stv & tvi victorian national selections · stv & tvi victorian national selections state...

STV & TVI Victorian National Selections

State Netball and Hockey Centre Brens Drive, Parkville

Poomsae Sunday 26th July 2015 - 9.00am - 4.00pm

ENTRIES CLOSE: Midnight, Wednesday 22nd July 2015

NOTE: all entries to be completed online at www.internetentries.com

ENTRIES CLOSE: Midnight, Tuesday 28th July 2015

NOTE: all entries to be completed online at www.peopleinaction.net.au

Sparring Sunday 2nd August 2015 9.00am - 4.00pm

State Netball and Hockey Centre Brens Drive, Parkville

Dear Instructor,

1. To provide competition practice for all Victorian athletes2. To promote friendship and co-operation within the Victorian Taekwondo community3. To provide Victorian athletes a selection event to qualify for the 2015 STA Nationals

TVI and STV encourages good sportsmanship and promotes a bullying free environment. Coaches, parents, athletes and spectators must comply with the code of conduct (see attached) or face expulsion and / or disquali cation of all athletes from the associated club.

Entry is only available online. Please note all entries will be payable via credit card or debit card only. As the online system is automated, no entries can be processed after this date.

Our continued thanks go to all of the clubs who enter their enthusiastic athletes. We alsogreatly appreciate the ongoing support of the judges who o ciate at these competitions and ourwonderful volunteers who give up their time to ensure the smooth running of these events. Without the contributions of any of these groups, our competitions would not be a success.

Yours sincerely,

Barry AkehurstPresident

Taekwondo Victoria Inc.

On behalf of Taekwondo Victoria Inc and Sports Taekwondo Victoria it is our pleasure to invite you and your club to participate in the 2015 STV & TVI Victorian National Selection Event at the State Netball and Hockey Centre, Parkville. This is a championship event aimed at athletes from all Taekwondo disciplines. The competition has three goals:

If you are able to assist with the running of this competition, please contact the following:

Sparring referees and judges: Sam Tarascio [email protected]

Poomsae judges: Marco Moro [email protected]

Volunteers: Maddie Rathborne [email protected]

Jemal HasanPresident

Sports Taekwondo Victoria

STV & TVI VICTORIAN NATIONAL SELECTIONS

General Information

All ages are as at 31st December 2015:

CHILD YOUTH CADET JUNIOR SENIOR MASTER 1 MASTER 2

6-8 9-11 12-14 15-17 18-30 31-45 46+

Born 2007 to 2009

Born 2004 to 2006

Born 2001 to 2003

Born 1998 to 2000

Born 1985 to 1997

Born 1970 to 1984

Born 1969 or prior

Eligible Competitors: To be eligible to contest the 2015 STV & TVI Victorian National Selection event athletes must have at all times acted in a proper manner and not have engaged in any conduct that would bring the Association, our sport or any of our sta into disrepute or censure.

Registration: All competitors MUST bring their completed competition entry form (signed byparent/guardian if under 18 years of age on the day of competition). Please print this when you complete the on line entry.[

Competition Schedule: Poomsae Selection Event - Sunday 26th July 2015

Registration 8.15amPoomsae Competiton 9.00am - 4.00pm

Detailed schedule to be released after entries close

Indemnity: All participants take part at their own risk. The organiser can under no circumstancesbe held responsible for any damage, injury, or loss to individuals or equipment.

Uniform Requirements: White V neck or Y neck dobok for coloured belts (including Cho Dan Bo). Black V neck or Y neck dobok for Black Belts.No stripes or prominent brand logos (applies to Poomsae only) .No jewelry is to be worn. Allowance is made for wedding bands which cannot be removed.

Spectator Prices:

Food: Canteen available at venue.

Poomsae - $77 for single event, $20 per subsequent event Sparring - $77 for single Division, $20 per subsequent eventSparring Junior and Senior division $97 (available to 15-17 year olds only)

Sparring Selection Event - Sunday 2nd August 2015

Registration 7.45amSparring Competiton 9.00am - 4.00pm

Adults $10 (16+ yrs of age)Children $5 (Under 6yrs of age FREE)Family $25 ( Includes 2 adults and 2 children)

Competition Entry Fees:

Awards: All divisions will recognise the top 4 players / teams with Gold, Silver and two Bronze medals.

