Sample BJJ Tournament Form Sample Form -- 2016 Taiwan International BJJ / No-Gi Championship Sample Form -- 2016 Taiwan International BJJ / No-Gi Championship Please fill out this form to register for the 2016 Taiwan International BJJ / No-Gi Championship. The registration fee is NON-REFUNDABLE. If you encounter any problems, please send an email to tournament@taiwanbjj.org. Time 121234567891011 : 0030 AMPM First Name 姓名(請填英文) * Last Name 姓氏(請填英文) * Chinese or Japanese name (if any) 中文姓名/日本語名 Enter your Chinese or Japanese name, if you have one. 請輸入您的中文或日語名字. Gender 性別 * Male Female Email Address 電子郵件信箱 * Phone Number 聯絡電話 * Address 地址 * City 城市 * Country 國家 * Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Colombia Comoros Congo Costa Rica Côte d‘Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria Norway Northern Mariana Islands Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Yemen Zambia Zimbabwe Emergency Contact Person 緊急聯絡人 * Person to contact in case of an emergency. Emergency Contact Number 緊急聯絡人電話 * Contact telephone number to call in case of an emergency. Academy Name 所屬武館 Other 大安MMA ALAVANCA Arete BJJ Bangkok Fight Lab BJJ Borneo BJJ Philippines Team Fabricio BJJ Singapore BON SAI Jiu-Jitsu Taiwan Club Barbarian Duro Gym Danimal BJJ / Kaohsiung Danimal BJJ / Tainan EMAC EPIC MMA Equilibrium MMA Escobar BJJ EVOLVE MMA FPBJJO Ivan Sakamoto Team Gracie Barra Hong Kong GRIPS His Chih City Dojo Hong Kong Jiu-Jitsu Hsinchu BJJ I Fighting Martial Fitness IMPACT MMA INSEAD Fighting Salamanders Juggernaut Fight Club Kowloon BJJ Kylin BJJ Macau BJJ Martial Armour MMA & Fitness New Taipei City Aikido Jiujitsu NEX Sports Nova União Nova União Japan O3 Fitness Over Limit BJJ Paraestra Higashi Osaka Paraestra Kasai PMA Brazilian Jiu-Jitsu PUREBREAD Guam Q23 Academy ATT Thailand RB Academy Saigon Jiu-Jitsu Saigon Luta Livre Shanghai BJJ Shuraba MMA Streit BJJ Studio 23 Suita Jiu-Jitsu Suto Academy SYNERGY BJJ SZ-Wan Sheng MMA Taichung Muay Thai Taidong MMA Taiwan BJJ Taiwan BJJ Keelung Taiwan BJJ Taichung Team CHOCO Team LINK The Paraestra Okinawa TMMA TRI-FORCE Jiu-Jitsu Academy Trust Jiu-Jitsu VERSUS PERFORMANCE Visca Waka Jiu-Jitsu WK HEARTS Yoseikan Carlos Toyota Please select the academy or school you train at. If your academy is not listed, please select "Other" from the list and then provide the name in the next field. If your academy is not listed above fill in the name here 如果上述表列沒有您的武館名子請在這裡填入 If your school or academy name is not listed in the previous drop down menu, please select "Other" from the list and fill in your school or academy name here. Belt Rank (or equivalent) 柔術級別 * Please choose 請選擇 Kids & Juvenile 兒童&青少年 -- White 白帶 Kids & Juvenile 兒童&青少年 -- Grey 灰帶 Kids & Juvenile 兒童&青少年 -- Yellow 黃帶 Kids & Juvenile 兒童&青少年 -- Orange 橘帶 Kids & Juvenile 兒童&青少年 -- Green 綠帶 White 白帶 Blue 藍帶 Purple 紫帶 Brown 棕帶 Black 黑帶 Age Category 參賽年齡屬 * Please choose 請選擇 Kids BJJ - Mighty Mite (6 years old or younger) 少年1組 Kids BJJ - Pee Wee (7-9 years old) 少年2組 Kids BJJ - Junior (10-12 years old) 少年3組 Kids BJJ - Teen (13-15 years old) 少年4組 Juvenile (16-17 years old) 青少年 Adult (18-29 years old) 成人 Master 1 (30-34 years old) 壯年1 Master 2 (35 years old or older) 壯年2 Please indicate the age category you would like to compete in. Registration Category 報名賽事類別 * Please choose 請選擇 0 Kids BJJ - Mighty Mite 少年1 Kids BJJ - Pee Wee 少年2 Kids BJJ - Junior 少年3 Kids BJJ - Teen 少年4 Juvenile - Gi only (7/23) 青少年道袍 Juvenile - No-gi only (7/24) 青少無道袍 Juvenile - Gi and No-gi 青少年道袍&無道袍 Adult/Master 1&2 - Gi only (7/23) 成年/壯年1&2道袍 Adult/Master 1&2 - No-gi only (7/24) 成年/壯年1&2無道袍 Adult/Master 1&2 - Gi and No-gi 成年/壯年1&2道袍&無道袍 Please select the event you would like to register for. Open Category 無差別賽事 * No 否 Yes, Gi only 是,道袍 (+NT$300) Yes, No-Gi only 是.