bagwell academy of martial arts llc, presents mid...
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Contact: Herbie Bagwell
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Bagwell Academy of Martial Arts LLC, Presents
Mid-Connecticut Karate Championships
The Fourth Annual
Sunday October 15, 2017Jonathan Law High School
20 Lansdale Ave, Milford, CT 06460
www.bagwelltaekempo.com
Cash Prizes
Phone: 203-606-0098 Fax: 203-877-5425
Pre-Registration$70.00 for All Events
Pre-Registration ends October 6 2017Day of Event $80.00 First event $10.00 each additional
Adult Black Belt Grand Championships - $350.00Junior Black Belt Championships - $100.00
Senior Grands Men and Women Black Belt Fighting Champions - $200
Event will begin at 9 AM Sharp
Ratings: Krane AAAA (Plus)
Information
DATE: Sunday October 15, 2017 REGISTRATION BEGINS AT 7:30 AM Location: Jonathan Law High School 20 Lansdale Ave, Milford, CT 06460 TOURNAMENT PROMOTER: Herbie Bagwell Bagwell Academy of Martial Arts 487 Bridgeport Ave. Milford, CT 06460 (203) 877.5425 Email: [email protected] TOURNAMENT COORDINATORS: Don Rodrigues and Tony Cogliandro RATINGS: Krane – AAAA (Plus) See www.krane.org for all rules for ages 17 and under – Face Shields and Chest Protectors Mouth Guard required in all fighting divisions: EMT: Ted Plamondon (Medical Assistance, Taping and Mouthpieces) PRE-REGISTRATION $70 for ALL Events Must be received no later than October 6th, 2017. No personal checks!!! Bank Checks or Money Orders only.Payable to: Bagwell Academy of Martial Arts LLC Address: 487 Bridgeport Ave. Milford, CT 06460 REGISTRATION DAY OF EVENT: $80 for 1st event. $10 for each additional event. Cash only will be accepted at the door. NO Refunds Granted SPECTATOR FEE: $10 Pre-Registration $15.00 Day of Event Children under 5 years old free
AWARDS Trophies: 1st – 4th Place All divisions Medals: 5th – 8th Place in all divisions CASH AWARDS Youth Black Belt 13 & under Weapons Grandchampionship - $100.00 Youth Black Belt 14-17 Weapons Grandchampionship - $100.00 Youth Black Belt 13 & under Forms Grandchampionship - $100.00 Youth Black Belt 14-17 Forms Grandchampionship - $100.00 Adult Black Belt Men Weapons Grandchampionship -$200.00 Adult Black Belt Women Weapons Grandchampionship - $200.00 Adult Black Belt Men Forms Grandchampionship - $200.00 Adult Black Belt Women Forms Grandchampionship - $200.00 Adult Black Belt Men Fighting Grandchampionship - $350.00 Adult Black Belt Women Fighting Grandchampionship - $350.00 Senior Grands Men’s Black Belt fighting Grandchampionship - $200 Senior Grands Women’s Black Belt fighting Grandchampionship- $200
Directions:
Directions from Interstate 95 Northbound or Southbound Get off exit 34, Take a left off the exit on to Bridgeport Ave. Take a right ¼ of a mile onto Lansdale Ave. Jonathan Law High School is on the right, TOURNAMENT HOTEL ACCOMMODATION: Hampton INN Suites 126 Plains Rd. Milford, CT 06460 203.874.4400 Discount Code: Mid CT Karate (Register before 10/1/17 for discount) Please call about our 14+ Same School Competitor Discount
If you are able to Time Keep, Score Keep & Judge, please contact Herbie Bagwell(203) 877-5425. Thank you In advance!
*All Weapons division will begin at 9:00 AM Sharp. Please be on time. The tournament will run straight through.
