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WFF

CZECH

WORLD

FUDOKAN

FEDERATION FUDOKAN KARATE FEDERATION

TRADITIONAL

CTFKF

5 WORLD FUDOKAN KARATE CHAMPIONSHIP


- In memory of Sensei Dan Stuparu Veterans, Seniors, Youths, Juniors, Cadets Childern World Karate Cup

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PRAGUE CZECH REPUBLIC November 28.-29.-30.-December 1., 2013 Sport Hall Sokol Praha Krlovsk Vinohrady, Polsk 2400/1, Praha 2

5th WORLD FUDOKAN KARATE CHAMPIONSHIP - In memory of Sensei Dan Stuparu Veterans, Seniors,Youths, Juniors, Cadets Children World Karate Cup Prague, Czech Republic November 28.-29.30.- December 1, 2013

WFF
WORLD FUDOKAN FEDERATION
To: Fudokan Karate National Federation Prague, June 30, 2013

INVITATION
to the 5 WORLD FUDOKAN KARATE CHAMPIONSHIP - In the memory of Sensei Dan Stuparu Veterans, Seniors, Youths, Juniors, Cadets Children World Karate Cup PRAGUE CZECH REPUBLIC - November 28.-29.-30.-December 1., 2013
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Dear friends, The WORLD FUDOKAN FEDERATION and the CZECH TRADITIONAL FUDOKAN KARATE FEDERATION have the great honour and pleasure to invite you to the WORLD FUDOKAN KARATE CHAMPIONSHIPS for VETERANS, SENIORS, YOUTHS, JUNIORS, CADETS and to the CHILDREN WORLD KARATE CUP. With the great pleasure we will welcome here your athletes, coaches, referees and official representatives of your National Federation. We are looking forward to your participation.

Univ.Prof.Ilija Jorga MD.,PhD. Soke 10 DAN Founder of Fudokan Founder of WFF

Mr.Rajeev Sinha 7 Dan President of WFF

Dipl.Eng.Rachmy Soebajo 8 Dan Tournament Organizing Committee Chairman


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5th WORLD FUDOKAN KARATE CHAMPIONSHIP - In memory of Sensei Dan Stuparu Veterans, Seniors,Youths, Juniors, Cadets Children World Karate Cup Prague, Czech Republic November 28.-29.30.- December 1, 2013

OFFICIAL INFORMATIONS
GENERAL OUTLINE
Title

Hosted by Sanctioned by Place Date

Czech Traditional Fudokan Karate Federation World Fudokan Federation Sport Hall, TJ Sokol Krlovsk Vinohrady, Polsk 2400/1, Praha 2 - Vinohrady 28.-29.-30. November 1.December 2013

SCHEDULE & PROGRAM


PROGRAM for JUDGES: Arrival- Accommodation: 27.- 28. November 2013 HOTEL DUO, (Teplick 492, Prague 9)

The JUDGE COURSE WILL BE LEADED BY: Univ. Prof. Vladimir JORGA, M.D., Ph.D, 9. DAN

ATTENTION!

ATTENDING THE JUDGE COURSE IS MANDATORY FOR ALL JUDGES!

27th November 2013 Wednesday 28th November 2013 Thursday

Judge Course: 5:00 p.m. - 8:00 p.m. Judge Course: 10:00 a.m. - 2:00 p.m. EXAMS: 3:00 p.m. - 5:00 p.m.

PROGRAM for ATHLETES: 28 th November 2013 Thursday Arrival of Teams to: HOTEL DUO, (Teplick 492, Prague 9) 9:00 a.m. - 5:00 p.m. Registration Office of the World Championship HOTEL DUO, (Teplick 492, Prague 9) Registration Closed Fudokan Karate-do Seminar (mandatory for all the athletes) Soke Prof. Dr. Ilija Jorga 10 DAN

5:00 p.m. 5:00 p.m. 6:30 p.m. ATION CLOSED

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5th WORLD FUDOKAN KARATE CHAMPIONSHIP - In memory of Sensei Dan Stuparu Veterans, Seniors,Youths, Juniors, Cadets Children World Karate Cup Prague, Czech Republic November 28.-29.30.- December 1, 2013
29 th November 2013 Friday 9:00 a.m.- 10:00 a.m. Fudokan Karate-do Seminar (mandatory for all the athletes) Soke Prof. Dr. Ilija Jorga 10 DAN Eliminations, semifinals Closing Ceremony Start of Competition CHILDREN WORLD KARATE CUP Eliminations, semifinals, Finals

10:30 a.m. 10:00 p.m. 30 th November 2013 Saturday 9:00 a.m. 10:00 p.m.