7.30am

Poomsae Competi on method ALL DIVISIONS WTF cut off system will be used for all division. (WTF and NON WTF) Semi Final round when 9 to 19 compe tors are in division. Final round when 8 or less compe tors are in division. 2 poomsae per round to be performed by compe tors from compe on poomsae list. Poomsae will be drawn by tournament OC and posted on STV Facebook page, 3 days prior to event start.

Online Entry Instruc ons

Black Belts can either enter the WTF or the NON WTF divisions, not both. Athletes entering the Mixed Teams (NON WTF), Mixed Pairs (NON WTF) and Pairs/Teams Freestyle

divisions should make sure that if you have a Mixed Belt (Rank) Team or Pair, the Highest Belt (Rank) Athlete enters first and others in Team/Pairs join a er, this will ensure you are placed in the correct division.

Poomsae uniform requirement Poom/Dan Belts WTF Poomsae Divisions including Freestyle Individual, and Black Belt only Pairs and Teams.

WTF wrap around dobok (see document WTF Divisions dobok requirements 2015 ) must be worn.. STA badge on le arm or no badge is acceptable, no sponsorship markings, only current na onal team

members to have na onal marking on dobok. Current Na onal Team Members are those whom competed in the 2014 World Poomsae Championship and the 2014 Commonwealth Games. Dobok rule to be followed NO EXEPTIONS, there will be an inspec on desk!

Age group and Poomsae list for WTF Individual Divisions POOM/DAN Belts

NON WTF Divisions including Freestyle individual colour belts and Colour belts only teams / pairs

Black Belts: Choice of either Black V neck or official WTF wrap around style dobok. Colour Belts: White V neck dobok. STA badge on le arm or no badge is acceptable.

WTF - Poomsae divisions ( Poom/Dan Belts) WTF Individual Division ( WTF style separate male and female divisions)

6 - 11 yrs Taegeuk 4, 5, 6, 7, 8 & Koryo Cadet (12 - 14 yrs) Taegeuk 4, 5, 6, 7, 8 Jang, Koryo, Keumgang Junior (15 - 17 yrs) Taegeuk 4, 5, 6, 7, 8 Jang, Koryo, Keumgang, Taeback Under 30 ( 18-30 yrs) Taegeuk 6, 7, 8 Jang, Koryo, Keumgang, Taeback, Pyongwon, Shipjin Under 40 (31-40 yrs) Taegeuk 6, 7, 8 Jang, Koryo, Keumgang, Taeback, Pyongwon, Shipjin Under 50 (41-50 yrs) Taegeuk 8 Jang, Koryo, Keumgang, Taeback, Pyongwon, Shipjin, Jitae, Chonkwon

Koryo, Keumgang, Taeback Pyongwon, Shipjin, Jitae, Chonkwon, Hansu Under 60 (51-60 yrs) Under 65 (61-65 yrs) Koryo, Keumgang, Taeback Pyongwon, Shipjin, Jitae, Chonkwon, Hansu Over 65 (66 yrs +) Koryo, Keumgang, Taeback Pyongwon, Shipjin, Jitae, Chonkwon, Hansu

WTF Pairs Division (one male one female) & WTF Team Division (three male or three female)

6 - 11 yrs Taegeuk 4, 5, 6, 7, 8 & Koryo 12 - 14 yrs (Cadets) Taegeuk 4, 5, 6, 7, 8, Koryo & Keumgang 15 - 17 yrs (Junior) Taegeuk 4, 5, 6, 7, 8, Koryo, Keumgang & Taeback 18 - 30 yrs Taegeuk 6, 7, 8, Koryo, Keumgang, Pyongwon & Shipjin 31 + yrs Taegeuk 8, Koryo, Keumgang, Pyongwon, Shipjin, Jitae & Chonkwon

Age group and Poomsae list for Pairs and Teams POOM/DAN Belts

Poomsae CoachesPoomsae Coaches need to register online at InternetEntries.com by the 22nd July 2015. Only those coaches


(NON WTF)Poomsae divisions

Individual by rank Division (Separate male and female divisions)