CREDIT CARD: MASTERCARD OR VISA ONLY (CIRCLE ONE) NAME; _____________________________________________ CREDIT CARD # _____________________________________ EXP: _______________________ SIGNATURE: ________________________________________ No personal or business checks accepted. U.S. funds only please. No refunds or credits on registration fees or spectator tickets! COMPETITOR ENTRY FEES: $70 for All Events
MAIL TO – BAGWELL ACADEMY 487 BRIDGEPORT AVE. MILFORD, CT 06460
Black Belt Divisions Weapons Forms Fighting Weapons Forms Fighting
9&UN TRAD(BOYS/GIRLS) 9&UN OPEN(BOYS/GIRLS) 10-11 TRAD(BOYS/GIRLS) 10-11 OPEN(BOYS/GIRLS) 12-13 TRAD(BOYS/GIRLS) 12-13 OPEN(BOYS/GIRLS) 14-15 TRAD(BOYS/GIRLS) 14-15 OPEN(BOYS/GIRLS) 16-17 TRAD(BOYS/GIRLS) 16-17 OPEN(BOYS/GIRLS)
9&UN TRAD(BOYS/GIRLS) 9&UN OPEN(BOYS/GIRLS) 10-11 TRAD(BOYS/GIRLS) 10-11 OPEN(BOYS/GIRLS) 12-13 TRAD(BOYS/GIRLS) 12-13 OPEN(BOYS/GIRLS) 14-15 TRAD(BOYS/GIRLS) 14-15 OPEN(BOYS/GIRLS) 16-17 TRAD(BOYS/GIRLS) 16-17 OPEN(BOYS/GIRLS)
9&UNDER(BOYS) 9&UNDER (GIRLS) 10-11 (BOYS) 10-11 (GIRLS) 12-13(BOYS) 12-13 (GIRLS) 14-15 (BOYS) 14-15 (GIRLS) 16-17 (BOYS) 16-17 (GIRLS)
18-29 TRAD MEN 18-29 OPEN MEN 18-29TRADWOMEN 18-29 OPEN WOMEN 30-39 MEN 30-39 WOMEN 40-49 MEN 40-49 WOMEN 50-59 MEN 50-59 WOMEN 60&OVER MEN 60&OVER WOMEN
18-29 TRAD MEN 18-29 OPEN MEN 18-29TRADWOMEN 18-29 OPEN WOMEN 30-39 MEN 30-39 WOMEN 40-49 MEN 40-49 WOMEN 50-59 MEN 50-59 WOMEN 60&OVER MEN 60&OVER WOMEN
18-29MEN 159LBS&UNDER 18-29MEN 160-179LBS 18-29 MEN 180LBS&OVER 18-29 WOMEN129lbs&UNDER 18-29 WOMEN130lbs&OVER 30-39 MEN 30-39 WOMEN 40-49 MEN 40-49 WOMEN 50-59 MEN 50-59 WOMEN 60&OVER MEN 60& OVER WOMEN
Under Black Belt Divisions Weapons Forms Fighting WEAPONS Forms FIGHTING
18-29 BEG MEN 18-29 BEG WOMEN 18-29 INTER MEN 18-29 INTER WOMEN 18-29 ADV MEN 18-29 ADV WOMEN 30-39 BEG MEN 30-39 BEG WOMEN 30-39 INTER MEN 30-39 INTER WOMEN 30-39 ADV MEN 30-39 ADV WOMEN 40-49 BEG MEN 40-49 BEG WOMEN 40-49 INTER MEN 40-49 INTER WOMEN 40-49 ADV MEN 40-49 ADV WOMEN 50+ALL RANKS MEN 50+ALL RANKS WOMEN
18-29 BEG MEN 18-29 BEG WOMEN 18-29 INTER MEN 18-29 INTER WOMEN 18-29 ADV MEN 18-29 ADV WOMEN 30-39 BEG MEN 30-39 BEG WOMEN 30-39 INTER MEN 30-39 INTER WOMEN 30-39 ADV MEN 30-39 ADV WOMEN 40-49 BEG MEN 40-49 BEG WOMEN 40-49 INTER MEN 40-49 INTER WOMEN 40-49 ADV MEN 40-49 ADV WOMEN 50+ALL RANKS MEN 50+ALL RANKS WOMEN
PHYSICALLY CHALLENGED