Start of Competition Eliminations, semifinals, Finals cadets and juniors Eliminations youth WFF Meeting

1 st December 2013 Sunday 9:00 a.m. 3:00 p.m.

4:00 p.m. 5:00 p.m.

Start of Competition Semifinals, finals - Youth, Eliminations, semifinals Seniors, Veterans OFFICIAL OPENING CEREMONY Finals for Seniors and Veterans Closing Ceremony Departure

2 th December 2013 Monday

PARTICIPANTS:
Athletes officially selected by the WFF- National Federation Members of each country according to the following requirements: 1. 2. 3. 4. 5. 6. Each country shall be represented by one official team. Each athlete must be a citizen of the represented country. Each athlete must know, thoroughly understand and be able to compete under the WFF-Competition Rules. Each athlete must be free of any psychical or mental handicap so as not to cause difficulties in the competition under the WFF Rules. All competitors must have International insurance stipulated by their National Federation. All competitors must have Medical Release.

All National Federation participants must be WFF Member for 2013. Participation in the World Fudokan karate Championships conditioned by the payment of all membership fees to WFF (affiliation for the new members, annual membership fee for 2013). All athletes who want to enter the WORLD FUDOKAN KARATE CHAMPIONSHIP competitions MUST have a Fudokan BUDOPASS with the Annual Visa 2013 All athletes for all kumite categories must have the proper protector according to the official WFF Competition Rules.
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5th WORLD FUDOKAN KARATE CHAMPIONSHIP - In memory of Sensei Dan Stuparu Veterans, Seniors,Youths, Juniors, Cadets Children World Karate Cup Prague, Czech Republic November 28.-29.30.- December 1, 2013

COMPETITION CATEGORIES Children


A. CHILDREN AGE 6-7 YEARS (BORN IN 2007-2006) Individual Kata Girls 8 athletes/Country Team Kata Girls Individual Kata Boys 8 athletes/Country Team Kata Boys Ind. Kihon Girls 8 athletes/Country En-bu Girl-Boy Ind. Kihon Boys 8 athletes/Country En-bu Boy-Boy Ind. Kihon-Ippon-Kumite Girls 8 athletes/Country Ind. Kihon-Ippon-Kumite Boys 8 athletes/Country B. CHILDREN AGE 8-9 YEARS (BORN IN 2005-2004) 8 athletes/Country Team Kata Girls 8 athletes/Country Team Kata Boys 8 athletes/Country Enbu Girl-Boy 8 athletes/Country Enbu Boy-Boy 8 athletes/Country 8 athletes/Country 2 teams/Country 2 teams/Country 2 teams/Country 2 teams/Country

Individual Kata Girls Individual Kata Boys Ind. Kihon Girls Ind. Kihon Boys Ind. Kihon-Ippon-Kumite Girls Ind. Kihon-Ippon-Kumite Boys

2 teams/Country 2 teams/Country 2 teams/Country 2 teams/Country

Individual Kata Girls Individual Kata Boys Ind. Kihon Girls Ind. Kihon Boys Ind. Jiyu-Ippon-Kumite Girls Ind. Jiyu-Ippon-Kumite Boys

C. CHILDREN AGE 10-11 YEARS (BORN IN 2003-2002) 8 athletes/Country Team Kata Girls 8 athletes/Country Team Kata Boys 8 athletes/Country En-bu Girl-Boy 8 athletes/Country En-bu Boy-Boy 8 athletes/Country 8 athletes/Country D. CHILDREN AGE 12-13 YEARS (BORN IN 2001-2000) 8 athletes/Country Team Kata Girls 8 athletes/Country Team Kata Boys 8 athletes/Country En-bu Girl-Boy 8 athletes/Country En-bu Boy-Boy 8 athletes/Country Team Ko-Go-Kumite Girls 8 athletes/Country Team Ko-Go-Kumite Boys

2 teams/Country 2 teams/Country 2 teams/Country 2 teams/Country

Individual Kata Girls Individual Kata Boys Ind. Jiyu-Ippon-Kumite Girls Ind. Jiyu Ippon Kumite Boys Ind. Ko-Go-Kumite Girls Ind. Ko-Go-Kumite Boys

2 teams/Country 2 teams/Country 2 teams/Country 2 teams/Country 2 teams/Country 2 teams/Country

SYSTEM OF CONTEST:
KATA Groups: , , , D (Children) eliminations/semifinal/ final FLAG SYSTEM.