Yellow Belt Taegeuk 1, 2 Blue Belt Taegeuk 1, 2, 3 & 4 Red Belt Taegeuk 4, 5, 6 & 7 1st Poom/Dan Taegeuk 6, 7, 8 & Koryo 2nd Poom/Dan Taegeuk 7, 8, Koryo & Keumgang 3rd Poom/Dan Taegeuk 8, Koryo, Keumgang & Taeback 4th Poom/Dan Koryo, Keumgang, Taeback & Pyongwon 5th & 6th Dan Taeback, Pyongwon, Shipjin & Jitae 7th & 8th Dan Shipjin, Jitae, Chonkwon & Hansu 6 - 7 yrs 8 - 9 yrs 10 - 11 yrs 12 - 14 yrs 15 - 17 yrs 18 - 30 yrs 31 - 40 yrs 41 - 50 yrs 51 - 60 yrs 61 - 65 yrs 66 + yrs

Age groups and Poomsae list for Individual by rank Division

WTF Freestyle - Poomsae divisions

Please bring copy of your music to compe on, no music means disqualifica on iPod or MP3 format on USB only ( ONLY ONE SOUND TRACK ON DEVICE - NO OTHER MUSIC)

Individual Division seperated by age group, gender and belt (yellow - blue - red - black)Pairs and Team Division separated by age group and highest belt in Pair/Team

Freestyle Division See WTF compe on rules for judging

Individual, Pairs & Team 6 - 11 yrs 12 - 17 yrs 18 + yrs Composi on of Pairs 1 Male and 1 Female Composi on of Team 3 to 5 Team Members - At least 1 Male or 1 Female

Age groups divisions for freestyle

Can be mixed rank but must perform pa ern according to highest belt in team

Mixed Pairs Division (2 members, any gender mix, same age division)

Yellow Belt Taegeuk 1, 2 Blue Belt Taegeuk 1, 2, 3 & 4 Red Belt Taegeuk 4, 5, 6 & 7 1st Poom/Dan Taegeuk 6, 7, 8 & Koryo 2nd Poom/Dan Taegeuk 7, 8, Koryo & Keumgang 3rd Poom/Dan Taegeuk 8, Koryo, Keumgang & Taeback 4th Poom/Dan Koryo, Keumgang, Taeback & Pyongwon 5th & 6th Dan Taeback, Pyongwon, Shipjin & Jitae 7th & 8th Dan Shipjin, Jitae, Chonkwon & Hansu 6 - 11 yrs 12 - 17 yrs 18 - 30 yrs 31 - 50 yrs 50 + yrs

Age groups and Poomsae list for Mixed Pairs Division

Can be mixed rank but must perform pa ern according to highest belt in team

Mixed Team Division (3 to 5 Team member, any gender mix, same age division)

Yellow Belt Taegeuk 1, 2 Blue Belt Taegeuk 1, 2, 3 & 4 Red Belt Taegeuk 4, 5, 6 & 7 1st Poom/Dan Taegeuk 6, 7, 8 & Koryo 2nd Poom/Dan Taegeuk 7, 8, Koryo & Keumgang 3rd Poom/Dan Taegeuk 8, Koryo, Keumgang & Taeback 4th Poom/Dan Koryo, Keumgang, Taeback & Pyongwon 5th & 6th Dan Taeback, Pyongwon, Shipjin & Jitae 7th & 8th Dan Shipjin, Jitae, Chonkwon & Hansu 6 - 11 yrs 12 - 17 yrs 18 - 30 yrs 31 - 50 yrs 50 + yrs

Age groups and Poomsae list for Mixed Team Division


WTF Divisions Poom/Dan Belts - Dobok requirements 2015

51 years and above

Junior and 50years and under

Cadets and 11 yrs and under

Poom Belt (half red half black)must be worn with Cadet WTF Dobok and no solid black belt



Gender: Male, Female

Age Divisions: 6 – 8, 9 – 11, 12 – 14, 15 – 17, 15+, 31+. Juniors may enter in both the Junior (15 – 17)and Senior (15+) divisions. Novice entries may only enter one (1) sparring event.

Weight Divisions: Players may only compete in 1 weight division per age category.

