August 4th, 2007
Adult Men and Women Divisions
Masters (35 & up) Division
Junior Combined Divisions
Kids Divisions
Kids start first @ 8:00 am
Adults start @ 12:00 pm
Adult only first place winners receive a Gi
(Sizes as available, must have grappled to win)
Cost is $55.00 for pre-registration
$65.00 for same day registration
(Kids are $55 or $45 for pre-registration)
Location of Tournament
Jesuit College Preparatory School
12345 Inwood Rd, Dallas, Texas
$5.00 spectator fee
www.starbjj.com 214-483-2202
STAR JIU JITSU CHAMPIONSHIP
Registration Form *All mail-in entries must be received prior to Aug. 3rd, 2007 to be eligible for the pre-registration discount.*
Name:________________________________________________ Birth Date:___________________
If Minor Parents Name:_______________________________________________________________
Address:_________________________________________________ Apt. #:__________________
City:______________________________________________ State:________ ZIP:_______________
Email:________________________________________________ Phone:(_____) ______ – ________
Team:_____________________________________________________________________________
A complete listing of rules and event schedule can be found at www.starjiujitsu.com
Adult Men $65 ($55 if pre-registered) Brackets will be combined as necessary.
Belt White, Blue, Purple
Weight Class Under 140, 140 – 149, 150 – 159, 160 – 169, 170 – 179,
180 – 189, 190 – 204, 205 – 220, Over 220
Adult Women $65 ($55 if pre-registered) Brackets will be combined as necessary.
Level White, Blue/Purple
Weight Class Under 115, 115 – 124, 125 – 139, 140 and over
Adult Masters (35 & up) $65 ($55 if pre-registered) Brackets will be combined as necessary.
Belt White, Blue, Purple
Weight Class Under 170, 170 –204, 205 & Over
Kids (5-11) $55 ($45 if pre-registered) Brackets will be combined as necessary.
Belt Level Beginner [less than 18 months] Advanced [over 18 months]
Weight Class Under 39, 39 – 48, 49 –58, 59 –68, 69 – 78, 79 – 88, 89 – 98,
99 – 108, Over 108
“Between†(12-15) $55 ($45 if pre-registered) Brackets will be combined as necessary.
Belt Level White, Blue/ Purple
Weight class Under 110, 110 -130, 130 & up
Pre weigh-in at Star Friday Night from 5-8 pm – Adult day of weigh-in at Jesuit from 11- 12 pm
After 12:00 pm no one will be weighed in. You will not be allowed to compete if you haven’t weighed in.
***TOURNAMENT RELEASE AND WAIVER (Please read completely before signing)***
***For competitors under 18 years of age, this must be signed by a parent or legal guardian***
I, the undersigned, hereby waive all claims against any and all persons associated with any of the participating schools and competitors. I understand the rules of the tournament and will abide by them. I understand that I am participating in a sport that has body contact. I assume full responsibility for all of my actions during and connected to the above tournament. I understand the risk of competing in this form of Martial Arts competition and hereby release the event organizers and all of its employees and associates, tournament sponsors, and the event facility, from any type of injury, loss, or death sustained while competing in this competition. I, the undersigned also state that I am in good physical condition and know of no reason why I cannot participate in this Martial Arts event. I have current and valid health insurance. Divisions or weight classes are subject to change. In case of an emergency, I hereby authorize any licensed medical personnel to perform any accepted medical procedure deemed necessary and I agree to bear the expense of any such treatment. I also agree that my attendance and/or performance at the tournament may be photographed, filmed, or taped and used by any parties and I waive any compensation thereof. I, the undersigned, have read the release above and the rules of the tournament and agree to all of its terms and sign below to complete this form:
Signed: _______________________Print Name: ____________________ Date: __________
Tournament held this year at Jesuit College Preparatory School, 12345 Inwood Rd, Dallas, Texas
Please note there will be a $5.00 spectator fee this year. Thank you
For pre-registration send this form with a check, cashiers check or money :
STAR JIU JITSU , 3030 N. JOSEY LANE #102, CARROLLTON, TEXAS 75007
