Online Registration Opens October 1, 2015! General Information Sheet and Welcome. Dear Tae Kwon Do Athletes, Coaches, Referees and Families,

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2 General Information Sheet and Welcome Dear Tae Kwon Do Athletes, Coaches, Referees and Families, We are pleased to invite you to the 9th annual Michigan-Midwest Tae Kwon Do Championships being held on Saturday, November 21, Once again this year s event will be held at the Macomb Community College Sport and Expo Center to accommodate the competition and those that arrive to watch. The Sports & Expo Center on the campus of Macomb Community College is a unique venue, with a great deal of space to spread out and move around. It is also close to major freeways, dining and accommodations for overnight stay. It is our goal to provide high level competition for all competitors and a great overall experience to go with it. As always, we work hard to make sure each and every athlete and parent leave having had a great day. As you will see in the following pages, we are again an online PRE-REGISTRATION ONLY EVENT! For Michigan coaches, this is an event that brings National and International players and gives your athletes the opportunity to have quality competition close to home without the expense of long distance travel. We pride ourselves in being able to provide high-level competition in the Michigan area to help those that want to further their experience or prepare for National competition. Take advantage of this double elimination format to gain valuable ring time! As the first event in Michigan to bring in the Daedo scoring system for competition, we are happy to announce that ALL DIVISIONS WILL BE USING THE DAEDO SCORING SYSTEM and black belt divisions are running the Daedo Scoring system with DOUBLE ELIMINATION competition. This year will will also be implementing Sport Poomsae for black belt divisions 12 years old and up. Bring your poomsae athletes to help grow this exciting part of our sport! Also this year, we are happy to announce the opportunity for select divisions to participate in the chance to win a $500 cash prize. Gold medalists from the 12-14, and year old black belt sparring divisions and 12-14, and 18 and older black belt poomsae divisions will be able to place their name in a raffle for the cash award. You don t need to be present to win. Once again we thank you for your ongoing support of the Michigan-Midwest Tae Kwon Do Championships throughout the years. We hope to finish 2015 with great competition and great experience for everyone! Sincerely, Master Russell Gale Master Tanya Panizzo Online Registration Opens October 1, 2015!

3 Tournament Information Sheet Venue: Macomb Community College Sports & Expo Center W. 12 Mile Rd. Warren, MI THIS IS A PRE-REGISTRATION ONLY EVENT! THERE WILL BE NO AT-THE-DOOR REGISTRATION. SPECTATOR TICKETS CAN BE PURCHASED DISCOUNTED RATE. Free Parking Report Times: 7:00am Doors Open 8:00am Coach/Referee Information Meeting 9:00am All forms & Sparring divisions EXCEPT 12-14,15-17 & Black Belt sparring. Times provided at credential pickup for these divisions. Black Belt Sparring Report Time: All 12-14, 15-17, Black Belt sparring competitors report at NOON. Please see the additional information sheet regarding report times. We will be using the connectunow text notification system for more specific report times. If athletes choose not to use this system, they should report to the venue at NOON. Equipment: All sparring divisions will be using the Daedo Scoring System and sensor socks are required. There will be some on site to rent but only a limited supply. We recommend you go to to purchase your socks ahead of time if you don t already have them. There will only be a limited supply available for rent at the venue. Head gear, mouth guard, chest protector, shin & instep protection, forearm protection, athletic cup for males (worn on the inside of dobok). Hand gloves optional and no cloth pads allowed. Poomsae: All Tae Geuk and Palgwe poomsae are acceptable for colored belts. Black Belt divisions 12 years old and up will have designated poomsae posted upon the closing of online registration. Please visit and select the tournament link to view these designated poomsae. Competitor Fees: $75 for 1 or 2 events for colored belts, black belts under the age of 12 and black belts 33 & up. $75 for 1 double elimination event for black belts (forms or sparring) $90 for 2 double elimination events for black belts 12 & up (forms & sparring) or (2 sparring division) $100 for 3 double elimination events for black belts 12 & up (forms & 2 sparring divisions) THERE ARE NO REFUNDS ON REGISTRATION FOR ANY REASON. PLEASE PLAN AHEAD. Current USAT Cadet, Jr. & Sr. National Team Members are FREE! Please call for your registration code. Coaching Fees: Each school will receive (2) complimentary coach passes that will be recorded at the door. Each school that provides an all-day referee for forms and sparring will receive an additional coach pass. Coach fee is $10/coach. Pass can be purchased online through the online registration system. YOU MUST HAVE A PASS TO ENTER THE COMPETITION AREA! Please let us know you are coming by using the online registration system for coaching passes. This will ensure your pass is waiting for you. Referee Stipend: IR s that referee all day will receive a stipend of $75. All other certified referees that referee ALL DAY will receive $50. Please see the Referee Registration page for additional information on how to receive the stipend. Parking: Deadline: This year s venue will have ample and FREE parking for all. Please do not mail cash or personal checks. Cashier s check or money order made out to Midwest Tae Kwon Do. Mail to 584 W. Ann Arbor Trail Plymouth, MI Registrations received by mail must be received by November 13, We strongly encourage you to utilize our online registration system. Online registration by credit card is open until November 10:00pm EST. No at-the-door registration! Pre-registration only event! Food & Beverage: There will be concession available and spectators are allowed to bring food and drink into the building. Only water and sports drinks are allowed in the competition area.