TYPE OF K (individual and team): Group A elimination/ semifinal/ final Heian 1-2-3-4-5 Group B elimination/ semifinal/ fina Heian 1-2-3-4-5, Heian Oi-Kumi, Bassai-Dai Group C elimination/ semifinal/ final Heian 1-2-3-4-5, Heian Oi-Kumi, Bassai-Dai,Kanku-Dai Group D elimination/ semifinal/ Heian 1-2-3-4-5, Heian Oi-Kumi,Bassai-Dai, Kanku-Dai,Jion final Tokui Kata (fudokan or others) TEAM KATA Each team will be composed of 3 contestants (1 athlete can be from the younger group). APLICATION of KATA Only children group D must demonstrate Kata Application (Bunkai) .
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5th WORLD FUDOKAN KARATE CHAMPIONSHIP - In memory of Sensei Dan Stuparu Veterans, Seniors,Youths, Juniors, Cadets Children World Karate Cup Prague, Czech Republic November 28.-29.30.- December 1, 2013

KIHON Group A, B, C
1. Oi-Tsuki-Jodan 2. Age-Uke/Gyaku-Tsuki 3. Gyaku-Tsuki 4. Uchi-Uke/Gyaku-Tsuki 5. Mae-Geri-Chudan 6. Gedan-Barai/Gyaku-Tsuki - 4 x forward last time ki-ai - 4 x backward last time ki-ai - 4 x forward last time ki-ai - 4 x backward last time ki-ai after - 4 x forward last time ki-ai - 4 x backward last time ki-ai

Kihon-Ippon-KUMITE Group A, B
Tori - attacks: 1. Kizami-Tsuki-Jodan 2. Oi-Tsuki-Chudan 3. Mae-Geri-Chudan Starting position: Hidari-Zenkutsu-Dachi / Gedan-Barai (steping forward) In final matches only - plus renzoku-kogeki-waza: 4. Mawashi-Geri-Jodan Uke - defence: ONLY Uke-waza, counterattack: Gyaku-Tsuki-Chudan. Starting position: Yoy-Dachi (steping backward).

Jiyu-Ippon-KUMITE Group C, D
Tori - attacks: 1. Kizami-Tsuki-Jodan 2. Oi-Tsuki-Jodan 3. Gyaku-Tsuki-Chudan 4. Mae-Geri-Chudan 5. Mawashi-Geri-Jodan Only one side of the body. Starting position: Hidari Kamae-Te. In final matches only - plus renzoku-kogeki-waza: 6. Kizami-Tsuki-Jodan / Mawashi-Geri-Jodan / Uraken-Uchi-Jodan / Gyaku-Tsuki-Chudan Uke - defence: Only Uke-waza, counterattack: Gyaku-Tsuki-Chudan. Starting position: Hidari Kamae-Te

ATTENTION! AN ATHLETE CAN PARTICIPATE AT INDIVIDUAL CATEGORIES ONLY AT HIS AGE CATEGORY. IF HE PARTICIPATES AT TEAM CATEGORY FOR A HIGHER AGE GROUP, HE CANNOT PARTICIPATE AT THE SAME TEAM CATEGORY IN HIS AGE GROUP

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5th WORLD FUDOKAN KARATE CHAMPIONSHIP - In memory of Sensei Dan Stuparu Veterans, Seniors,Youths, Juniors, Cadets Children World Karate Cup Prague, Czech Republic November 28.-29.30.- December 1, 2013

COMPETITION CATEGORIES Cadets, Juniors, Youths, Seniors


CADETS AGE 14-15 YEARS (BORN IN 1999-1998) Individual Kata Women Individual Kata Men Fuku-Go Women (Ko-go Kumite) Fuku-Go Men (Ko-go Kumite) Ind. Ko-go Kumite Women Ind. Ko-go Kumite Men Individual Kata Kobudo Women 8 athletes/Country 8 athletes/Country 8 athletes/Country 8 athletes/Country 8 athletes/Country 8 athletes/Country 8 athletes/Country Team Kata Women Team Kata Men En-bu Women/Man En-bu Man/Man Ko-go Kumite Team Women Ko-go Kumite Team Men Individual Kata Kobudo Men 1 team/Country 1 team/Country 1 team/Country 1 team/Country 1 team/Country 1 team/Country 8 athletes/Country

