WKF Kumite Referee Course Certification

Sponsored by International Traditional Karate Association

Sanctioned by
USA-National Karate Federation
National Governing Body for Karate
Member United States Olympic Committee

Saturday March 27th ,

This Referee Kumite Course will help you to obtain licenses or upgrade licenses. Benefits?
safety and fairness for our competitors along with gaining National and International recognition.

•  This is the ONLY rule set authorized by the International Olympic Committee and the United States Olympic Committee for Karate.
•  As determined by the Amateur Sports Act and the US Olympic Committee, the USA-NKF is the ONLY Karate Organization recognized in the
• United States. It is the largest in "nature, quality, scope and strength."
• It gives you the structure to provide SAFE and fair competitions by having certified referees and judges with US Olympic oversight.
• There are over 180 countries that use this rule set through the Pan American Karate Federation and the World Karate Federation.
•  All Karate Styles are welcome, though the competitions are aimed at the four major styles of Shotokan, Goju, Shito and Wado. All you have to do    to be involved is to know and follow the rules.

The Referee Course will be conducted by:
Sensei Alex Miladi member

USA-NKF Referee Committee,
NKF / P.K.F / WKF Karate Referee
Miladi Sensei is one of the official examiner for referee courses in the world.
study of rules and written test for Licensing.
Time 3:30 to 6:30 PM location ITKA Headquarters. 5945 W. Irving Park. Chicago il 60634.

RULES:
Rules and Test may be downloaded at http://www.usankf.org/). It is the coach and competitor’s responsibility to know and understand the rules of competition. This is an excellent opportunity for athletes and parents to audit the course in order to have a better understanding of the rules of competition. This course is being offered to help increase the quality of our referees for this and all future events. Please don’t miss this great opportunity to improve your skills.

Fee Schedule:
$110.00 Kumite Course for license
Non-license participation $50.00
This is great for athletes, parents, coaches and anyone who wants a better understanding of the rules of competition.
All information is posted at www.itka-karate.com
To register please complete the attached form and return it to the address below as soon as possible.

Make Money Order payable to
ITKA Karate mail to 5945 W. Irving Park Rd. Chicago IL 60634.
OFFICIAL'S NUMBER_______________
(For Office Use Only)

U.S.A.-N.K.F.
REFEREE COURSE
ENTRY FORM

2010 USA-NKF Membership No.:
New or Upgrade License Kumite Fee: $110.00 Auditing Only Fee: $50.00 Referee passport: $20.00
NAME: BIRTHDATE: USA-NKF KARATE GRADE:
ADDRESS: PHONE: SEX: AGE:
CITY: STATE: ZIP: EMAIL

CERTIFICATION RECORD
RANK DATE STYLE RANK DATE USA-NKF
sanctioned rank 1st. Dan ______________ ______________________________ __________________ ___________________________________________
2nd. Dan ______________ ______________________________ __________________ ___________________________________________
3rd. Dan ______________ ______________________________ __________________ ___________________________________________
4th. Dan ______________ ______________________________ __________________ ___________________________________________
5th. Dan ______________ ______________________________ __________________ ___________________________________________
6th. Dan ______________ ______________________________ __________________ ___________________________________________
7th. Dan ______________ ______________________________ __________________ ___________________________________________
8th. Dan ______________ ______________________________ __________________ ___________________________________________
USA-NKF REFEREE QUALIFICATION: KUMITE:_______________________KATA:
DATE:____________ PLACE:
RED WKF PASSPORT:
Place of Issue:____________________________________Date:

In Lieu of an Official Passport, please list all national and internationally sanctioned courses attended.
DATE LOCATION INSTRUCTOR QUALIFICATION ACHIEVED
_______________ _________________________________ __________________________________ _________________________________
_______________ _________________________________ __________________________________ _________________________________
_______________ _________________________________ __________________________________ _________________________________
_______________ _________________________________ __________________________________ _________________________________
PERSONAL CERTIFICATION
I hereby certify that the above facts are true and accurate and that I fully understand that any certification of recognition given to me may be withdrawn in the event of misrepresentation or fraud.
Personal Signature:_______________________________________________ Date:______________________________