The document summarizes an official bulletin for the 2017 China International Karate Open to be held from August 1-5, 2017 in Laiyuan City, Hebei Province, China. The bulletin provides information on the competition dates and venue, categories, rules, registration process, accommodation, transportation, training programs, and contact details for the organizing committee. Key details include kumite and kata categories for seniors, juniors, cadets, and kids, as well as awards, prizes, and instructions from world champion coaches.
The Minister of State (Independent Charge) for Youth Affairs and Sports Shri Sarbananda Sonowal has said that the details of achievements of sportspersons and teams of the country in terms of medals won, sports discipline-wise, in Glasgow Commonwealth Games 2014 and Incheon Asian Games 2014 are given in Annexure. Sportspersons from the country did not win any medal in FIG Artistic Gymnastics, 45th World Championship held in Nanning, China from 3rd to 12th October 2014.
The Minister of State (Independent Charge) for Youth Affairs and Sports Shri Sarbananda Sonowal has said that the details of achievements of sportspersons and teams of the country in terms of medals won, sports discipline-wise, in Glasgow Commonwealth Games 2014 and Incheon Asian Games 2014 are given in Annexure. Sportspersons from the country did not win any medal in FIG Artistic Gymnastics, 45th World Championship held in Nanning, China from 3rd to 12th October 2014.
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2. 1. DATE: August 1-5, 2017
2. VENUE: Laiyuan City, Hebei Province of China
3. CONTACT INFORMATION
Chinese Karatedo Association (CKA)
Address: No.2, Tiyuguan Road, Dongcheng District, Beijing, 100763, China
Tel: +86-10-87182932
Fax: +86-10-87182934
E-mail: chinakaratedo@foxmail.com
4. COMPETITION RULES
1) The updated WKF rules will be applied in the competition. Final competition method will be
formulated by the OC according to the registration and explained at Team Manager meeting
2) -55kg for senior male will be included according to AKF competition format.
3) In case of less than 8 competitors in each category, OC has authority to combine relevant
categories into one.
4) Competitors must bring by themselves WKF/AKF/CKA approved dogis and equipments. CKA &
OC has NO obligation to provide.
5. Entry
1) OC accept entries by NF, Dojos or Clubs;
2) Each NF/Dojo/Club can register maximum of 2 teams and 2 competitors in each
category with exception of the host country.
2) Junior kata competitors can participate in both senior and junior kata competitions if they meet
the terms of registration limit.
6. EVENTS & CATEGORIES
A Senior
Kumite: Age +18 (Born before 31/12/1999)
Individual Kumite: Female : -50kg, -55kg, -61kg, -68kg, +68kg
Male : -55kg, -60kg, -67kg, -75kg, -84kg, +84kg
Team kumite: Female (3 competitors) & Male (5 competitors)
Kata : Age +16 (Born before 31/12/2001)
Individual kata: Female & Male
Team kata: Female & Male
B Junior
Age: 16-17 (Born between 01/01/2000 and 31/12/2001)
Kumite:
Individual kumite: Female : -48kg, -53kg, -59kg, +59kg
Male : -55kg, -61kg, -68kg, -76kg, +76kg
Team kumite: Female (3 competitors) & Male (5 competitors)
Kata:
Individual kata: Female & Male
Team kata : Female & Male
3. C Cadet
Age: 14-15 (Born between 01/01/2002 and 31/12/2003)
Kumite:
Individual Kumite: Female : -47kg, -54kg, +54kg
Male : -52kg, -57kg, -63kg, -70kg, +70kg
Team Kumite: Female (3 competitors) & Male (3 competitors)
Individual Kata : Female & Male
D Kids (boys & girls)
Age: 6-13 (Born between 01/01/2005 and 31/12/2011)
Kumite:
Individual kumite:
Girls: 4 age categories:
age 6-7:-19kg, -21kg, -23kg, +23kg
age 8-9:-23kg, -25kg, -27kg, +27kg
age 10-11:-27kg, -29kg, -31kg, +31kg
age 12-13: -34kg, -36kg, -38kg, +38kg
Boys: 4 age categories
age 6-7: -21kg, -23kg, -25kg, +25kg
age 8-9: -26kg, -28kg, -30kg, +30kg
age 10-11: -31kg, -33kg, -35kg, +35kg
age 12-13: -36kg, -38kg, -40kg, +40kg
Team Kumite:
Girls: 3 age categories: age 6-8/9-11/12-13 (3 competitors)
Boys: 3 age categories: age 6-8/9-11/12-13 (3 competitors)
Kata:
Individual Kata for girls: 4 age categories: age 6-7/8-9/10-11/12-13
Individual Kata for boys: 4 age categories: age 6-7/8-9/10-11/12-13
7. Referees
Each team can register 1 referee with valid AKF/WKF license. The OC will provide free
accommodation. Please fill in the Referee Registration Form and send it back to the OC. In
addition, each delegation can register maximum 5 referees with valid AKF/WKF license.