Ind. Free Style Kumite (Sanbon Shobu) Women Ind. Free Style Kumite (Sanbon Shobu) Men

8 athletes/Country 8 athletes/Country

-48kg, -55kg, +55kg -50kg, -55kg, -60kg, -65kg, -70kg, +70kg

JUNIORS AGE 16-17 YEARS (BORN IN 1997-1996) Individual Kata Women Individual Kata Men Fuku-Go Woman (Kogo Kumite) Fuku-Go Men (Kogo Kumite) Ind. Ko-go Kumite Women Ind. Ko-go Kumite Men Individual Kata Kobudo Women 8 athletes/Country 8 athletes/Country 8 athletes/Country 8 athletes/Country 8 athletes/Country 8 athletes/Country 8 athletes/Country Team Kata Women Team Kata Men En-bu Woman/Man En-bu Man/Man Ko-go Kumite Team Women Ko-go Kumite Team Men Kumite Team Men Individual Kata Kobudo Men 1 team/Country 1 team/Country 1 team/Country 1 team/Country 1 team/Country 1 team/Country 1 team/Country 8 athletes/Country

Ind. Free Style Kumite (Sanbon Shobu) Women Ind. Free Style Kumite (Sanbon Shobu) Men

8 athletes/Country 8 athletes/Country

-50kg, -57kg, +57kg -55kg, -60kg, -65kg, -70kg, -75kg, +75kg

YOUTHS AGE 18-20 YEARS (BORN IN 1995 -1994 - 1993) Individual Kata Women Individual Kata Men Fuku-Go Woman (Ippon Shobu) Ind. Fuku-Go Men(Ippon Shobu) Ind. Kumite Women(Ippon Shobu) Ind. Kumite Men(Ippon Shobu) Individual Kata Kobudo Women 8 athletes/Country 8 athletes/Country 8 athletes/Country 8 athletes/Country 8 athletes/Country 8 athletes/Country 8 athletes/Country Team Kata Women Team Kata Men En-bu Woman/Man En-bu Man/Man Kumite Team Women Kumite Team Men Individual Kata Kobudo Men 1 team/Country 1 team/Country 1 team/Country 1 team/Country 1 team/Country 1 team/Country 8 athletes/Country

Ind. Free Style Kumite (Sanbon Shobu) Women Ind. Free Style Kumite (Sanbon Shobu) Men

8 athletes/Country 8 athletes/Country

-53kg, -60kg, -70kg -59kg, -64kg, -69kg, -75kg, -82kg, +82kg

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5th WORLD FUDOKAN KARATE CHAMPIONSHIP - In memory of Sensei Dan Stuparu Veterans, Seniors,Youths, Juniors, Cadets Children World Karate Cup Prague, Czech Republic November 28.-29.30.- December 1, 2013
SENIORS OVER 21 YEARS ( YOUNGER : AGE 21 35) Individual Kata Women Individual Kata Men Fuku-Go Women (Ippon Shobu) Ind. Fuku-Go Men (Ippon Shobu) Ind. Kumite Women (Ippon Shobu) Ind. Kumite Men (Ippon Shobu) Individual Kata Kobudo Women 8 athletes/Country 8 athletes/Country 8 athletes/Country 8 athletes/Country 8 athletes/Country 8 athletes/Country 8 athletes/Country Team Kata Women Team Kata Men En-bu Woman/Man En-bu Man/Man Kumite Team Women Kumite Team Men Individual Kata Kobudo Men 1 team/Country 1 team/Country 1 team/Country 1 team/Country 1 team/Country 1 team/Country 8 athletes/Country

Ind. Free Style Kumite (Sanbon Shobu) Women Ind. Free Style Kumite (Sanbon Shobu) Men

8 athletes/Country 8 athletes/Country

-53kg, -60kg, -70kg light: -64kg, half-light -69kg, medium -75kg, half-heavy -82kg, heavy -90kg, super heavy +90kg

