Knights Refrigeration presents
10th Portland Open Border Challenge
Saturday 9 July 2022 - 10:00AM
Portland Secondary College Gym, Must St, Portland
Please ensure that you have read the instructions to correctly complete this form - CLICK HERE FOR INSTRUCTIONS
This entry form to be completed and received with entry fee by no later than 2 July 2022
Entry Cost: $20
MEDICAL FORM: must be obtained from your doctor within 3 weeks of the event
Full Contact Entry Form
Date of Birth
Age on day of the tournament
Martial Arts History:
If Kyokushin, how long have you been training for?
Prior to joining Kyokushin have you trained in another martial art?
Please give details of Tournament History
Total training time in all martial arts:
Adult Division (18yo and over)
Please select both a Contact and Weight Division
* Novice Contact: Head guards (optional), 8 oz gloves are compulsory and will be provided by Tournament organisers. Shin, Mouth & Groin guards are compulsory and to be provided by competitor.
** Full Contact: Mouth & Groin guards are compulsory. 5th Kyu and below shin guards are optional. Protective equipment to be provided by competitor
Colts Divisions (16yo & 17yo)
Junior Colts Divisions (14yo & 15yo)
I am interested in competing in the Junior Colts Division
Head guards, 8 oz gloves & Body guards (14–15 years) are compulsory and will be provided by Tournament organisers. Shin & Mouth guards are compulsory and to be provided by competitor. Soft cup chest protectors are optional.
All contact competitors will be required to weigh-in either on Friday evening from 5–7 pm at the Portland Dojo 28 Percy Street or on the day from 9.00 am at the venue.
All participants are required to have a signed Doctor’s permission letter to be presented at Weigh-in before being able to participate.
Conditions of Entry
Entry Fee: $20.00 Please pay into this account
BSB: 633000 Acct No: 142432913 Acct Name: Portland Kyokushin Karate Club
Further information may be obtained by telephoning Shihan Ron Jorgensen or Sempai Debbie Jorgensen – 0477 387 244
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 dated no earlier than 3 weeks of the event date.
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 and are to be provided by the competitor. Head guards are optional, 8oz gloves are compulsory and will be provided by Tournament organisers.
5th Kyu and below 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.
Colts & Junior Colts - Head protection, shin guards & 8 oz gloves, plus Body shields (14–15 year old), are compulsory . Soft cup chest protectors are optional for females. Colts and Novice Competitors are encouraged to bring their own head protection, gloves & body shields to limit the spread of an infection. If you do not have access to such equipment, the tournament organisers will supply these items and they will be sanitised between each round.
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. & Portland Kyokushin Karate Club) 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. or related bodies-corporate.
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 2022 Portland Open Border Challenge, 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
You have not completed all the fields
FORM NOT SUBMITTED