King of the Mountain Brazilian Jiu Jitsu Challenge
June 2^nd 2007

Registration Form-Individual Competitor

Important! Check off each to let us know that you have read our 6 tournament instructions.

Make sure your are registered!
1. _______ To make sure that we have received your registration and that you are part of a bracket, please check our website on our event page and click on registered competitors for your name. If your name is not on the list, you will not be competing. We should have names posted within 24 hours of registration and have them all up the night before the event.

Free Coach or Instructor Admission
2. _______ We allow 2 free Instructor or coaches from each Academy, please add their names during registration so they can get free admission. Instructor and coach list will also be posted on the website under the registered competitor link on our event page.

Medals and Podium Pictures
3. _______ If you have won a medal, don't leave without your medal and before taking the podium picture. If you have to leave, please check in at the front booth and they will take a single picture of you and give you your medal. Handing out medals and taking podium pictures start shortly after your division is done.

Tournament Rules
4. _______ It's your responsibility to read tournament rules before the tournament.

Spectator Fee
5. _______ Please let friends and family know that there is a $5 spectator fee so they are not surprised at the door.

Date: Saturday June 2^nd, 2007 - starting at 10:00 am

First Check in begins at 10:00am- Rules will start at 10:00am, tournament begins afterwards.

Please Note:
Entry information can be received by sending an email to the address below. If you are entering as a school there will be a entry reduction for eight or more individuals representing the same school. It must be specified as a school entry and not an individual. If it is not marked properly the reduced rate will not be offered. Please be sure to mark as a school or an individual. 

Competitor Name _________________________________________________________________________

Street Address _______________________________________ City_________________________________

State __________________________Zip Code___________________ Country ________________________

Day Phone_________________________________ Evening Phone__________________________________

Email ___________________________________________________

Emergency Contact ____________________________________Phone_______________________________

Help support your Academy by filling in as much information as possible.

Jiu-Jitsu Academy Name____________________________________________________________________

Address _______________________________________________City_______________________________

State __________________________ Zip Code___________________ Phone_________________________

Instructor / coach 1_____________________________

Instructor / coach 2_____________________________


Where did you hear about the tournament? ( circle one)    

Academy    Flyer    Online Search    Online Forum    Our Website    Different Website    Newsletter    Friend    

Other ____________________________________

Competitor Information

Place a check mark or an X in the relevant box for each section.

Division:

Novice (0 to 9 months) ___
Beginner (9 to 18 months) ___  
Intermidium (18 to 36 months) ___
Advanced (36 months and over) ___

Gender:

Male____ Female____

Age Division

Teen: 14 to 17 year-old ___ (with parent consent only) (Beginner and Novice only at this time)

Adult: 18 years-old and up___

Master: 35 year-old and over ___

This question applies to all age categories: If no other competitor registers for your weight division, are you willing to fight up on weight categories? Yes___ No___

This question is for masters only! If there are no competitor on your age division  are you willing to fight in the adult division?
Yes___ No___

Note: If there are no competitors in the age or weight division you choose and you’re not willing to move up in weight or down in age division, you may still enter absolute division. No refunds will be given. We highly recommend that you mark YES on the questions above to increase your chances of having a match.


Please check your T-shirt size

Medium____ Large____ Extra Large____ Double Extra Large____

Weight Category

Please find your category on the following tables and place a check in the box to the right of your category. Note that we will weigh each competitor before his or her first match. You only get ONE CHANCE to make weight, so PLEASE be sure to register for the correct category in order to avoid DISQUALIFICATION.

Please mark the weight division you wish to enter. Mark only ONE division and only one Absolute division!
Absolute divisions will only be used if time permits it. You will be able to sign up the absolute division after your weight division bracket is concluded at the tournament.

Note: Absolute divisions will only happen if time permits. The "Adult Male Advanced Division" will only have one absolute class (open weight).

Note: Photo ID will be required as a proof of age in order to enter the Teen's _ Master's divisions. If a competitor enters the wrong division he will NOT be able to change divisions at the day of the tournament and will be DQ, registration fee is NON - REFUNDABLE! Be sure to enter the appropriate age division.

Send Registrations to:
Colorado Brazilian Jiu Jitsu Academy
6441 E Evans Ave. Denver, CO 80222

Tournament Location:
Colorado Convention Center      700 14^th Street, Downtown Denver, Colorado

Date and time: Saturday, June 2^nd starting at 10:00 am.