Child (6-8), Youth (9-11) A B C D E F G H Male <19 19-22 22-25 25-28 28-31 31-34 34-38 38-42

Female <19 19-22 22-25 25-28 28-31 31-34 34-38 38-42 I J K L M N O Male 42-46 46-50 50-55 55-60 60-65 65-70 70+

Female 42-46 46-50 50-55 55-60 60-65 65-70 70+ Cadet (12 – 14)

Straw Fin Fly Bantam Feather Light Welter Middle Cruiser Heavy Male <33kg 33-37kg 37-41kg 41-45kg 45-49kg 49-53kg 53-57kg 57-61kg 61-65kg 65+kg

Female <29kg 29-33kg 33-37kg 37-41kg 41-44kg 44-47kg 47-51kg 51-55kg 55-59kg 59+kg Junior (15 – 17)

Fin Fly Bantam Feather Light Welter Light Middle

Middle Light Heavy

Heavy

Male <45kg 45-48kg 48-51kg 51-55kg 55-59kg 59-63kg 63-68kg 68-73kg 73-78kg 78+kg Female <42kg 42-44kg 44-46kg 46-49kg 49-52kg 52-55kg 55-59 kg 59-63kg 63-68kg 68+kg

Senior (15+), Ultra (31+)

Fin Fly Bantam Feather Light Welter Middle Heavy Male <54kg 54-58kg 58-63kg 63-68kg 68-74kg 74-80kg 80-87kg 87+kg Female <46kg 46-49kg 49-53kg 53-57kg 57-62kg 62-67kg 67-73kg 73+kg

Novice Divisions: Players who have competed in less than 3 state competitions may elect to compete in a

novice division. Novice entries may only enter one (1) sparring event.

Round Times: Black belt Senior: 3 rounds x 1.5 minutes Black belt other: 3 rounds x 1 minute

setunim 5.1 x sdnuor 3 :roineS tleb deruoloC etunim 1 x sdnuor 2 :rehto tleb deruoloC etunim 1 x sdnuor 2 :ecivoN

Head Kicks: No head kicks in novice divisions.

.snoisivid artlU ro htuoY ,dlihC ni skcik daeh oN Head kicks allowed in all Cadet, Junior and Senior divisions. Format: Single elimination format.

Weigh In: Sunday 26 th July:

Country competitors may weigh in at 8:00am on the morning of competition.

South Eastern Joon No Taekwondo 9.00 -9.30am 14 Birch Ave Dandenong NorthCentral MTC Malvern 10.00-10.30am 125 Gelnferrie Rd MalvernWestern The Taekwondo Academy 11.00 -11.30am 25 Wallace Ave Point CookNorth Central State Hockey & Netball Centre 12.00-2.00pm Brens Drive Parkville

SPARRING

Safety Equipment: All competitiors must supply their own WTF approved standard trunk protectors. All divisions arerequired to wear groin ( Males only), shin, arm, head and mouth guards. Head guards must be white or thew same colour as the hogu. Mouth guards must be white or clear.

The Daedo Electronic Points Scoring System will be used for BLACK BELT Cadet , Junior and Senior only. Competitors in these divisions must supply their own electronic foot socks. These must NOT havethe additional heel insert


1) COMPETITORS MUST BRING REGISTRATION FORM SIGNED BY THEIR HEAD INSTRUCTOR TO WEIGH IN OR BE DISQUALIFIED

2) COACHES, ATHLETES AND PARENTS WILL BE EXPECTED TO ADHERE TO THE COACHES CODE OF CONDUCT.

3) ALL COACHES WILL NEED TO SIGN THE CODE OF CONDUCT (see attached) ON THE DAY OF COMPETITION OR THEY WILL NOT RECEIVE THEIR COACH ES PASS NOR BE ALLOWEDENTRY TO THE COMPETITION.

To complete entry process please proceed to online entry websites

Checklist

Print your declaration form Sign declaration form, or Have declaration form signed by Parent / Guardian if under 18 Have declaration form signed by Head Instructor

POOMSAE ENTRIES - www.internetentries.com

SPARRING ENTRIES - www.peopleinaction.net.au (Entries close 28th July 2015)

(Entries close 22nd July 2015)

Appendix 1: Sparring Coaches’ Notes

1) Dispute resolution Please consult the following o�cials in case of disputes:

Referees - Sam Tarascio Coaching - Alf Dell’Orso Administration - Tony Susac or Chris White 2) Professionalism It is expected that all coaches present themselves with a high level of professionalism at all times. If a coach fails to follow the code of conduct, they will be presented with a yellow card. If they are approached again for poor behaviour and given a second warning, they will be requested to leave the venue. 3) Structure Schedule of the days event will be provided approx two days prior.

Event draw will be posted approx two days prior to the event.