OLDER: age 36 49 Individual Kata Women Individual Kata Men Fuku-Go Women (Ippon Shobu) Ind. Fuku-Go Men (Ippon Shobu) Ind. Kumite Women (Ippon Shobu) Ind. Kumite Men (Ippon Shobu) Individual Kata Kobudo Women 8 athletes/Country 8 athletes/Country 8 athletes/Country 8 athletes/Country 8 athletes/Country 8 athletes/Country 8 athletes/Country Team Kata Women Team Kata Men En-bu Woman/Man En-bu Man/Man Kumite Team Women Kumite Team Men Individual Kata Kobudo Men 1 team/Country 1 team/Country 1 team/Country 1 team/Country 1 team/Country 1 team/Country 8 athletes/Country

Ind. Free Style Kumite (Sanbon Shobu) Women Ind. Free Style Kumite (Sanbon Shobu) Men

8 athletes/Country 8 athletes/Country

-53kg, -60kg, -70kg light: -64kg, half-light -69kg, medium -75kg, half-heavy -82kg, heavy -90kg, super heavy +90kg

VETERANS AGE CATEGORIES: 50 54, 55 59, 60 64, 65 69, 70 OVER DISCIPLINES: Individual Kata Women Individual Kata Men Ind. Ko-go Kumite Women Ind. Ko-go Kumite Men Tsume-ai Individual Women Tsume-ai Indiviadual Men Self defence Individual Women stick, knife, pistol Self defence Individual Men stick, knife, pistol Tameshi-wari Individual Women Tameshi-wari Individual Men PARTICIPATION Minimal number of participants per each categorie should be three (3).
ATTENTION! 1. AN ATHLETE CAN PARTICIPATE AT INDIVIDUAL CATEGORIES ONLY AT HIS AGE CATEGORY. IF HE PARTICIPATES AT TEAM CATEGORY FOR A HIGHER AGE GROUP, HE CANNOT PARTICIPATE AT THE SAME TEAM CATEGORY IN HIS AGE GROUP Example: One junior athlete can participate at individual categories only for juniors. He can participate in team kata for youth. In this case he cannot be part of juniors team kata. Page | 7

5th WORLD FUDOKAN KARATE CHAMPIONSHIP - In memory of Sensei Dan Stuparu Veterans, Seniors,Youths, Juniors, Cadets Children World Karate Cup Prague, Czech Republic November 28.-29.30.- December 1, 2013

BOARD AND ACCOMMODATION


We have reserved places in different hotels. Daily Cost: Hotel 2** ... accommodation in multiple-bedded rooms: EUR 35 per person per 1 night breakfast + dinner

Hotel 3*** accommodation in twin rooms:

EUR 42 per person per 1 night breakfast + dinner

Hotel 4**** accommodation in twin rooms:

EUR 48 per person per 1 night breakfast + dinner

Voucher (obligatory for everybody)

15 EUR each person

We offer assistance with transportation from the airport to the hotel (EXTRA PAID)

The teams that will not choose the accommodation provided by the organizer will have to pay an additional fee of 30 EURO /person. Please, respect the deadline and send us your requests and forms as soon as possible in order to ensure the successful World Championship.

For a pleasant registration we will prepare a free friendly reception for the representatives of each Federation between 9.00 - 14.00 oclock 28. November. We look forward to your participation. Deadline for applications is 5 October 2013
CZECH TRADITIONAL FUDOKAN KARATE FEDERATION PAKOMICK 28, 18200 PRAGUE 8, CZECH REPUBLIC, www.fudokan.cz, fudokan@volny.cz PHONE/FAX : ++420 2 868 403 29, MOBILE: ++420 608 703 235

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5th WORLD FUDOKAN KARATE CHAMPIONSHIP - In memory of Sensei Dan Stuparu Veterans, Seniors,Youths, Juniors, Cadets Children World Karate Cup Prague, Czech Republic November 28.-29.30.- December 1, 2013

ENTRY PROCEDURE
A. The following documents must be sent to the Championships Organizing Committee by October 5, 2013 at the latest: 1. Completed entry application form (hotel and categories). 2. Completed "Medical Release" form for each competitor. B. Entry fee payment at the Championship Office by November 28, 2013 - by cash. (Entry registration deadline 5 p.m.) Please consider to be warned, that the deadline for your registration is 5 p.m. on November 28, 2013.
PARTICIPATION FEES (Cadets, Juniors, Youth, Seniors, Veterans) EUR 25 per person, per category EUR 40 for En-bu EUR 50 for Kata team EUR 50 for Kumite team