Optional writing -but helpful for us to provide you with better tournaments.

What did you like or and dislike about our past tournaments?________________________________________

________________________________________________________________________________________

What would you like to see in the future with our tournaments?_______________________________________

________________________________________________________________________________________

King of the Mountain Brazilian Jiu Jitsu Challenge RELEASE OF LIABILITY

I, _____________________________________________, UNDERSTAND THAT BY ENTERING THIS COMPETITION, I WILL BE COMPETING AT MY OWN RISK AND NEITHER DAVID RUIZ, SHAWN RAY, VYOTECH, JEFF TAYLOR, COLORADO PRO SHOW, CITY OF DENVER, THE KING OF THE MOUNTAIN BRAZILIAN JIU JITSU CHALLENGE NOR  SHALL BE HELD RESPONSIBLE OR LIABLE FOR ANY INJURIES, DAMAGES OR DEATH SUSTAINED DURING THIS COMPETITION OR AS A RESULT THEREOF.

FURTHERMORE, IF THE COMPETITOR IS A MINOR, I ASSERT THAT I AM HIS OR HER LEGAL GUARDIAN AND I GRANT MY PERMISSION FOR HIM OR HER TO PARTICIPATE IN THE TOP OF THE KING OF THE MOUNTAIN BRAZILIAN JIU JITSU CHALLENGE.

ALL COMPETITORS UNDERSTAND THAT UPON ENTERING THE COMPETITION ARENA, THEIR IMAGE MAY BE RECORDED BY VARIOUS MEANS, INCLUDING BUT NOT LIMITED TO AUDIO, VIDEO, AND STILL PHOTOGRAPHY. ALL COMPETITORS RELEASE DAVID RUIZ, SHAWN RAY, VYOTECH, JEFF TAYLOR, COLORADO PRO SHOW, CITY OF DENVER, THE KING OF THE MOUNTAIN BRAZILIAN JIU JITSU CHALLENGE   FROM ANY LIABILITY ASSOCIATED WITH THE USE OF SUCH IMAGES. ALL COMPETITORS WAIVE ANY RIGHT TO THE USE OR OWNERSHIP OF SUCH IMAGES.

SKILL LEVEL VERIFICATION POLICY IN ORDER TO ENSURE THAT ALL COMPETITORS ARE TRULY QUALIFIED FOR THEIR LEVEL OF COMPETITION, THE KING OF THE KING OF THE MOUNTAIN BRAZILIAN JIU JITSU CHALLENGEREQUIRES ALL COMPETITORS TO READ AND SIGN THE FOLLOWING CERTIFICATION:

THE UNDERSIGNED CERTIFIES:

1) THAT HE/SHE IS THE RANK OF __________________

2) THAT HE/SHE HAS NOT COMPETED IN PAST TOURNAMENTS AT A HIGHER DIVISION LEVEL;

3) THAT HE/SHE WILL NOT COMPETE IN FUTURE TOURNAMENTS AT A LOWER DIVISION LEVEL.

THE UNDERSIGNED AGREES THAT THE KING OF THE MOUNTAIN BRAZILIAN JIU JITSU CHALLENGE MAY CONDUCT AN INVESTIGATION AS TO THE ACCURACY OF THE ABOVE CERTIFICATION, AND CAN PUBLISH THE RESULTS WITH OTHER BJJ/GRAPPLING PROMOTERS AND THE KING OF THE MOUNTAIN BRAZILIAN JIU JITSU CHALLENGE IN ORDER TO VERIFY THE ACCURACY THEREOF.

ANY VIOLATION OF THE ABOVE POLICY WILL RESULT IN IMMEDIATE FORFEITURE OF REGISTRATION FEES AND DISQUALIFICATION FROM THE CURRENT TOURNAMENT, AND MAY RESULT IN DISQUALIFICATION FROM FUTURE TOURNAMENTS.

FINALLY, I ACKNOWLEDGE THAT BY AUTHORIZING THIS PAYMENT I CONSENT TO ALL THE TERMS AND CONDITIONS CONTAINED HEREIN.

PARTICIPANT SIGNATURE__________________________________________________________________

DATE______________________


PARENT OR GUARDIAN SIGNATURE __________________________________________________________

DATE______________________