4 Hotel/Transportation & Other Miscellaneous Information The airport that is in close proximity to the venue is Detroit Metropolitan Airport (airport code DTW). This airport is approximately 20 minutes from the venue. The venue is also 30 minutes from the USA-Canadian border in Ontario. Hotel Options: Quality Inn & Suites Detroit-Warren Tech Center. This is a hotel with a discount rate Van Dyke Ave. Warren, MI Please note there is NO free shuttle to or from the airport. HOST HOTEL****SPECIAL RATE****Mention Midwest Tae Kwon Do Championships in your reservation. Courtyard Marriott Detroit-Warren Van Dyke Ave. Warren, MI No shuttle available. Holiday Inn Express Van Dyke Ave. Warren, MI No shuttle available. The Sterling Inn. Athletes and families can enjoy their attached Water Park for entertainment. The hotel address is Van Dyke Ave. Sterling Heights, MI Please note there is NO free shuttle to or from the airport. PLEASE NOTE: BOOK YOUR ROOMS EARLY. WE WERE INFORMED THERE IS A VERY LARGE HOCKEY EVENT GOING ON FOR THIS SAME WEEKEND. HOTEL ROOMS WILL BE LIMITED DUE TO THIS. DO NOT DELAY IN MAKING YOUR ROOM RESERVATIONS AT ANY OF THESE HOTELS. ********************************************************************* Spectator Fees: Spectators can purchase tickets for a discounted rate through the online tournament registration system. SPECTATOR TICKETS BOUGHT ONLINE ARE NON REFUNDABLE! If you pay for spectator tickets ahead of time, please bring in your receipt and bring it to Spectator Check-In for your wristband. Online spectator fee $8/adult, $5 for 6-12 year olds, 5 and under FREE. At-the-door spectator fee $10/adult, $8 for 6-12 year olds, 5 and under FREE. If you pay at the door you will go to At-The-Door- Spectator Tickets area for your wristband. Credential Pick-Up: Athletes can pick up their credentials the night before the event at the competition venue. Credentials are available Friday, November 20 th from 5:00-7:00pm. On the day of the event, athletes, coaches & referees can pick up their credentials at the Registration Area. Competition Location: The competition will take place in the Sports & Expo Center on the campus of Macomb Community College E. 12 Mile Rd. Warren, MI There is free parking available.

