2019 NEW SOUTH WALES KARATE FEDERATION

NEW SOUTH WALES KARATE FEDERATION INC.
2019 STATE SQUAD REGISTRATION
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Home Phone
Work Phone
Mobile Phone*
E-mail*
Gender*

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Date of Birth*

DayMonthYear
Date
Age Cut off 2019

Age for NSW tournaments is age as at 2 August 2019

If competitors wish they may compete in 2019 as age as at 23 October 2019 for WKF Cadet, Junior & U21 age categories.

Example 1: a competitor who is 13 as at 2 August 2019 but will be 14 as at 23 October, may choose to compete in U14 or Cadet but not both.

Example 2: a competitor who is 15 as at 2 August 2019 but will be 16 as at 23 October, may choose to compete as a cadet or Junior but not both. Please note this only applies to Cadet, Junior & U21 age categories so this competitor may compete as a junior in kata but not as a senior

Example 3: a competitor who is 17 as at 2 August 2019 but will be 18 as at 23 October, may choose to compete as a Junior or U21 but not both. Please note this only applies to Cadet, Junior & U21 age categories so this competitor may compete in U21 kumite but not as a senior.
Style / Dojo*
Instructor*

NSW State Team Application for Selection
Name
List each and every division for which you are applying for selection.
Kata
Children Kumite
Cadet Kumite
Junior Kumite
U21 Kumite
Veteran Kumite
Senior Kumite
Number of Divisions
Please be aware that Team Selection will be at the State Championships and announced at the compulsory NSW Selection and Awards Evening on 16 March 2019, unless otherwise advised by the NSW Coaching Panel.

2019 NSW Tournament Entry
Name
State team members entry fee is included in your instalments.
NSW All Styles - 2 March 2019*
NSW STATE CHAMPIONSHIP - 16 March 2019*
NSW OPEN CHAMPIONSHIP - 11 May 2019*
NSW CUP - 29 June 2019*
Competitor or Parent/Guardian if under 18

Payment Details
Name
Late Fee $120

Payment Includes:

Application for selection $300 Refundable if not selected
State Squad registration
State Squad training Sessions
Awards Night Dinner
NSW All Styles unlimited events
NSW State championships unlimited divisions
NSW Open unlimited events
NSW Cup unlimited events
Athlete Administration fee National Championships
2019 AKF Individual competitor participation levy

Payment does not include compulsory tracksuit and apparel

Instalment due by 28 January 2019	$375
Instalment 1
Instalment due by 24 February 2019	$375
Instalment 2
Instalment due 7 Apr 2019	$375
Instalment 3
Instalment due 5 May 2019	TBA
National Championships Hotel / Ground Transport (less $300 application)

Late Fee
$120

Online payment has now closed. Payment can only be made in cash at state training.
Late Fee*

$120
Pay via PayPal / Credit Card
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Instalment 1 only (future payments in cash at State Training) incl late fee$495.00AUD

Instalments 1, 2 and 3 (instalment 4 in cash at State Training) incl late fee$1,245.00AUD
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