18-29 BEG MEN 18-29 BEG WOMEN 18-29 INTER MEN 18-29 INTER WOMEN 18-29 ADV MEN 18-29 ADV WOMEN 30-39 BEG MEN 30-39 BEG WOMEN 30-39 INTER MEN 30-39 INTER WOMEN 30-39 ADV MEN 30-39 ADV WOMEN 40-49 BEG MEN 40-49 BEG WOMEN 40-49 INTER MEN 40-49 INTER WOMEN 40-49 ADV MEN 40-49 ADV WOMEN 50+ALL RANKS MEN 50+ALL RANKS
WOMEN
5&UNDER(BOYS/GIRLS) OPEN 5&UNDER(BOYS/GIRLS) TRAD 6&7 BEG TRAD (BOYS/GIRLS) 6&7 BEG OPEN (BOYS/GIRLS) 6&7 INT TRAD (BOYS/GIRLS) 6&7 INT OPEN (BOYS/GIRLS) 6&7 ADV TRAD (BOYS/GIRLS) 6&7 ADV OPEN (BOYS/GIRLS) 8-9 BEG(BOYS/GIRLS) OPEN 8-9 BEG(BOYS/GIRLS)TRAD 8-9 INT(BOYS/GIRLS)OPEN 8-9 INT(BOYS/GIRLS)TRAD 8-9ADV(BOYS/GIRLS)OPEN 8-9ADV(BOYS/GIRLS)TRAD 10-11 BEG(BOYS/GIRLS)OPEN 10-11 BEG(BOYS/GIRLS)TRAD 10-11 INT(BOYS/GIRLS)OPEN 10-11INT(BOYS/GIRLS)TRAD 10-11ADV(BOYS/GIRLS)OPEN 10-11ADV(BOYS/GIRLS)TRAD 12-13 BEG(BOYS/GIRLS)OPEN 12-13 BEG(BOYS/GIRLS)TRAD 12-13INT(BOYS/GIRLS)OPEN 12-13 INT(BOYS/GIRLS)TRAD 12-13ADV(BOYS/GIRLS)OPEN 12-13ADV(BOYS/GIRLS)TRAD 14-15 BEG(BOYS/GIRLS)OPEN 14-15 BEG(BOYS/GIRLS)TRAD 14-15INT(BOYS/GIRLS)OPEN 14-15 INT(BOYS/GIRLS)TRAD 14-15ADV(BOYS/GIRLS)OPEN 14-15ADV(BOYS/GIRLS)TRAD 16-17 BEG(BOYS/GIRLS)OPEN 16-17 BEG(BOYS/GIRLS)TRAD 16-17INT(BOYS/GIRLS)OPEN 16-17INT(BOYS/GIRLS)TRAD 16-17ADV(BOYS/GIRLS)OPEN 16-17ADV(BOYS/GIRLS)TRAD
4 & UNDER (BOYS/GIRLS) 5 YR OLD (BOYS/GIRLS) OPEN 5 YR OLD (BOYS/GIRLS) TRAD 6-7 BEG(BOYS/GIRLS) OPEN 6-7 BEG(BOYS/GIRLS)TRAD 6-7 INT(BOYS/GIRLS)OPEN 6-7 INT(BOYS/GIRLS)TRAD 6-7ADV(BOYS/GIRLS)OPEN 6-7 ADV(BOYS/GIRLS)TRAD 8-9 BEG(BOYS/GIRLS) OPEN 8-9 BEG(BOYS/GIRLS)TRAD 8-9 INT(BOYS/GIRLS)OPEN 8-9 INT(BOYS/GIRLS)TRAD 8-9ADV(BOYS/GIRLS)OPEN 8-9ADV(BOYS/GIRLS)TRAD 10-11 BEG(BOYS/GIRLS)OPEN 10-11 BEG(BOYS/GIRLS)TRAD 10-11 INT(BOYS/GIRLS)OPEN 10-11INT(BOYS/GIRLS)TRAD 10-11ADV(BOYS/GIRLS)OPEN 10-11ADV(BOYS/GIRLS)TRAD 12-13 BEG(BOYS/GIRLS)OPEN 12-13 BEG(BOYS/GIRLS)TRAD 12-13INT(BOYS/GIRLS)OPEN 12-13 INT(BOYS/GIRLS)TRAD 12-13ADV(BOYS/GIRLS)OPEN 12-13ADV(BOYS/GIRLS)TRAD 14-15 BEG(BOYS/GIRLS)OPEN 14-15 BEG(BOYS/GIRLS)TRAD 14-15INT(BOYS/GIRLS)OPEN 14-15 INT(BOYS/GIRLS)TRAD 14-15ADV(BOYS/GIRLS)OPEN 14-15ADV(BOYS/GIRLS)TRAD 16-17 BEG(BOYS/GIRLS)OPEN 16-17 BEG(BOYS/GIRLS)TRAD 16-17INT(BOYS/GIRLS)OPEN 16-17INT(BOYS/GIRLS)TRAD 16-17ADV(BOYS/GIRLS)OPEN 16-17ADV(BOYS/GIRLS)TRAD
