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REGISTRANT INFORMATION
While completing this form, do not use the browser BACK or FORWARD buttons; use only the buttons on this form. Fields in this color are required.
Closes at:  13 November 2017 11:59 PM US/Central
Competitor Information:

First name:
Last Name:
Date Of Birth: //
Gender:MaleFemale
Weight (lbs without gi):
(integer only)
Contact Information:

Email:
Address1:
Address2:
City:
State:

(If outside USA, enter below the state,
province, district, or area)
 
ZIP:
Country:
Day Tel:
Night Tel:
Academy, Gym, or Club:

Instructor(s):
Select
Academy
from list:
(If not on list, type name below)
Academy:
Address:
City:
State:

(If outside USA, enter below the state,
province, district, or area)
 
ZIP:
Country:
Telephone:
Emergency Contacts:

Name:
Phone:
T-shirt Size
Adult Small  
Adult Medium  
Adult Large  
Adult XL  
Adult XXL  
Kid Small  
Kid Medium  
Kid Large  
REGISTERED CATEGORIES
Place a check mark next to each category for which you wish to register. All fields appearing under a label of this color are required for the category.
Gi Males: 65.00 USD (Enable checkbox to register.)
Divisions for BJJ GI competition for MALES JUVENILE (16-17 yrs), ADULT (ages 18 yrs and up), MASTERS (ages 30 years and up) and SENIORS (ages 40 years and up).
Rank  
Belt
Weight  
Class
Age  
Age Group
If no one else in registered division...  
Move up Weight Division? No
Yes
Move an Age Group? NO or Not Applicable because registering as Adult
Move down from Master or Senior
Move up from Juvenile to Adult
Gi Females: 65.00 USD (Enable checkbox to register.)
Divisions for BJJ GI competition for FEMALES JUVENILE (16-17 yrs), ADULT (18 yrs and up), MASTER(30 yrs and up), and SENIOR (40 yrs and up).
Rank  
Belt
Weight  
Class
Age  
Age Group
If no one else in registered division...  
Move up Weight Division? No
Yes
Move an Age Group? NO or Not Applicaple because registering as Adult
Move down from Master or Senior
Move from Juvenile to Adult
Gi Kids: 65.00 USD (Enable checkbox to register.)
BJJ Gi competition for Kids. Kids can easily fluctuate in weight over the course of a few weeks. It is advised that if your child is close to the maximum weight limit, that you register them at a higher weight class to avoid disqualification.
Experience  
Belt
Age  
Age Group
Weight  
Class
Gender  
Gender Group
Gi Absolute Adult: 65.00 USD (Enable checkbox to register.)
BJJ Gi Absolute Adult division for Men and Women. You can add this division for only $20 more if you are also registering for a standard weight division in Adult Men or Women.
Experience  
Belt
Division  
Division
Gi Absolute Juvenile: 65.00 USD (Enable checkbox to register.)
BJJ Gi Absolute Juvenile division for males and females ages 16-17 years. You can add this division for only $20 more if you are also registering for a standard weight division in Juvenile.
Experience  
Belt
Gender  
Gender Group
No-Gi Males: 65.00 USD (Enable checkbox to register.)
Divisions for NO GI competition for MALES JUVENILE (16-17 yrs), ADULT (ages 18 yrs and up), MASTERS (ages 30 years and up) and SENIORS (ages 40 years and up). Weight value in each weight division is the maximum weight WITHOUT GI on.
Experience  
Level
Weight  
Class
Age  
Age Group
If no one else in registered division...  
Move up in weight? No
Yes
Move an Age Group? NO, or Not Applicable because registering as Adult
Move down from Master or Senior
Move from Juvenile to Adult
No-Gi Females: 65.00 USD (Enable checkbox to register.)
Divisions for NO GI competition for FEMALES JUVENILE (16-17 yrs), ADULT (18 yrs and up), MASTER(30 yrs and up), and SENIOR (40 yrs and up).
Experience  
Level
Weight  
Class
Age  
Age Group
If no one else in registed division...  
Move up in Weight Class? No
Yes
Move an Age group? NO, or Not Applicable because registering as Adult
Move down from Master or Senior
Move from Juvenile to Adult
No-Gi Kids: 65.00 USD (Enable checkbox to register.)
No Gi competition for Kids. Kids can easily fluctuate in weight over the course of a few weeks. Because of this, all kid competitors will be allowed a 1 lb variance when weighing in for their matches. However, it is advised that if your child is close to the maximum weight limit, that you register them at a higher weight class to avoid disqualification.
Experience  
Level
Age  
Age Group
Weight  
Class
Gender  
Gender Group
No-Gi Absolute Adult: 65.00 USD (Enable checkbox to register.)
No Gi Absolute Adult division for Men and Women. You can add this division for only $20 more if you register for a standard No Gi weight division.
Experience  
Level
Division  
Division
No-Gi Absolute Juvenile: 65.00 USD (Enable checkbox to register.)
No Gi Absolute Juvenile division for males and females. You can add this division for only $20 more if you register for a standard No Gi weight division.
Experience  
Level
Gender  
Gender Group
OPTIONAL ITEMS
Click on "Add To Cart" if you wish to purchase an item with your registration.
Optional T-shirt ADULT SMALL
Price: 15.00 USD
Desc: Official tournament T-shirt size Adult Small.
Qnty:
Add to Cart
Optional T-Shirt ADULT MEDIUM
Price: 15.00 USD
Desc: Official tournament T-shirt size Adult Medium.
Qnty:
Add to Cart
Optional T-shirt ADULT LARGE
Price: 15.00 USD
Desc: Official tournament T-shirt size Adult Large.
Qnty:
Add to Cart
Optional T-shirt ADULT XL
Price: 15.00 USD
Desc: Official tournament T-shirt size Adult XL.
Qnty:
Add to Cart
Optional T-shirt ADULT XXL
Price: 15.00 USD
Desc: Official tournament T-shirt size Adult XXL.
Qnty:
Add to Cart
Optional T-shirt KID SMALL
Price: 15.00 USD
Desc: Official tournament T-shirt size Kid Small.
Qnty:
Add to Cart
Optional T-shirt KID MEDIUM
Price: 15.00 USD
Desc: Official tournament T-shirt size Kid Medium.
Qnty:
Add to Cart
Optional T-shirt KID LARGE
Price: 15.00 USD
Desc: Official tournament T-shirt size Kid Large.
Qnty:
Add to Cart
Spectator Ticket
Price: 10.00 USD
Desc: One general spectator admission. Competitors and kids under 5 are free.
Qnty:
Add to Cart
INSTRUCTIONS
After submitting your registration, you will be directed to Paypal's website to complete the online payment. Paypal will offer you an option to pay with a credit card without a Paypal login. In case you are not immediately directed to Paypal for payment, you will be emailed a backup payment link.
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