State, Regional, National

             Coach Certification Clinic

Sunday April 7, 2019

                                 Open to USA Judo, USJA, USJF, ATJA and AJJF Members

Location             HOJT/SOHK Judo Club                 Phone: 214-566-9591

                                    25770 Interstate 45                                   

                                    Spring, Texas 77386

Clinician             Manmohan Chima, International Gold Coach

                        North Texas Judokai

Registration      Required Documentation and Validation at Clinic – After the clinic, you will be responsible for mailing the Coach application form and fee to national organization.      

Intent to attend     email Chima at:  sewadhar@hotmail.com

appreciated                  

Clinic Topics     Classroom                       Mat Session

                             Risk Management                       Ukemi, Newaza, Nagewaza,

                                    Goal Setting & Motivation         Shimewaza, Kansetsuwaza

                                    Dress Code, Web Site Content, Responsibility, Attitude

                                   Coach & the Player, Coach & the Referee   

                                    Set up, Preparation, Lesson Planning

                                    History of Judo                           Current rules of Competition

Schedule            Starts at 9 am

Requirements   Current USA Judo, USJA, USJF, AJJF or ATJA Member (bring card)

                                    Rank Requirement – Ikkyu or above

                                    Minimum 18 years of age

                                    Signed Code of Conduct (forms available at clinic)

                                   USOC SafeSport, Heads Up Certificate of Completion

                                   Background Screening (form available at clinic or on-line).      

                                    * Passport picture for coaching ID badge (your name on back)

Coach Certification Clinic for State, Regional, National only

April 7, 2019

                                                 WARNING!

 WAIVER AND RELEASE OF LIABILITY AND AGREEMENT TO PARTICIPATE

In consideration of being permitted to participate in any way, including travel to and from, the Coach Certification and related events and activities of United States Judo, Inc., United States Judo Federation, United States Judo Association, American Traditional Jujutsu Association, American Judo and Jujitsu Federation, Texas Judo Inc, North Texas Judokai, School of Hard Knocks, Houston Open Judo Tournament Inc., Diamondback Judo Club, and the Friends of Houston Judo Inc. I hereby:

1. Acknowledge that I am familiar with the sport of Judo and understand the rules governing the sport of Judo.
2. Agree that prior to participating, I will inspect the mats, equipment, facilities, competition pools or divisions and the elimination or scoring system to be used, and if I believe anything is unsafe or beyond my capability, I will immediately advise my coach, supervisor, and/or a tournament official of such conditions and refuse to participate.
3. Acknowledge and fully understand that I will be engaging in a contact sport that might result in serious injury, including permanent disability or death, and severe social and economic losses due to not only my own actions, inactions, or negligence, but also to the actions, inactions, or negligence of others, the rules of the sport of Judo, or conditions of the premises or of any equipment used. Further, I acknowledge that there may be other risks not known to me or not reasonably foreseeable at this time.
4. Knowing the risks involved in the sport of Judo, I assume all such risks and accept personal responsibility for the damages following such injury, permanent disability, or death.
5. Release, waive, discharge and covenant not to sue the United States Judo, Inc., United States Judo Federation, United States Judo Association, American Traditional Jujutsu Association, American Judo and Jujitsu Federation, Texas Judo Inc, School of Hard Knocks, Houston Open Judo Tournament Inc., Diamondback Judo Club and Friends of Houston Judo Inc. and the North Texas Judokai, together with their affiliated clubs, their respective administrators, directors, agents, coaches and other employees or volunteers of the organization, event officials, medical personnel, other participants, their parents, guardians, supervisors and coaches, sponsoring agencies, sponsors, advertisers, and if applicable, owners, lessors, and lessees of premises used to conduct the event, all of whom are herein referred to as “releasee”, from any and all claims, demands, losses, or damages on account of injury, including permanent  disability and death and damage to property, caused or alleged to be caused in whole or in part by the negligence of the releasee or otherwise to the fullest extent permitted by law.

I have read the above Warning, Waiver and Release, understand that I give up substantial rights by signing it, and knowing this, sign it voluntarily. I agree to participate knowing the risk and conditions involved and do so entirely of my own free will. I affirm that I am at least 18 years of age, or, if I am under 18 years, I have obtained the required consent of my Parent/Guardian as evidenced by their signature below.

____________________________            __________________________         _______

Participant’s Printed Name                        Participant’s Signature                   Date

USA Judo, USJA, USJF, AJJF or ATJA Number  __________ Expiration ________

Home Address __________________________________________________________

Email ______________________________________@__________________________

Telephone _____________________________________