Rounds for each age group could change depending on numbers for athletes and time constraints. We will endeavour to adhere to advertised times where possible.

Protests will only be provided to �nal event for each Black belt age groups eg cadets, juniors and seniors.

Daedo systems will only be available for Black belt cadets, juniors and seniors. We will provide a minimum of three daedo courts where possible. Deado body protectors will be available on each court and must be returned to that same court after use. All Daedo players will need to supply their own electronic foot socks but must NOThave the additional heel insert.

We will no longer wait for athletes and disquali�cations will occur after the third and �nal call. We need coaches to prepare athletes and have them ready by the star t times and/or when called. We will no longer wait forathletes or coaches as this is ongoing issue to events not completed on time.

Head kicks for all black belt and colour belt even ts. If coaches or athletes are concerned or unprepared for head kicks, they are advised to enter the novice divisions. 4) Novice events Coaches who place experienced players into the novice divisions will have their player disquali�ed and no refund for the event. Players are only allowed to do one event; that is, sparring or novice and not both. No head kicks will apply to all novice divisions. I must stress that the novice divisions are purely for developing players only and for clubs to increase their medal tally. If a mismatch occurs please see me (Alf) ASAP and a decision will be made to reschedule or disqualify players.

STV & TVI COACH CODE OF CONDUCT

STV AND TVI VICTORIAN PLAYER DECLARATIONPLEASE READ CAREFULLY BEFORE SIGNING

____________________________________________________________________

I, THE APPLICANT NAMED ABOVE HEREBY ACKNOWLEDGE AND DECLARE FOR MYSELF, MY HEIRS, EXECUTORS AND LEGAL REPRESENTATIVES THAT: 1. I have been advised by the association and understand the risks of Hepatitis B and HIV infection and undertake to provide and use my own pe sonal drink container and towel, each marked with my name. 2. 3. I have not knowingly used any drugs or substances for the purpose of enhancing my performance and I acknowledge that I may be tested at any time by the Australian Sports Drugs Agency. Prohibited drugs include: Anabolic steroids, Beta-blockers, stimulants (eg Caffeine), Narcotics/analgesics (eg Codeine, Pseudoephrine found in medicine for Colds and flu) and Diuretics. DRUGS HOTLINE: 1800 020 506 4. In the event of any illness and / or accident, I hereby authorise and direct the Association and / or its authorised representatives to seek and obtain all necessary medical and / or surgical treatment as may be required and I accept the responsibility for payment and / or reimbursement of all medical expenses incurred on my behalf by the Association. 5. I undertake to observe all regulations and by-laws of the Association and shall comply with all reasonable directions and decisions of its officials and instructors. 6. I further declare that should I be selected for a team as a result of this event:

a) I am a citizen of the Commonwealth of Australia and am eligible to apply for and obtain an Australian passport (applicable to all eligible for Australian team selection.) b) I will train at the standard expected of me by the appointed team officials and attend all meetings training sessions and appointments required as a team member as directed from time to time by any official of the Association. c) Should I fail to meet any of my obligations as set out herein or fail to observe any regulation of by-law of the Association or to comply with any reasonable direction of any officer, of the Association or shall in the opinion of the Association fail to satisfy any requirements or obligations of a team member, then and in the event I acknowledge that I may be dismissed from the team of the Association and I shall not make any claim or demand for any compensation, damages and / or outgoings incurred by me. d) All expenses agreed to be paid on my behalf by the Association will be and are subject to my conduct, demeanour, performan ce and behaviour being satisfactory in the opinion of the Association and I acknowledge that failure to fully and properly satisfy my obligations hereunder may render me liable to refund to the Association part or all of such expenses.

7. I hereby acknowledge that a condition of my entry to the event is that I will indemnify and keep indemnified the Associati on, its Committees, Trustees, Servants, Agents, Instructors or Members against any liability arising from my participation in the event or the event for which the team is selected, or from any pre-event training and preparation of other team activity and from travel to and from these events and activities. 8. I understand that the above player/s cannot compete if they have been concussed within 30 days prior to this competition a nd hereby confirmm that they have not been so concussed. I also confirm that, in the event that a concussion has occurred prior to that, medical clearance for participation has been obtained. 9. I hereb acknowledge that a condition of my entry to the event is that I will indemnify and keep indemnified Sports Taekwondo Australia and Sports Taekwondo Victoria, Taekwondo Victoria Inc., its committees, Trustees, Servants, Agents, Instructors and members for any injury,damage or loss to any individual.