8. Awards & Prize
(1) Top 3 competitors in each category will be awarded with medals and diplomas;
(2) All participants will be awarded with participation certificates;
(3) Top 3 winners in senior male/female team kumite will be awarded with prize as follows:
1st
Place: USD1, 000
2nd
Place: USD 500
3rd
Place (2 Teams): USD 300
4. 9. ARRIVAL & DEPARTURE
Participants are recommended to arrive and leave at Beijing Capital International
Airport, and the OC will provide free transportation between airport and the official hotel
according to their travel schedule. It will take 1.5 hours by bus from the airport to Laiyuan.
10. STADIUM:
The blue whale convention and exhibition center of Laiyuan
11. HEADQUARTER HOTEL
Hotel Name: Holiday Inn Central China*****
All international teams will be accommodated in HQ hotel, and the package price is 500
USD/person. All teams should check in on Aug.1 and check out before 12:00 AM on Aug.5, 2017.
The following items are included in the package price:
1) Accommodation from Aug.1 -5,2017 (Double Room)
2) Full board
3) Transportation between Beijing Capital International Airport and HQ Hotel
4) Bus Service between HQ Hotel and Competition Venue
5) Training Camp Activities
6) To attend 2017 China International Karate Open
Standing in Baishi mountain hot springs
resort, with outstanding design concept and
perfect facilities, and as the theme of physical
fitness and cultural fitness, the Blue Whale
Convention and Exhibition Center opened a
new era of leisure, conference and exhibition
in Laiyuan.
The construction area of Blue Whale
Convention and Exhibition Center, which was
named after the buildings shaped like the blue
whale, is 1.2 square meters. It is one of the
largest light membrane structure building in
north China, and has advantages in major six
aspects of green, energy saving, low carbon,
environmental protection, unique and
beautiful. People-oriented and the design of
return to natural were mixed together
artistically, which bring us super shock and
visual impact.
As chief cultural convention and exhibition
center and sports leisure center, the Blue
Whale Convention and Exhibition Center is
committed to creating Laiyuan high-end BBS.
With high standard sports ground, reasonable building structure, scientific layout, and complete
facilities, the Blue Whale Convention and Exhibition Center can satisfy various kinds of sports fitness,
training , basketball, volleyball, table tennis, badminton, running, and etc.
5. Hotel Introduction:
12. PROGRAMME (Tentative)
August 1, 2017 Tuesday
Time Event Venue
9:00-22:00
Arrival of Officials, Athletes and Delegations;
Registration of Teams & Referees
HQ Hotel
August 2, 2017 Wednesday
9:00-18:00 Summer Camp Activities TBD
August 3, 2017 Thursday
9:00-18:00 Summer Camp Activities TBD
13:00-14:00 Team Leader meeting & drawing TBD
14:00-17:00 Referee Briefing TBD
The hotel is invested by Central
China Group and located in Baishi
Hill Hot Springs Resort area of
Laiyuan County, Baoding City of
Hebei province. It is a holiday resort
hotel as the core of Hot Springs SPA
and gathering business, catering,
international conference, theme
exhibition, leisure and other projects
as a whole. Convenient
transportation, complete functions,
preventing sunstroke in summer,
Hot Springs SPA in winter and Four
Seasons theme exhibition make the
hotel to become the best choice for
the major enterprises and high-end
6. August 4, 2017 Friday
8:00-9:00 Weigh in
Stadium
9:00-19:30 Competition
Awarding Ceremony
Stadium
August 5, 2017 Saturday
Time Event Venue
Departure
14. Training Camp Instructors
We have pleasure to invite four World Karate Champions MGogita Arkania, CAROL DE LA PAZ, Hoang
Ngan Nguyen & Hoang Ngan Nguyen to instruct the training camp. They will teach karate skills and
provide assistance in competition and training camp to improve the trainees’ technical level. And they
will participate in all the activities so as to give chance to everyone to know them well outside the
competition area.