PARTICIPATION FEES (Children A, B, C, D) PARTICIPATION FEES for Dr. ILIJA JORGAs Seminar

EUR 15 per person, per category EUR 20 for En-bu team EUR 30 for Kata team EU 10 per person - SPECIAL PRICE

PARTICIPATION FEES for: JUDGES/COACH COURSE 35 EUR / per Person JUDGES EXAMS (CATEGORY A, B, C,) KATA / EN-BU 25 EUR / per Person JUDGES EXAMS (CATEGORY A, B, C,) KUMITE / FUKUGO 25 EUR / per Person For each Category C. Hotel reservation form by October 5, 2013 at the latest. D. Each National Federation must grant each register participant or visitor as for their own insurance (minimum 10.000 EUR). The local organizers are not responsible for participants risk if participants are not insured; Personal belongings are always under responsibility of the owner. E. Each participating Nation is required to bring its national anthem (on CD) and flags 1,5 m x 2m. F.DRAWING: All Coaches should attend the drawing and verify that names and categories of their athletes are correctly placed. It is strongly recommended for the coaches to attend the drawing till the end of the session and verify that their athletes participation is correctly selected. D.We strongly recommend each country to bring 2 judges minimum, because we will have foundation meeting for referee committee of WFF. If you have any questions, please contact: CZECH TRADITIONAL FUDOKAN KARATE FEDERATION PAKOMICK 28, 18200 PRAGUE 8, CZECH REPUBLIC, www.fudokan.cz, fudokan@volny.cz PHONE/FAX : ++420 2 868 403 29, MOBILE: ++420 608 703 235 We wish you a very pleasant staying and we are looking forward to welcoming you soon at the World Fudokan Karate Championship 2013 in Prague. Yours sincerely,

Univ.Prof.Ilija Jorga MD.,PhD. Soke 10 DAN Founder of Fudokan Founder of WFF

Mr.Rajeev Sinha 7 Dan President of WFF

Dipl.Eng.Rachmy Soebajo 8 Dan Tournament Organizing Committee Chairman


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5th WORLD FUDOKAN KARATE CHAMPIONSHIP - In memory of Sensei Dan Stuparu Veterans, Seniors,Youths, Juniors, Cadets Children World Karate Cup Prague, Czech Republic November 28.-29.30.- December 1, 2013

MEDICAL RELEASE
FOR WORLD FUDOKAN FEDERATION
NAME:___________________________________________________________ COUNTRY:________________________________________________________________________________ SEX:__________________________ EVENT: Name of Event: City / Country: Date(s): WORLD FUDOKAN KARATE CHAMPIONSHIP PRAGUE, CZECH REPUBLIC 11 29 2013 to month day year AGE:_____________________________

12 1 month day Fuku-go En-bu Self defence

2013 year Ko-go Tsume-ai Tamashi-wari


PARTICIPATION CATEGORY: Invidual Kumite Team Kumite Individual Kata Synchronized Kata Kobudo MY PRESENT HEALTH HISTORY IS AS FOLLOWS:
1. Extreme Heart Murmur 2. Severe Hypestension 3. Recent Infection 4. Bone Fracture Within Past 6 Moth 5. Concussion or Severe Head Trauma Within Past Year 6. Seizures 7. Eye Injury 8. Nose Injury 9. Severe Bone Bruise Requiring Padding 10.Kidney Injury

11. Drug Allergies 12. Bleeding Disordes 13. Syncopes of Diffrerent Origin 14. Joint Injury 15. Spinal Injury 16. Neck Injury 17. Facial Injury 18. Ear Injury 19. Hepatitis of Different Origin 20. Sexual Transmitted Diseases 21. Currently Taking Any Medication or Treatment

If my medical history is not as represented above, I wil tak all responsibility and release all tournament officials from an y and all liabilities.