5 Hotel/Transportation & Other Miscellaneous Information Continued: Referee Information: We at the Michigan-Midwest Championship would like to thank you in advance for your support & dedication. We know that it is because of this dedication that we are able to host such a successful event. We will be providing you with a light lunch then a gracious dinner in the evening. The attire for referees is black pants, white shirt & red tie. There will be a shuttle from the Sterling Inn to the competition venue for referees and staff only. Coaching Information: Please bring an adequate number of coaches to support your team. Each coach will be given (1) HOLD CARD to delay a ring for coaching athletes. You can give this card to the head referee to hold a match and once used, you cannot hold up a ring to coach another player later in the day. PLEASE BRING ADEQUATE STAFF TO COACH YOUR TEAM! THIS IS CRUCIAL FOR TIME MANAGEMENT OF THE EVENT. Awards: All division winners will receive top quality medals and for ages 11 and under, a prize with their medal. We are also happy to announce the opportunity for select divisions to participate in the chance to win a $500 cash prize. Gold medalists from the 12-14, and year old black belt sparring divisions and 12-14, &18 and older black belt poomsae divisions will be able to place their name in a raffle for the cash award. You don t need to be present to win. Text Notification System for Black Belt Sparring Report Times: We will be using text notification to help black belt sparring competitors in the divisions know their report time. 24 hours prior to the event, via athletes will be able to send a text to to enroll in this system. This will keep athletes notified of how the event is running and help plan their arrival. Those black belts that do not want to participate in this should arrive at the venue at noon to report. 24 hours prior to the event the text information will be sent out via & also announced at the venue.

6 Referee Application Any school that supplies a Referee that officiates ALL DAY for both forms & sparring will receive 1 FREE Coach Pass. You can complete and submit this form This will make your credential pick-up much faster and smoother. We encourage all to register online so we can plan for your arrival. We would like to thank you for your support and participation in the Michigan Midwest Tae Kwon Do Championships! This year we will provide a light lunch in the afternoon and a gracious meal in the evening. The dress code for referees will be black pants, white shirt and red tie. There will be a referee meeting for an explanation of the rules and all scoring at 8:00am. Please complete the paper form below and return via post at 584 W. Ann Arbor Trail Plymouth, MI 48170, or utilize the online registration system. Name: Address: Phone: Dan Rank: Referee Level: Name of School: Phone: LIABILITY WAIVER In consideration of your acceptance of my entry, I do hereby, for myself, my heirs, executors and administrators, waive, release and forever discharge any and all rights and claims for damages against Midwest Tae Kwon Do LLC, Macomb Community College, the Michigan Midwest Open Championships, sponsors, volunteers, officials, agents, competitors, other participants and advertisers for any and all damages which may be sustained by me in connection with my association with or entry in the Michigan-Midwest Open Championships Tae Kwon Do Tournament, or which may arise out of travel to or from this event. I understand that Tae Kwon Do is a body contact sport which involves risk of injury. The risk of injury from the activities involved in this event is significant, including the potential of permanent paralysis and death, and while particular rules, equipment and personal discipline may reduce this risk, there is still a level of serious injury that can occur. I knowingly and freely assume all such risks, both known and unknown, even if arising from negligence of the releases or others and assume full responsibility for my participation. I also fully understand that any medical treatment I receive will be First-Aid only. In addition, I also consent that any pictures taken of me in connection with this event can be used for publicity purposes, including print or internet. I have read this release of liability and fully understand its terms. I understand that there are no refunds of tournament fees for any reason. Signature: Date: Please note: Upon arrival at the Referee and Coaches Meeting for the Rules, each Referee will receive a Referee Stipend Submission Form. These forms can be turned in at the end of the event to the Tournament Director for a stipend. International Referees that participate and referee all day for poomsae and sparring will receive a stipend of $75. All other certified referees that participate and referee all day for both poomsae and sparring will receive a stipend of $50. Please make sure you attend the Referee/Coach Meeting at 8:00am to understand the rules for the event and also to receive this form.