umite Instructors:
1) Gogita Arkania ( Georgia )
K
World Championships
WKF World Champion in Bremen 2014
WKF Champion in Premier League two times
Paris and Nederland 2013/2014
7. 2) Laura Palacio Gonzalez
ata Instructors:
1) CAROL DE LA PAZ
K
World Championships
WKF Silver Medal Kumite Team in Linz
WKF Bronze Medal Kumite + 68 kg in Bremen
EKF Gold Medal Kumite Team in Izmir
EKF Gold Medal Region Championships in Kocaeli
& Ankara
World Championships
2012 World Karate Championship 7th Place
2016 World Karate Championship 11th Place
8. 2) Hoang Ngan Nguyen
15.City Introduction
Laiyuan is located in the northwest of Baoding city of Hebei province, at the north end of Taihang
Mountain, and its name means the source of Lai Shui. The total area is 2448 square kilometers, and
the average elevation is about 1000 meters. 160 kilometers Northeast from Beijing, 210 kilometers
east from Tianjin, 89 kilometers southeast from Baoding, Jing-Yuan Railway and National Highways
108, 112, 207 and other traffic lines run throughout Laiyuan. 8 scenic spots represented by "The
World Geological Park" Baishi Hill, "National Urban WetlandPark" Ju Ma Yuan, and "National Key
Cultural Relics Protection Unit" Court Temple and so on, has unique landscape.
World Championships
WKF World Champion Kata individual in Tokyo
World Games Champion Kata individual in Chinese Taipei
Asian Champion Kata Team in 2015
WKF Kata instructor in Croatia 2014 / 2015
Vietnam National Coach
9. 16. ENTRY FORMS
Please send the relevant forms back to CKA before or on the deadline required.
Tel: +86-10-87182932
Fax: +86-10-87182934
E-mail: chinakaratedo@foxmail.com
Entry form A: on or before May 31, 2017
Term of Responsibility: on or before May 31, 2017
Referee Registration Form: on or before June 15, 2017
Entry form B: on or before June 15, 2017
Transportation & Accommodation Form: on or before June 15, 2017
Room List: on or before June 15, 2017
Electronic Photo: on or before June 15, 2017
A. Please submit a separate folder including all e-format photos of your delegation together with
entry form B.
B. Each photo should be saved in the person’s name plus his position.
(For example: Full Name_ Position)
17. PAYMENT
Invoice will be sent to each delegation upon receiving the reservation, and full payment must be
transferred to the designated bank account on the invoice in USD before June 30, 2017. Please
note that if the full payment is not received by the required date, your reservation will not be
guaranteed.
10. ENTRY FORM A
COUNTRY/REGION
NAME OF FEDERATION
NAME OF DOJO/CLUB
ADDRESS
TELEPHONE
FAX
EMAIL
WILL PARTICIPATE (YES/NO)
IF YES, PLEASE SPECIFY THE NUMBER OF:
DELEGATION LEADER
REFEREE
COACH
OFFICAL
COMPETITORS
SENIOR
JUNIOR
CADET
KID
TOTAL
Name of the President/Secretary General: ___ ___ _______________
Signature & Stamp : ___________________________ Date: ___ __________________
Must be typed and returned on or before May 31, 2017
E-mail: chinakaratedo@foxmail.com Fax No: +86+10-87182934
11. TERM OF RESPONSIBILITY
I, _____________________________ the undersigned, as the Chief of Delegation of my
country/region, duly enrolled to participate in the 2017 China Internation Karate Open, which will
be held in Laiyuan City of Hebei Province of China from August 1 to 5, 2017, with full knowledge of the
Statutes, the Rules and the Norms of the Chinese Karatedo Association, pledge myself to faithfully
accomplish the regulations of this before mentioned entity, and I take any and all administrative, civil
and criminal responsibilities of whatever happens to our athletes, coaches and other members of our
delegation participating in this championship, before, during and after the competition, such as
physical injuries, personal expenses, or monetary debts and casual material damages to the hotels,
the venue, means of transportation, departure on time, etc.
Furthermore, I exempt from any legal, civil or criminal responsibilities the organizers of the
Championships, Chinese Karatedo Association, its directors, as well as any person, company, or entity
related to the event (sponsors, public and private entities).
I authorize the organizers of the event to use images, photos and the names of our competitors and
other members of our delegation (as considered necessary) for the sport activities and publications of
karate, related to the event, without any monetary compensation.
