – Adult- Must be a current member of one of the following:  USA Judo, USJA, USJF, ATJARules:
- Round robin in divisions of 4 or less.
- Golden score for all matches.
- No chokes in U7, U9, U11, U13
- No arm-bars in U7, U9, U11, U13Match Time:
*3 minutes for U7, U9, U11, U13
          *4 minutes for U15, U18, U21, SeniorsJudo Gi  color:  *Blue & White is mandatory in U18, U21 & Seniors
 *  U7 – U15 are responsible for providing their own white & blue belts.
   *Judo gi size will be enforced.
Awards       * 1st, 2nd, 3rd place awards
                         *Each coach will receive $5.00 per athlete
                         

NYSTATE TOURNAMENT CATEGORIES
Bantam-1 Born     2015, 2016	MALE/FEMALE  23 +23 Kg		Cadet 2004, 2005, 2006, (2007)	M 50 55 60 66 73 81 90 +90KG F 40 44 48 52 57 63 70 +70KG
Bantam-2 Born    2013, 2014, (2015)	MALE/FEMALE  23 27 31 35 +35Kg		IJF Junior 2001, 2002, 2003, 2004, 2005, 2006, (2007)	M 60 66 73 81 90 100 +100KG F 48 52 57 63 70 78 +78KG
Bantam-3 Born     2011, 2012, (2013)	Male 25 30 36 42 +42 Kg  Female 27 32 37 +37 Kg		Seniors Born 2006 or earlier	NOVICE WHITE -GREEN BROWN-BLACK
Intermediate-1 Born 2009, 2010, (2011)	M 28 31 34 38 42 47 52 +52 KG F 28 31 34 38 42 47 52 +52KG		Veterans Born 1991 or earlier	NOVICE WHITE -GREEN BROWN-BLACK
Juvenile-1 Born 2007, 2008, (2009)	M 36 40 44 48 53 58 64 +64KG F 36 40 44 48 53 58 64 +64KG

*Club with the most Golds will receive $100.00

*Club with the most Medals will receive $50.00

FIRST NAME.		LAST NAME
DATE OF BIRTH
MALE		FEMALE

Address:______________________________ City:______________________ State: ______ Zip:_______ Phone:___________________________________ E-mail:_____________________________________

Card:

USA  JUDO

USJA USJF #

Weight in____Kg

Club: ____________________________________Club Phone:_______________________________ Coach:___________________________________ALL WEIGHTS ARE IN KILOGRAMS (weight in pounds divided by 2.2 equals weight in kilograms)
The Tournament Director reserves the right to make any changes he deems necessary to insure the safety and fairness to all competitors.CATEGORY:GENDER:WEIGHT  DIVISION:WARNING!    WAIVER  AND  RELEASE  OF  LIABILITY  AND  AGREEMENT  TO  PARTICIPATEIn consideration of being permitted to participate in any way, including travel to and from, in any judo tournament, practice, clinic, and related events and activities of the USA Judo, USJA, USJF, ATJA SALESIAN HIGH SCHOOL, Totalformfitness, New York State Judo, Inc., Tournament Director, Tournament Organizers, Tournament Staff, The 2021 New York State Championships,  I hereby:

1. 1.Acknowledge that I am familiar with the sport of Judo and understand the rules governing the sport of Judo. 

1. 2.Agree that prior to participating, I will inspect the mats, equipment, facilities, competition pools or divisions and the elimination or scoring system to be used, and if I believe anything is unsafe or beyond my capability, I will immediately advise my coach, supervisor and/or a tournament official of such condition(s) and refuse to participate. 

1. 3.Acknowledge and fully understand that I will be engaging in a contact sport that might result in serious injury, including permanent disability or death, and severe social and economic losses due to not only my own actions, inactions or negligence, but also to the action, inaction of negligence of others, the rules of the sport of Judo, or conditions of the premises or of any equipment used. Further, I acknowledge that there may be other risks not known to me or not reasonably foreseeable at this time. 

1. 4.Knowing the risks involved in the sport of Judo, I assume all such risks and accept personal responsibility for the damages following such injury, permanent disability or death. 

1. 5.Release, waive, discharge and covenant not to sue USA Judo, USJA, USJF, ATJA SALESIAN HIGH SCHOOL, Totalformfitness, New York State Judo, Inc., Tournament Director, Tournament Organizers, Tournament Staff, together with their affiliated clubs, their respective administrators, directors, agents, coaches, and other employees or volunteers of the organization, event officials, medical personnel, other participants, their parents, guardians, supervisors and coaches, sponsoring agencies, sponsors, advertisers, and if applicable, owners, lessors, and lessees of premises used to conducting the event, all of whom are hereinafter referred to as “releasee,” from any and all claims, demands, losses, and 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. 

I HAVE READ THE ABOVE WARNING , WAIVER AND RELEASE, UNDERSTAND THAT I GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND KNOWING THIS, SIGN IT VOLUNTARILY. I AGREE TO PARTICIPATE KNOWING THE RISKS AND CONDITIONS INVOLVED AND DO SO ENTIRELY OF MY OWN FREE WILL. I AFFIRM THAT I AM AT LEAST 18 YEARS OF AGE, OR IF I AM UNDER 18 YEARS OF AGE, I HAVE OBTAINED THE REQUIRED CONSENT OF MY PARENT/GUARDIAN AS EVIDENCED BY THEIR SIGNATURE BELOW.Participant (please print name)Participants SignatureDateFOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE (UNDER 18 AT TIME OF REGISTRATION)This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release, as provided above, of all the Releasees, and , for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child's involvement or participation in these programs as provided above, even if arising from their negligence, to the fullest extent permitted by law. I have instructed the minor participant as to the above warning and conditions and their ramifications.Parent/Guardian (please print name)Parent/Guardian's SignatureDateCERTIFICATE  REGARDING  NON-BLACK  BELT  CONTESTANTSI______________________, A judo instructor, who has been awarded the Judo rank of Shodan or higher, recognized by USA Judo, USJA, USJF, ATJA hereby certify that the above contestant, although not having been awarded the Judo rank of Shodan or higher, is of sufficient aptitude and skill in Judo to compete in these championships.A copy of my proof of rank (rank certificate or my USA Judo membership card having the verification symbol “(V)” printed following my rank) is attached.Signature  of  Judo  Instructor.                          Rank