NC STATE BJJ / SUBMISSION CHAMPIONSHIPSIs shaping up to be another Hot one!!!
The NC State BJJ/Submission Championships will be held on November 11th at the
Sun Valley High School Monroe, N.C.
There will be GI & No Gi divisions.
Pro- division for a $$ Pot.
($100 entry fee -Winner takes The POT!!!)
Weighins will start Nov 11th at 9:30am / event to start at 11:30am
Fee: $50 pre reg. – $60 at the door — one divisionKids: $35 pre reg. – $45 at the door
ALLIANCE ATLANTA MEMBERS $60 FOR MULTI DIVISIONS GI/NO GI
This years championship is a RANKED event!!
Any questions or suggestion please email info@ncbjjf.com
www.ncbjjf.com
Sponsored by:
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2007 NC State BJJ/Submission Championships
INDIVIDUAL COMPETITOR REGISTRATION FORM
NCBJJF ID#: __________________________________
School: _________________________________ (______) ________-_________________
School Phone #
Name: __________________________________ __________________________________
First Last
Address: _______________________________ (__________________) (_____) (_________)
Street City State Zip Code
Telephone: (_______) _________-______________ Date of Birth: ______/______/_______
Month Date Year
Email Address:________________________________________________________________
Emergency Contact: _______________________________ (______) _______-___________
Name Phone #
AGE CATEGORY
BELT
WEIGHT DIVISION ( male )
16 yrs. and older
WEIGHT DIVISION ( female)
16 yrs. and older
* Kids ( 5 – 15)
White Belt
Rooster
110 – 121lbs
Rooster
110 – 121lbs
Juniors (16 – 17)
Yellow Belt
Super Feather
122 – 134lbs.
Super Feather
122 – 134lbs
Adults (18 – 29)
Orange Belt
Feather
135 – 147lbs.
Feather
135 – 147lbs
Masters (30 – 39)
Green Belt
Light
148 – 160lbs.
Light
148 – 160lbs
Seniors (40 & Older)
Blue Belt
Middle
161 – 173lbs.
Middle
161 – 173lbs
Women
Purple Belt
Light Heavy
174 – 187lbs.
Light Heavy
174 – 187lbs
* Kids *
All the matches
will be the closest
weight, age, and belt.
Brown Belt
Heavy
188 – 202lbs.
Heavy
188 – 202lbs
Black Belt
Super Heavy
203 – 213lbs.
Super Heavy
203 – 213lbs
Unlimited
214lbs. &Over
Unlimited
214 lbs&Over
Open Class
All weights
Open Class
All weights
PLEASE MARK AN “X” (FOR AGE CATEGORY, BELT, WEIGHT DIVISION (MALE & FAMALE)
_______________________________________________________________________________
GI DIVISION —— NO GI DIVISIONS BEG INTER ADV
I__________________________________________, understand that by entering this competition I will be competing at my own risk and agree
that NCBJJF, Inc
inc inluding Luis Togno, and any heir, successor, assign, executor, employee, member, representative, owner or director of any or all of them by any third party as a
direct or indirect result of my participation in the participation in any activity directly or indirectly associated with the 2007 NC State BJJ/Submission Championships Tournament are
not responsible or liable for any injuries or damages sustained during this competition or as result thereof.
X____________________________________________ ________/________/_______
Signature (Parent or guardian if under 18) Month Date Year
*Note: Some Divisions may be combined.