10. I acknowledge that photographs maybe taken during by the organisers or other persons and that I may appear in those photo graphs. I authorise Sports Taekwondo Victoria and Taekwondo Victoria Inc. to use and authorise use of the photographs taken at this competition for promotional purposes, including publication on the association websites. I will make no claim against Sports Taekwondo Australia or Sports Taekwondo Victoria for any fee or royalty in relation to the use of the photographs.

I, BEING THE APPLICANT OR PARENT / LEGAL GUARDIAN OF THE APPLICANT (if under 18yrs)HEREBY ACKNOWLEDGE AND DECLARE THAT I HAVE READ AND FULLY UNDERSTAND THE TERMS AND CONDITIONS SET OUT IN THEABOVE APPLICATION AND CONSENT TO BE BOUND BY SUCH CONDITIONS.

I have the following condition/allergy which could affect medical assesment or treatment

Player/s full name:(One form may be used for more than one player if the players concerned are juniors and immediate family, otherwise seperate player declaration forms are required

APPLICANT / PARENT LEGAL GUARDIAN (Delete those inapplicable)

SIGNED DATE:

TVI Code of Conduct

1. Respect the rights, dignity and worth of every

human being • Within the context of the activity, treat everyone equally regardless of sex,

disability, ethnic origin or religion

2. Ensure the athlete's time spent with you is a

positive experience • All athletes are deserving of equal attention and opportunities

3. Treat each athlete as an individual • Respect the talent, developmental stage and goals of each individual athlete • Help each athlete reach their full potential

4. Be fair, considerate and honest with athletes • Display high standards in your language, manner, punctuality, preparation

and presentation

• Display control, respect, dignity and professionalism to all involved with the

sport - this includes opponents, coaches, officials, administrators, the

media, parents and spectators

• Encourage your athletes to demonstrate the same qualities

5. Be professional and accept responsibility for your

actions

6. Make a commitment to providing a quality service

to your athletes • Maintain or improve your current NCAS accreditation

• Seek continual improvement through performance appraisal and ongoing

coach education

• Provide a training program which is planned and sequential

• Maintain appropriate records

7. Operate within the rules and spirit of your sport • The guidelines of national and international bodies governing your sport

should be followed. Please contact Sports Taekwondo Australia for a copy

of its rule book, constitution, by-laws, relevant policies, eg anti-doping

policy, selection procedures, etc

• Coaches should educate their athletes on drugs in sport issues in

consultation with the Australian Sports Drug Agency (ASDA

8. Any physical contact with athletes should be: • appropriate to the situation

• necessary for the athlete's skill development

9. Refrain from any form of personal abuse towards

your athletes • This includes verbal, physical and emotional abuse

• Be alert to any forms of abuse directed toward your athletes

• from other sources while they are in your care

10. Refrain from any form of harassment towards your

athletes • This includes sexual and racial harassment, racial vilification and

harassment on the grounds of disability

• You should not only refrain from initiating a relationship with an athlete,

but should also discourage any attempt by an athlete to initiate a sexual

relationship with you, explaining the ethical basis of your refusal

11. Provide a safe environment for training and

competition • Ensure equipment and facilities meet safety standards

• Ensure equipment, rules, training and the environment are appropriate for

the age and ability of the athletes

12. Show concern and caution toward sick and injured

athletes • Provide a modified training program where appropriate

• Allow further participation in training and competition only when

appropriate

• Encourage athletes to seek medical advice when required

• Maintain the same interest and support toward sick and injured athletes

13. Be a positive role model for your sport and

athletes

Please refer to the Harassment-free Sport guidelines available from the Australian Sports Commission for more information onharassment issues

I agree to the following terms:

1. I agree to abide by the TVI Code of Conduct outlined above;

2. I acknowledge that TVI may take disciplinary action against me if I breach the code of conduct. (I

understand that TVI are required to implement a complaints handling procedure in accordance

with the principles of natural justice, in the event of an allegation against me);

3. I acknowledge that disciplinary action against me may include the disqualification of my player/s.

__________________________ ____________________________ ___________________________ ____/_____/____ Name Signature (if under 18, parent/guardian signature)

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