7 Registration for Coaches Each school will receive (2) complimentary coach passes. We encourage you to register online so we can have these passes waiting for you upon your arrival. If you are a school owner and plan to coach please register online. As your passes are retrieved at the door we will log the names of each coach. Please note that all additional passes (3 or more) must be paid for. Please plan ahead for this. Each coach will also be given (1) Hold Pass to use in the event that they are busy coaching another player in another ring. Please think ahead and bring adequate coaching staff to support your team. The pass will be given to the head referee when used, after which you will not be able to hold up a ring due to lack of availability. Again, please bring enough staff to support your team as this is crucial for time management of the event. Coaches must register and display a Coach s Pass in order to accompany an athlete to, or coach an athlete in, a ring. Staff will be on the floor to enforce this policy to ensure a safer environment for all competitors & participants. We strongly encourage you to register online as it makes the credential pick up much faster for you. Any school that provides an ALL DAY Referee for BOTH forms & sparring will receive (1) additional Pass. Coach s meeting begins PROMPTLY at 8:00am! All Instructors, Officials and Coaches must attend this meeting in order to understand the competition format. Please complete and submit the form below. You can also complete this ONLINE at Coach fee $10 each pass. Coach Name: Address: City/State/ZIP: Phone: Dan Rank: Name of TKD School: Address of TKD School: Phone: Instructor: LIABILITY WAIVER In consideration of your acceptance of my entry, I do hereby, for myself, my heirs, executors and administrators, waive, release and forever discharge any and all rights and claims for damages against Midwest Tae Kwon Do LLC, Macomb Community College, the Michigan Midwest Open Championships, sponsors, volunteers, officials, agents, competitors, other participants and advertisers for any and all damages which may be sustained by me in connection with my association with or entry in the Michigan-Midwest Open Championships Tae Kwon Do Tournament, or which may arise out of travel to or from this event. I understand that Tae Kwon Do is a body contact sport which involves risk of injury. The risk of injury from the activities involved in this event is significant, including the potential of permanent paralysis and death, and while particular rules, equipment and personal discipline may reduce this risk, there is still a level of serious injury that can occur. I knowingly and freely assume all such risks, both known and unknown, even if arising from negligence of the releases or others and assume full responsibility for my participation. I also fully understand that any medical treatment I receive will be First-Aid only. In addition, I also consent that any pictures taken of me in connection with this event can be used for publicity purposes, including print or internet. I have read this release of liability and fully understand its terms. I understand that there are no refunds of tournament fees for any reason. Signature: Date: Mail to: Midwest Tae Kwon Do Paper registration is by cashier check only. Credit card 584 W. Ann Arbor Trail registrations must utilize the online registration system. Plymouth, MI 48170

8 Registration for Athletes This is a pre-registration ONLY event. Registrations must be received by November 13, 2015 and ONLINE REGISTRATION closes on November 17, 2015 at 10:00pm EST. NO REGISTRATIONS WILL BE ACCEPTED AT THE DOOR AND NO REFUNDS FOR ANY REASON. Athlete Name: Athlete age: Athlete rank (not belt color): Athlete Weight Address: City/State/ZIP: Phone: Name of TKD School: Address of TKD School: Phone: Instructor: LIABILITY WAIVER In consideration of your acceptance of my entry, I do hereby, for myself, my heirs, executors and administrators, waive, release and forever discharge any and all rights and claims for damages against Midwest Tae Kwon Do LLC, Macomb Community College, the Michigan Midwest Open Championships, sponsors, volunteers, officials, agents, competitors, other participants and advertisers for any and all damages which may be sustained by me in connection with my association with or entry in the Michigan-Midwest Open Championships Tae Kwon Do Tournament, or which may arise out of travel to or from this event. I understand that Tae Kwon Do is a body contact sport which involves risk of injury. The risk of injury from the activities involved in this event is significant, including the potential of permanent paralysis and death, and while particular rules, equipment and personal discipline may reduce this risk, there is still a level of serious injury that can occur. I knowingly and freely assume all such risks, both known and unknown, even if arising from negligence of the releases or others and assume full responsibility for my participation. I also fully understand that any medical treatment I receive will be First-Aid only. In addition, I also consent that any pictures taken of me in connection with this event can be used for publicity purposes, including print or internet. I have read this