Dated: _______________ Signature: ___________________________
Country/Nation
Surname, First Name
Passport No. & Expiry Date
Credit Card Details & Expiry Date
Position in the Federation
Address
Tel
Fax
E-mail
Please fill out this form and send it back to the Chinese Karatedo Association on or before May 31, 2017
Fax: +86-10-87182934 E-mail: chinakaratedo@foxmail.com
12. TRANSPORTATION & ACCOMMODATION FORM
Arrival Information
Arrival Venue: ______________________ Arrival Date: ______________________
Arrival Time: ______________________ Flight No: __________ _________
Number of Persons: _______________ other transportation: ______________
Departure Information
Departure Venue: _____________________ Departure Date: _____________________
Departure Time: _____________________ Flight No: ___________________
Number of Persons: ______________ other transportation: ______________
HOTEL BOOKING
Hotel Name
Number
of Person
Number of Room
Number
of Nights
Check-in
Date
Check-out
Date
INVOICE DETAILS
Name: _____________________________________________________
Address: ______________________________________________________________
Zip Code: ________________________ Telephone: _______________________
Fax: _______________________________ E-mail: _______________________________
13. NAME LIST
Federation: ________________________ Dojo/Club: __________________________
Person in charge: ________________ _ Mobile: ____________________________
Tel: ___________ __Fax: _________ ___E-mail: _________________________
No Full Name
Gender
(M/F)
Position *
Check in
Date
Check out
Date
Number
of
Nights
Extra
Requirement
* Positions: A=Athlete, CO=Coach, VIP=President & Delegation Head, NF=Leaders of National
Federation, R=Referees/Judges, M/P=Media/Press, O=Others
14. ENTRY FORM B
Federation: ______________________ Dojo/Club: ____________________________
Contact person: ______________________ Tel: _____________ ___
Fax: _____________ _____________ E-mail: ______________________________
SENIOR [MALE KUMITE]
No Full Name Date of Birth
Individual Kumite Team Kumite
-55
kg
-60
kg
-67
kg
-75
kg
-84
kg
+84
kg
Team
1
Team
2
Signature of President/ Secretary
General:_____________________________ Stamp:__________________________
Remarks: Please tick the category boxes. If the space is not enough, please enclose an additional sheet.
15. ENTRY FORM B
Federation: ______________________ Dojo/Club: ___________________________
Contact person: ______________________ Tel: _____________ ___
Fax: _____________ _____________ E-mail: ______________________________
SENIOR [FEMALE KUMITE]
No Full Name Date of Birth
Individual Kumite Team Kumite
-50
kg
-55
kg
-61
kg
-68
kg
+68
kg
Team
1
Team
2
Signature of President/ Secretary
General:_____________________________ Stamp:__________________________
Remarks: Please tick the category boxes. If the space is not enough, please enclose an additional sheet.
16. ENTRY FORM B
Federation: ______________________ Dojo/Club: ___________________________
Contact person: ______________________ Tel: _____________ ___
Fax: _____________ _____________ E-mail: ______________________________
SENIOR
[MALE KATA]
No Full Name Date of Birth Individual Team 1 Team 2
[FEMALE KATA]
No Full Name Date of Birth Individual Team 1 Team 2
Signature of President/ Secretary
General:_____________________________ Stamp:__________________________
Remarks: Please tick the category boxes. If the space is not enough, please enclose an additional sheet.
17. ENTRY FORM B
Federation: ______________________ Dojo/Club: ___________________________
Contact person: ______________________ Tel: _____________ ___
Fax: _____________ _____________ E-mail: ______________________________
JUNIOR [MALE KUMITE]
No Full Name Date of Birth
Individual Kumite Team Kumite
-55
kg
-61
kg
-68
kg
-76
kg
+76
kg
Team
1
Team
2
Signature of President/ Secretary
General:_____________________________ Stamp:__________________________
Remarks: Please tick the category boxes. If the space is not enough, please enclose an additional sheet.
18. ENTRY FORM B
Federation: ______________________ Dojo/Club: ___________________________
Contact person: ______________________ Tel: _____________ ___
Fax: _____________ _____________ E-mail: ______________________________
JUNIOR [FEMALE KUMITE]
No Full Name Date of Birth
Individual Kumite Team Kumite
-48
kg
-53
kg
-59
kg
+59
kg
Team
1
Team
2
Signature of President/ Secretary
General:_____________________________ Stamp:__________________________
Remarks: Please tick the category boxes. If the space is not enough, please enclose an additional sheet.