4& UNDER (BOYS) 4& UNDER(GIRLS) 5 YR OLD (BOYS) 5 YR OLD (GIRLS) 6-7 BEG(BOYS) 6-7 BEG(GIRLS) 6-7 INT(BOYS) 6-7 INT(GIRLS) 6-7ADV(BOYS) 6-7 ADV(GIRLS) 8-9 BEG(BOYS) 8-9 BEG(GIRLS) 8-9 INT(BOYS) 8-9 INT(GIRLS) 8-9ADV(BOYS) 8-9ADV(GIRLS) 10-11 BEG(BOYS) 10-11 BEG(GIRLS) 10-11 INT(BOYS) 10-11INT(GIRLS) 10-11ADV(BOYS) 10-11ADV(GIRLS) 12-13 BEG(BOYS) 12-13 BEG(GIRLS) 12-13INT(BOYS) 12-13 INT(GIRLS) 12-13ADV(BOYS) 12-13ADV(GIRLS) 14-15 BEG(BOYS) 14-15 BEG(GIRLS) 14-15INT(BOYS) 14-15 INT(GIRLS) 14-15ADV(BOYS) 14-15ADV(GIRLS) 16-17 BEG(BOYS) 16-17 BEG(GIRLS) 16-17INT(BOYS) 16-17INT(GIRLS) 16-17ADV(BOYS) 16-17ADV(GIRLS)
Name:_______________________________________ Address:_____________________________________ City: _________________ State: ________ Zip: ______Rank: ________________________________________Age: ________ D.O.B: ____________ Phone:_________
School Name: ____________________________________ Address: _________________________________________ City: _________________ State: ________ Zip: _________ Instructor: _______________________________________ Phone: __________________________________________
Pre-Registration Form 2017 MID CT KARATE CHAMPIONSHIP
(This form may be used only until Friday, Oct 6 2017)Event: Sunday, October 15 2017
Jonathan Law High School
E-MAIL ADDRESS
______________________________________________________
SPECTATOR TICKET: _______ @ $10.00 = _________________
I, __________________________the undersign herby release Herbert Bagwell, Bagwell Academy LLC, and all persons associated and/or participation at the above specified event. Furthermore, I hereby waive any compensation whatsoever for the use of pictures, movies, media coverage, etc. utilized by these associated with this event at anytime. I clearly understand that fighting aspect of this sport and competition involved bodily contact. I have read, understand and agree to abide by the rules associated with this event and assume all responsibility and any associated liability for infringement of such rules. Additionally, I am fully aware of my personal medical condition and hereby certify that I am mentally and physically fit to compete at said karate competitions.
__________________________________________________________
Signature of Parent or Guardian if under 18
Mid-Connecticut Karate Championships
Cash Prizes
Herbie BagwellBagwell Academy of Martial Arts487 Bridgeport Ave.Milford, CT 06460
PRE-REGISTER NOW AND SAVE MONEY!INFO - (203) 877-5425 EMAIL: [email protected]