______________________ Date REMARK:

_______________________________ Applicants Signature / Parents Signaure

____________________ Coachs Signature

If you answered yes to any of the above, you will be required to check with the Tournament Medical Committee before competing in the tournament. (For Official Use Only)

Approved NOTE: (Approved with exception or restriction) ______________________ Date

Not approved for participation in this event

______________________ Chief Medical Judge


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5th WORLD FUDOKAN KARATE CHAMPIONSHIP - In memory of Sensei Dan Stuparu Veterans, Seniors,Youths, Juniors, Cadets Children World Karate Cup Prague, Czech Republic November 28.-29.30.- December 1, 2013
5th WORLD FUDOKAN KARATE CHAMPIONSHIP Prague, Czech Republic PRAGUE CZECH REPUBLIC November 28.-29.-30.-December 1., 2013

APPLICATION FORM Officials, Referees, Coaches, Doctors


Country, Organization Address Mail/phone

NAME FIRST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 MIDDLE LAST

POSITION

SEX

RANK

JUDGES KATA CLASS KUMITE CLASS

Signature. Date ...


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5th WORLD FUDOKAN KARATE CHAMPIONSHIP - In memory of Sensei Dan Stuparu Veterans, Seniors,Youths, Juniors, Cadets Children World Karate Cup Prague, Czech Republic November 28.-29.30.- December 1, 2013

Hotel Registration Form


Country, Organization Address No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Name/Surname Sex Arrival Departure

Signature... Date..
Please send completed booking card to:

CZECH TRADITIONAL FUDOKAN KARATE FEDERATION PAKOMICK 28, 18200 PRAGUE 8, CZECH REPUBLIC, www.fudokan.cz, fudokan@volny.cz PHONE: ++420 2 868 403 29, MOBILE: ++420 608 703 235
If you need information, please contact the organizer Page | 12

5th WORLD FUDOKAN KARATE CHAMPIONSHIP - In memory of Sensei Dan Stuparu Veterans, Seniors,Youths, Juniors, Cadets Children World Karate Cup Prague, Czech Republic November 28.-29.30.- December 1, 2013

APPLICATION FORM
World Fudokan Karate Championship - Prague, 28.10.-29.10.-30.10.-1.12. 2013
Organization, Country Contact /mail, phone start. No Name first, middle, last Date of Birth SEX Individual KATA M F 25 25 team KATA M F 50 50 Individual KUMITE M F 25 25 Individual KOGO M F 25 25 Team KUMITE M F 50 50 AGE CATEGORY TOTAL EN-BU MM MF 40 40 FUKU-GO M F 25 25 KOBUDO M F 25 25

No

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 TOTAL Date, Signature

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5th WORLD FUDOKAN KARATE CHAMPIONSHIP - In memory of Sensei Dan Stuparu Veterans, Seniors,Youths, Juniors, Cadets Children World Karate Cup Prague, Czech Republic November 28.-29.30.- December 1, 2013

APPLICATION FORM
Children World Karate Cup - Prague, 28.10.-29.10.-30.10.-1.12. 2013
Organization, Country Contact /mail, phone AGE CATEGORY KIHONIPPON

No

start . No

Name first, middle, last

Date of Birth

SEX

Individual

Team

Individual

JIYU IPPON

ind.KO-GO

Team KO-GO

TOTAL EN-BU
M/F 20 M/M 20

KATA
M 15 F 15

KATA
M 30 F 30

KIHON
M 15 F 15

KUMITE
M 15 F 15

KUMITE
M 15 F 15

KUMITE
M 15 F 15

KUMITE
M 30 F 30

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 TOTAL Date, Signature

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5th WORLD FUDOKAN KARATE CHAMPIONSHIP - In memory of Sensei Dan Stuparu Veterans, Seniors,Youths, Juniors, Cadets Children World Karate Cup Prague, Czech Republic November 28.-29.30.- December 1, 2013

APPLICATION FORM
World Fudokan Karate Championship - Prague, 28.-30.11. - 1.12. 2013
Organization, Country Contact /mail, phone

VETERANS
AGE CATEGORY Individual IND.KO-GO

start. No No

Name first, middle, last

date of Birth

SEX

Self defence stick M F M F 25 25 25 25 knife M F 25 25 pistol M F 25 25

KATA M F M F 25 25 25 25

Tameshi KUMITE Tsume-ai - wari

M 25

F 25

TOTAL

1 2 3 4 5 6 7 8 9 10 11 12 13

TOTAL
Date, Signature

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5th WORLD FUDOKAN KARATE CHAMPIONSHIP - In memory of Sensei Dan Stuparu Veterans, Seniors,Youths, Juniors, Cadets Children World Karate Cup Prague, Czech Republic November 28.-29.30.- December 1, 2013

