Keppel Prince Engineering presents the
2019 Portland Open Border Challenge
Saturday July 13

Portland Secondary College Gym, Must St, Portland

Please ensure that you have read the instructions to correctly complete this form - CLICK HERE FOR INSTRUCTIONS


Entry Cost:  $20
MEDICAL FORM:  must be obtained from your doctor within 3 weeks of the event

Full Contact Entry Form

First Name
Surname
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Gender
Weight
Address
Suburb
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Karate Grade
Post Code
Dojo
Telephone Number
Date of Birth
Email
Instructor Email
Age on day of the tournament
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Parent/Guardian Name
Martial Arts History:
If Kyokushin, how long have you been training for?
Prior to joining Kyokushin have you trained in another martial art?
If Yes, give details, training time, grade achieved:
Total training time in all martial arts:
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Adult Division (18yo and over)
Please select both a Grade and Weight Division
Grade Division
Weight Division
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Colts Divisions (16yo & 17yo)
Weight (kg)
Junior Colts Divisions (14yo & 15yo)
I am interested in competing in the Junior Colts Division
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Conditions of Entry
  • Your entry will not be accepted until your entry fee is received. Please pay directly into our bank account BSB 633 000, Account number 142 432 913, Account Name Portland Kyokushin Karate Club - Social Club Account and ensure you state who it is from. If you need to mail a cheque please mail to Shihancho, 38 Roxby St, Manifold Heights 3218 or contact him on 03 5229 5229

  • All competitors must provide a Doctor's Certificate stating that the applicant is fit to participate in a full contact karate tournament, and that the applicant does not have any person to person transferable infections or diseases.  This must either accompany this application OR be handed in at the official weigh-in.  The form must be obtained from your doctor within 3 weeks of the event.
You can download the form by clicking here.
NO FORM = NO FIGHT.
  • All competitors must have mouth guards (interstate and overseas competitors please note that this is a legal requirement and you will NOT be permitted to fight without a mouth guard).
  • Male competitors MUST wear a groin guard.
  • Female competitors may wear soft style breast guards only (VKKA approved type only).  You must present these for inspection at the weigh-in.
  • Any female competitor discovered fighting with a non-approved breast guard will be immediately disqualified. 
  • Novice competitors MUST wear shin/instep guards.
  • Intermediate competitors MAY wear shin/instep guards (optional).  Organisers reserve the right to combine divisions if needed (competitors will be notified); heavyweight competitors please note that the super heavyweight and heavyweight divisions may be merged.  
  • Late competitors, or competitors withdrawing from their match, will forfeit their entry fee and the match. Incorrect weight will result in disqualification, unless their is an opening in an alternative division. If the starting time or weigh-in time is altered, competitors will be notified.  
  • Competitors not weighed in by 11am on the day of the tournament, will be disqualified.  
  • By entering this tournament the competitor (or legal guardian, where the competitor is less than 18 years of age at time of tournament), hereby grants to the organisers (Victorian Kyokushin Karate Association, Inc.) a non-exclusive, non-royalty bearing and non-sublicensable licence to take photographs, record footage or live broadcast of the competitor ('content') and to use the content in any promotional material developed or distributed by the Victorian Kyokushin Karate Association, Inc.  
Declaration
I, whose electronic acknowledgement of the conditions of entry and email address that appears on this entry form, in consideration and as a condition of the acceptance of my entry in this tournament, hereby waive all and any claim, right or cause of action which I might otherwise have for, or arising out of loss or injury, damage or loss of any description whatsoever which I may suffer or sustain in the course of, or as a consequence upon my entry or participation in this tournament.  In participating in this 2019 Victorian Knockdown Championships, I am aware, and understand the risk of harm (including personal injury or death, damage to property or economic loss).  I am aware that this sport is "dangerous recreational activity" that involves significant risk of harm.  This waiver, release and discharge shall be and operate separately in favour of all persons, corporations and bodies involved or otherwise in promoting or staging this event and the servants, agents, representatives and officers of them.  I understand that the Victorian Kyokushin Karate Association, Inc. reserves the right to reject any entry which, in its sole judgement, will be detrimental to the tournament.  I will abide by the rules of this Kyokushin tournament.  I acknowledge that I have read and understood the "Conditions of Entry".  
I am a member of an Ambulance Scheme:
I acknowledge that I have read and understood the conditions of entry and declaration
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Shihancho can be contacted on 03 5229 5229 / 0418 347 088 or shihancho@vic.chariot.net.au