19. ENTRY FORM B
Federation: ______________________ Dojo/Club: ___________________________
Contact person: ______________________ Tel: _____________ ___
Fax: _____________ _____________ E-mail: ______________________________
JUNIOR
[MALE KATA]
No Full Name Date of Birth Individual Team 1 Team 2
[FEMALE KATA]
No Full Name Date of Birth Individual Team 1 Team 2
Signature of President/ Secretary
General:_____________________________ Stamp:__________________________
Remarks: Please tick the category boxes. If the space is not enough, please enclose an additional sheet.
20. ENTRY FORM B
Federation: ______________________ Dojo/Club: ___________________________
Contact person: ______________________ Tel: _____________ ___
Fax: _____________ _____________ E-mail: ______________________________
CADET [MALE KUMITE & KATA]
No Full Name Date of Birth
Individual Kumite Team Kumite
Kata
-52
kg
-57
kg
-63
kg
-70
kg
+70
kg
Team1 Team2
Signature of President/ Secretary
General:_____________________________ Stamp:__________________________
Remarks: Please tick the category boxes. If the space is not enough, please enclose an additional sheet.
21. ENTRY FORM B
Federation: ______________________ Dojo/Club: ___________________________
Contact person: ______________________ Tel: _____________ ___
Fax: _____________ _____________ E-mail: ______________________________
CADET [FEMALE KUMITE & KATA]
No Full Name Date of Birth
Individual Kumite Team Kumite
Kata
-47
kg
-54
kg
+54
kg
Team1 Team2
Signature of President/ Secretary
General:_____________________________ Stamp:__________________________
Remarks: Please tick the category boxes. If the space is not enough, please enclose an additional sheet.
22. ENTRY FORM B
Federation: ______________________ Dojo/Club: ___________________________
Contact person: ______________________ Tel: _____________ ___
Fax: _____________ _____________ E-mail: ______________________________
KIDS-INDIVIDUAL
[BOYS KUMITE & KATA]
Age 6-7
No. Full Name Date of Birth
Individual Kumite
Kata
-21 kg -23kg -25 kg +25 kg
Signature of President/ Secretary
General:_____________________________ Stamp:__________________________
Remarks: Please tick the category boxes. If the space is not enough, please enclose an additional sheet.
23. ENTRY FORM B
Federation: ______________________ Dojo/Club: ___________________________
Contact person: ______________________ Tel: _____________ ___
Fax: _____________ _____________ E-mail: ______________________________
KIDS ---INDIVIDUAL
[BOYS KUMITE & KATA]
Age 8-9
No. Full Name Date of Birth
Individual Kumite
Kata
-26 kg -28kg -30 kg +30 kg
Signature of President/ Secretary
General:_____________________________ Stamp:__________________________
Remarks: Please tick the category boxes. If the space is not enough, please enclose an additional sheet.
24. ENTRY FORM B
Federation: ______________________ Dojo/Club: ___________________________
Contact person: ______________________ Tel: _____________ ___
Fax: _____________ _____________ E-mail: ______________________________
KIDS---INDIVIDUAL
[BOYS KUMITE & KATA]
Age 10-11
No. Full Name Date of Birth
Individual Kumite
Kata
-31 kg -33kg -35 kg +35 kg
Signature of President/ Secretary
General:_____________________________ Stamp:__________________________
Remarks: Please tick the category boxes. If the space is not enough, please enclose an additional sheet.
25. ENTRY FORM B
Federation: ______________________ Dojo/Club: ___________________________
Contact person: ______________________ Tel: _____________ ___
Fax: _____________ _____________ E-mail: ______________________________
KIDS---INDIVIDUAL
[BOYS KUMITE & KATA]
Age 12-13
No. Full Name Date of Birth
Individual Kumite
Kata
-36 kg -38kg -40 kg +40 kg
Signature of President/ Secretary
General:_____________________________ Stamp:__________________________
Remarks: Please tick the category boxes. If the space is not enough, please enclose an additional sheet.
26. ENTRY FORM B
Federation: ______________________ Dojo/Club: ___________________________
Contact person: ______________________ Tel: _____________ ___
Fax: _____________ _____________ E-mail: ______________________________
KIDS---INDIVIDUAL
[GIRLS KUMITE & KATA]
Age 6-7
No. Full Name Date of Birth
Individual Kumite
Kata
-19 kg -21kg -23 kg +23 kg
Signature of President/ Secretary
General:_____________________________ Stamp:__________________________
Remarks: Please tick the category boxes. If the space is not enough, please enclose an additional sheet.