release of liability and fully understand its terms. I understand that there are no refunds of tournament fees for any reason. Signature: Date: Parent/Guardian Sign: Poomsae (forms): Check One Kyorugi (sparring): Check One Beginner 10 th -8 th geup Beginner 10 th -8 th geup Intermediate I 7 th -5 th geup Intermediate I 7 th -5 th geup Intermediate II 4 th -3 rd geup Intermediate II 4 th -3 rd geup Advanced 2 nd -1 st geup Advanced 2 nd -1 st geup Black Belt Dan/Poom Black Belt Dan/Poom Black Belt Sparring: Double Elim. Divisions Paper registration is by cashier check only. Credit card payment 12-14, & Black Belts: Select must utilize the online registration system. Male Female years yrs years Fighting two div. Weight $75 for 1 or 2 events for colored belts, black belts under the age of 12 and black belts 33 & up. $75 for 1 double elimination event for black belts (forms or sparring) $90 for 2 double elimination events for black belts 12 & up (forms & sparring) or (2 sparring division) $100 for 3 double elimination events for black belts 12 & up (forms & 2 sparring divisions)

9 ALL ATHLETES COMPETING AT THE MICHIGAN MIDWEST TKD CHAMPIONSHIPS MUST COMPLETE THIS FORM AND TURN IT IN AT REGISTRATION! BRING THIS WITH YOU! BARE ESSENTIALS SPORTS MEDICINE CONSENT FOR MEDICAL TREATMENT I,, as an athlete at the 2014 Midwest Taekwondo Championships, I CONSENT TO THE MEDICAL EVALUATION AND/OR TREATMENT for injuries/illnesses provided by Bare Essentials Sports Medicine Team Personnel, USA Taekwondo Approved Medical Personnel and/or Hospital/Medical Facility Staff (in the event that I have to be transported to a medical facility and/or emergency room/hospital). I authorize treatment by Bare Essentials Sports Medicine Staff, USA Taekwondo Approved Medical Personnel and/or Medical Facility/Hospital Personnel in the event of injury or illness occurring while I am in attendance at the event. I understand medical treatment available at event may include but is not limited to: general first aid care for injuries and wounds, evaluation for possible illness or disease, taping, stretching, modalities such as heat or ice, muscle stimulator/tens/ultrasound, over-the-counter medication/prescription medication (Rx by physician s order only), soft tissue massage, wound closure, splinting, chiropractic adjustment, acupuncture, being fitted for a sling or crutches, as well as basic and/or advance life support as deemed necessary by medical personnel. As a parent or legal guardian of, who is under the age of 18, I hereby (PRINT NAME OF MINOR CLEARLY) authorize medical treatment in the event of an injury or illness or as preventative measures as provided by a member of Bare Essentials Sports Medicine Personnel, USA Taekwondo Approved Medical Personnel, and/or Hospital/Medical Facility Staff. I understand medical treatment available the event may include but is not limited to: general first aid care for injuries and wounds, evaluation for possible illness or disease, taping, stretching, modalities such as heat or ice, muscle stimulator/tens/ultrasound, over-the-counter medication/prescription medication (Rx by physician s order only), soft tissue massage, wound closure, splinting, chiropractic adjustment, acupuncture, being fitted for a sling or crutches, as well as basic and/or advance life support as deemed necessary by medical personnel. I also attest that I have the legal right to sign as this athlete s parent or legal guardian, and have documentation to prove so. All medical evaluations completed by Bare Essentials Sports Medicine Personnel and/or USA Taekwondo Approved Medical Personnel for injuries or illnesses at events, camps or during team travel are considered CONFIDENTIAL and property of USA Taekwondo Medical Coordinator. Copies of medical injury forms completed by medical personnel at an event, camp or during team travel can by requested verbally either by the injured person, or parent/legal guardian of a minor who has been injured at the time of injury or requested in writing at a later date from the USA Taekwondo Medical Coordinator. No information about an individual s injury or illness will be released without that athlete's written permission in accordance with HIPAA Privacy Guidelines. Full injury report will only be released to an insurance agency upon the written request of the injured person and/or parent/legal guardian of a minor who has been injured. If athlete suffers a concussion and is given a WTF 30-day-out, information about athlete will be given to the CEO, Event Director & High Performance Director, and their assistants in order to enforce the 30-day-out rule. No details beyond the athlete s name, date of birth, weight division, belt color, age division, gender, when /where the concussion was sustained and/or what date he/she may return will be shared in accordance with HIPAA Privacy Rights of the athlete. Known Medical Conditions: Known Allergies: Is an epi-pen needed? YES NO Will you have the epi-pen with you? YES NO Do you use a rescue inhaler? YES NO Will you have the rescue inhaler with you? YES NO Medications presently taking (Athlete's Signature) (Date) Athlete s Date of Birth City/State/Country of Residence (Parent/Legal Guardian Signature) (Date) (Parent/Legal Guardian Name Printed)