無道袍 (+NT$300) Yes, Gi & No-Gi 是,道袍&無道袍 (+NT$600) Will you be competing in the Open category for Gi and/or No-Gi? Kids BJJ Gi Weight (Might Mite) 兒童巴西柔術量級 (少年1) Please choose 請選擇 22kg and below 22.1 - 28kg 28.1 - 34kg 34.1kg and above Kids BJJ Gi Weight (Pee Wee) 兒童巴西柔術量級 (少年2) Please choose 請選擇 30kg and below 30.1 - 36kg 36.1 - 42kg 42.1kg and above Kids BJJ Gi Weight (Junior) 兒童巴西柔術量級 (少年3) Please choose 請選擇 40kg and below 40.1 - 48kg 48.1 - 56kg 56.1kg and above Kids BJJ Gi Weight (Teen) 兒童巴西柔術量級 (少年4) Please choose 請選擇 52kg and below 52.1 - 60kg 60.1 - 69kg 69.1kg and above Gi Weight (Juvenile – Male) 青少年男子組量級 N/A 53.5kg and under 53.6 - 58.5kg 58.6 - 64.0kg 64.1 - 69.0kg 69.1 - 74.0kg 74.1 - 79.3kg 79.4 - 84.3kg 84.4 - 89.3kg 89.4kg and above Please select your category weight. For juvenile males only. Weigh-in with competition gear on. Gi Weight (Juvenile – Female) 青少年女子組量級 N/A 48.3kg and under 48.4 - 52.5kg 52.3 - 56.5kg 56.6 - 60.5kg 60.6 - 65.0kg 65.1kg and above Please select your gi weight category. For juvenile females only. Weigh-in with competition gear. Gi Weight (Adult/Master 1&2 – Male) 成人/壯年1&2男子組量級 N/A Rooster -- 57.5kg and under Light Feather-- 57.6 - 64kg Feather -- 64.1 - 70kg Light -- 70.1 - 76kg Middle -- 76.1 - 82.3kg Medium Heavy -- 82.4 - 88.3kg Heavy -- 88.4 - 94.3kg Super Heavy -- 94.4 - 100.5kg Ultra Heavy -- 100.6kg and above Please indicate the gi weight category you want to compete in. Weigh-ins will be done with competition gear on. For Adult/Master 1, 2 males only. Gi Weight (Adult/Master 1&2 – Female) 成人/壯年1&2女子組量級 N/A Rooster -- 48.5kg and under Light Feather -- 48.6 - 53.5kg Feather -- 53.6 - 58.5kg Light -- 58.6 - 64.0kg Middle -- 64.1 - 69.0kg Medium Heavy -- 69.1 - 74.0kg Heavy -- 74.1 - 79.3kg Super Heavy -- 79.4kg and above Please indicate the gi weight category you want to compete in. Weigh-ins will be done with competition gear on. For Adult/Master 1, 2 females only. No-Gi Level 無道袍巴西柔術級別 N/A Beginner (BJJ white belt or less than 2 years of no-gi grappling experience) 初級 (巴西柔術白帶或是無道袍兩年以下經驗) Advanced (BJJ blue belt or less than 5 years of no-gi grappling experience) 高級 (巴西柔術藍帶或是無道袍五年以下經驗) Elite (BJJ purple belt or above or more than 5 years of no-gi grappling experience) 精英級 (巴西柔術紫帶以上或是無道袍五年以上經驗) No-Gi Weight (Juvenile – Male) 無道袍巴西柔術 - 青少年男子組量級 N/A 59kg and under 59.1 - 69kg 69.1kg and above No-Gi Weight (Juvenile – Female) 無道袍巴西柔術 - 青少年女子組量級 N/A 48kg and under 48.1 - 56kg 56.1kg and above No-Gi Weight (Adult/Master 1&2 – Male) 無道袍巴西柔術 - 成人/壯年1&2男子組量級 N/A 63kg and under 63.1 - 70kg 70.1 - 77kg 77.1 - 88kg 88.1kg and above No-Gi Weight (Adult/Master 1&2 – Female) 無道袍巴西柔術 - 成人/壯年1&2女子組量級 N/A 58kg and under 58.1 - 68kg 68.1kg and above Registration Fee Total (NT$) 總繳金額 Registration fees are waived for Black Belts. Terms of Event 條款確認 * Yes, I have read and agree to the Terms and Conditions of this event. Terms and Conditions reCAPTCHA After clicking "Submit" you will be redirected to PayPal for payment processing. You can pay via credit card or a PayPay account. After paying, please click on the link going back to this site (亞洲巴柔有限公司 Asia Brazilian Jiu-Jitsu Limited Company).