27. ENTRY FORM B
Federation: ______________________ Dojo/Club: ___________________________
Contact person: ______________________ Tel: _____________ ___
Fax: _____________ _____________ E-mail: ______________________________
KIDS---INDIVIDUAL
[GIRLS KUMITE & KATA]
Age 8-9
No. Full Name Date of Birth
Individual Kumite
Kata
-23 kg -25kg -27 kg +27 kg
Signature of President/ Secretary
General:_____________________________ Stamp:__________________________
Remarks: Please tick the category boxes. If the space is not enough, please enclose an additional sheet.
28. ENTRY FORM B
Federation: ______________________ Dojo/Club: ___________________________
Contact person: ______________________ Tel: _____________ ___
Fax: _____________ _____________ E-mail: ______________________________
KIDS---INDIVIDUAL
[GIRLS KUMITE & KATA]
Age 10-11
No. Full Name Date of Birth
Individual Kumite
Kata
-27 kg -29kg -31 kg +31 kg
Signature of President/ Secretary
General:_____________________________ Stamp:__________________________
Remarks: Please tick the category boxes. If the space is not enough, please enclose an additional sheet.
29. ENTRY FORM B
Federation: ______________________ Dojo/Club: ___________________________
Contact person: ______________________ Tel: _____________ ___
Fax: _____________ _____________ E-mail: ______________________________
KIDS---INDIVIDUAL
[GIRLS KUMITE & KATA]
Age 12-13
No. Full Name Date of Birth
Individual Kumite
Kata
-34 kg -36kg -38 kg +38 kg
Signature of President/ Secretary
General:_____________________________ Stamp:__________________________
Remarks: Please tick the category boxes. If the space is not enough, please enclose an additional sheet.
.
30. ENTRY FORM B
Federation: ______________________ Dojo/Club: ___________________________
Contact person: ______________________ Tel: _____________ ___
Fax: _____________ _____________ E-mail: ______________________________
KIDS---TEAM KUMITE
CATEGORY:6-8 YEARS
[BOYS]
No Full Name Date of Birth Team 1 Team 2
[GIRLS]
No Full Name Date of Birth Team 1 Team 2
Signature of President/ Secretary
General:_____________________________ Stamp:__________________________
Remarks: Please tick the category boxes. If the space is not enough, please enclose an additional sheet.
31. ENTRY FORM B
Federation: ______________________ Dojo/Club: ___________________________
Contact person: ______________________ Tel: _____________ ___
Fax: _____________ _____________ E-mail: ______________________________
KIDS---TEAM KUMITE
CATEGORY:9-11 YEARS
[BOYS]
No Full Name Date of Birth Team 1 Team 2
[GIRLS]
No Full Name Date of Birth Team 1 Team 2
Signature of President/ Secretary
General:_____________________________ Stamp:__________________________
Remarks: Please tick the category boxes. If the space is not enough, please enclose an additional sheet.
32. ENTRY FORM B
Federation: ______________________ Dojo/Club: ___________________________
Contact person: ______________________ Tel: _____________ ___
Fax: _____________ _____________ E-mail: ______________________________
KIDS---TEAM KUMITE
CATEGORY:12-13 YEARS
[BOYS]
No Full Name Date of Birth Team 1 Team 2
[GIRLS]
No Full Name Date of Birth Team 1 Team 2
Signature of President/ Secretary
General:_____________________________ Stamp:__________________________
Remarks: Please tick the category boxes. If the space is not enough, please enclose an additional sheet.
33. REFEREE REGISTRATION FORM
FEDERATION: _______________________________
DOJO/CLUB: _______________________________________
On behalf of our federation, I sincerely recommend the mentioned referee to officiate in the coming
2016 China International Karate Open.
Personal Information
First name:_______________________ Family name:
Gender:_________ Mobile:_____________ E-mail:_________________________
Valid Referee/Judge License Holding
AKF Kata/Kumite License
Kata: Judge-B Judge-A
Kumite: Judge-B Judge-A Referee-B Referee-A
WKF Kata/Kumite License
Kata: Judge-B Judge-A
Kumite: Judge-B Judge-A Referee-B Referee-A
Signature of President/ Secretary
General: Stamp:
Please fill out this form and send it back to the Chinese Karatedo Association on or before June 15, 2017
Fax: +86-10-87182934 E-mail: chinakaratedo@foxmail.com