APPLICATION FORM- Free Style Kumite


World Fudokan Karate Championship - Prague, 28.-30.11. - 1.12. 2013
Organization, Country Contact /mail, phone

CADETS
AGE CATEGORY

No

start. No

Name first, middle, last

date SEX of Birth

Ind.Free Style Kumite Women 25 25 25 25 25

Ind.Free Style Kumite Men 25 25 25 25

TOTAL

"-48 kg "-55 kg "+55 kg "-50 kg "-55 kg "-60 kg "-65 kg "-70 kg "+70 kg


1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 TOTAL

Date, Signature

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5th WORLD FUDOKAN KARATE CHAMPIONSHIP - In memory of Sensei Dan Stuparu Veterans, Seniors,Youths, Juniors, Cadets Children World Karate Cup Prague, Czech Republic November 28.-29.30.- December 1, 2013

APPLICATION FORM- Free Style Kumite


World Fudokan Karate Championship - Prague, 28.-30.11. - 1.12. 2013
Organization, Country Contact /mail, phone

JUNIORS
AGE CATEGORY

No

start. No

Name first, middle, last

date SEX of Birth

Ind.Free Style Kumite Women -50 kg 25 -57 kg 25 +57 kg 25 -55 kg 25 -60 kg 25

Ind.Free Style Kumite Men -65 kg 25 -70 kg 25 -75 kg 25 "+75 kg 25

TOTAL

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 TOTAL

Date, Signature

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5th WORLD FUDOKAN KARATE CHAMPIONSHIP - In memory of Sensei Dan Stuparu Veterans, Seniors,Youths, Juniors, Cadets Children World Karate Cup Prague, Czech Republic November 28.-29.30.- December 1, 2013

APPLICATION FORM- Free Style Kumite


World Fudokan Karate Championship - Prague, 28.-30.11. - 1.12. 2013
Organization, Country Contact /mail, phone

YOUTHS
AGE CATEGORY

No

start. No

Name first, middle, last

date SEX of Birth

Ind.Free Style Kumite Women -53 kg 25 -60 kg 25 -70 kg 25 -59 kg 25 -64 kg 25

Ind.Free Style Kumite Men -69 kg 25 -75 kg 25 -82 kg 25 +82 kg 25

TOTAL

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 TOTAL

Date, Signature

Page | 18

5th WORLD FUDOKAN KARATE CHAMPIONSHIP - In memory of Sensei Dan Stuparu Veterans, Seniors,Youths, Juniors, Cadets Children World Karate Cup Prague, Czech Republic November 28.-29.30.- December 1, 2013

APPLICATION FORM- Free Style Kumite


World Fudokan Karate Championship - Prague, 28.-30.11. - 1.12. 2013
Organization, Country Contact /mail, phone

SENIORS
AGE CATEGORY

start. No No

Name first, middle, last

date of Birth

SEX

Ind.Free Style Kumite Women -53 kg 25 -60 kg 25 -70 kg 25 -59 kg 25 -64 kg 25

Ind.Free Style Kumite Men -69 kg 25 -75 kg 25 -82 kg 25 +82 kg 25 -90 kg 25 +90 kg 25

TOTAL

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 TOTAL

Date, Signature

Page | 19

5th WORLD FUDOKAN KARATE CHAMPIONSHIP - In memory of Sensei Dan Stuparu Veterans, Seniors,Youths, Juniors, Cadets Children World Karate Cup Prague, Czech Republic November 28.-29.30.- December 1, 2013

APPLICATION FORM- Free Style Kumite


World Fudokan Karate Championship - Prague, 28.-30.11. - 1.12. 2013
Organization, Country Contact /mail, phone

OLDER: AGE 36 49
AGE CATEGORY

start. No No

Name first, middle, last

date of Birth

SEX

Ind.Free Style Kumite Women -53 kg 25 -60 kg 25 -70 kg 25 -59 kg 25 -64 kg 25

Ind.Free Style Kumite Men -69 kg 25 -75 kg 25 -82 kg 25 +82 kg 25 -90 kg 25 +90 kg 25

TOTAL

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 TOTAL

Date, Signature

Page | 20

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