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State Games of MS
Martial Arts
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Register
Paper Entry Form
Participants
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Martial Arts Registration Form
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Categories
*
Single Event Registration-1 Event only
- $60.00
Multi Event Registration-2 or more Events
- $70.00
Participant Information
Contact Email
*
Participant First Name
*
Participant Last Name
*
Participant Birthdate
*
- month -
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- year -
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Participant Gender
*
Female
Male
Country
*
-- select country --
Canada
International
United States
Street Address (w/Apt#)
*
City
*
State
*
-- select state --
Alabama
Alaska
Arizona
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California
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Connecticut
Delaware
District of Col.
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South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
-- select state --
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Col.
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
-- select province --
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Zip Code
*
Phone
*
Would you like to
receive important event text alerts
on this number (eg. changes or delays)?
Emergency Contact
*
Emergency Phone
*
Select the size of your free event apparel
*
-- select one --
YM
YL
AS
AM
AL
AXL
AXXL
State Games Athlete T-shirt - 1 per participant
MKA #
Instructor's Name:
DOJO Name:
Belt Rank:
Select your division
YOU MUST SELECT A CATEGORY AT THE TOP OF THE FORM:
$60 for one event
$70 for Multi events - two or more events
Synchronized Kata
Synchronized Kata-select your division
*
18 & Over Beginner & Intermediate Men & Women
18 & Over Advance Men & Women
17 & Under Beginnger & Intermediate Male & Female
17 & Under Advanced Male & Female
Creative/Musical Kata with or without Music
Creative/Musical Kata with or without Music -select your division
*
Black Belt Men & Women
Adult Under Black Belt Beginner & Intermediate
Adult Under Black Belt Advance
14-17 Beginner & Intermediate
14-17 Advance
10-13 Beginner & Intermediate
10-13 Advance
9 & Under Beginner & Intermediate
9 & Under Advance
Creative/Musical Weapons with or without Music
Creative/Musical Weapons with or without Music-select your division
*
Black Belt Men & Women
Adult Under Black Belt Beginner & Intermediate
Adult Under Black Belt Advance
14-17 Beginner & Intermediate
14-17 Advance
10-13 Beginner & Intermediate
10-13 Advance
9 & under Beginner & Intermediate
9 & under Advance
Adult Black Belt- Traditional Kata
Adult Black Belt-Traditional Kata - select your division
*
18-34 Black Belt Men - Traditional Kata
35-47 Black Belt Men - Traditional Kata
48 & over Senior Black Blet Men - Traditional Kata
18-34 Black Belt Women - Traditional Kata
35 & over Executive Black Belt Women - Traditional Kata
Adult Black Belt-Traditional Weapons
Adult Black Belt-Traditional Weapons-select your division
*
18-34 Black Belt Men & Women
35 & Over Executive Black Belt Men & Women
Traditional Weapons
Traditional Weapons-select your division
*
18 & over Adult Under Black Belt Men & Women Beginners
18 & over Adult Under Black Belt Men & Women Intermediate
18 & over Adult Under Black Belt Men & Women Advance
14-17 Beginner
14-17- Intermediate
14-17 Advance
14-17 Black Belts
12-13 Beginners
12-13 Intermediate
12-13 Advance
10-11 Beginners
10-11 Intermediate
10-11 Advance
8 -9 Beginners
8-9 Intermediate
8-9 Advance
7 & under Beginners
7 & under Intermediate
7 & under Advance
Traditional Kata - Men
Traditional Kata-Men: select your divison
*
18-34 Men Beginners
18-34 Men Intermediate
18-34 Men Advance
35 & over Executive Men Beginners
35 & over Executive Men Intermediate
35 & over Executive Men Advance
Traditional Kata - Women
Traditional Kata-Women-select your division
*
18 & over Women Beginners
18 & over Women Intermediate
18 & over Women Advance
Traditional Kata - Young Adult
Kata-Young Adults-select your division
*
16-17 Young Adults Women Beginner
16-17 Young Adults Women Intermediate
16-17 Young Adults Women Advance
16-17 Young Adults Women Black Belt
16-17 Young Adults Men Beginner
16-17 Young Adults Men Intermediate
16-17 Young Adults Men Advance
16-17 Young Adults Men Black Belt
Traditional Kata - Juniors
Kata-Juniors-select your division
*
14-15 Junior Girls Beginners
14-15 Junior Girls Intermediate
14-15 Junior Girls Advance
14-15 Junior Girls Black Belt
14-15 Junior Boys Beginner
14-15 Junior Boys Intermediate
14-15 Junior Boys Advance
14-15 Junior Boys Black Belt
Traditional Kata - Children
Traditional Kata-Children-select your division
*
12-13 Pee Wee Beginners
12-13 Pee Wee Intermediate
12-13 Pee Wee Advance
12-13 Pee Wee Black Belt
10-11 Mini Pee Wee Beginners
10-11 Mini Pee Wee Intermediate
10-11 Mini Pee Wee Advance
8-9 Tots Beginners
8-9 Tots Intermediate
8-9 Tots Advance
6-7 Tiny Tots Beginners
6-7 Tiny Tots Intermediate
6-7 Tiny Tots Advance
4-5 Mini Tots - All Belts
Kumite - Men
Kumite-Men-select your division
*
18-34 Men Beginners
18-34 Men Intermediate
18-34 Men Advance
35 & over Executive Men Beginners
35 & over Executive Men Intermediate
35 & over Executive Men Advance
Kumite - Women
Kumite-Women-select your division
*
18-34 Women Beginners
18-34 Women Intermediate
18-34 Women Advanced
35 & over Women Beginners
35 & over Women Intermediate
35 & over Women Advance
Kumite - Young Adults
Kumite-Young Adults-select your division
*
16-17 Young Adults Women Beginners
16-17 Young Adults Women Intermediate
16-17 Young Adults Women Advance
16-17 Young Adults Women Black Belt
16-17 Young Adults Men Beginner
16-17 Young Adults Men Intermediate
16-17 Young Adults Men Advanced
16-17 Young Adults Men Black Belt
Kumite - Juniors
Kumite-Juniors-select your division
*
14-15 Junior Girls Beginners
14-15 Junior Girls Intermediate
14-15 Junior Girls Advance
14-15 Junior Girls Black Belt
14-15 Junior Boys Beginners
14-15 Junior Boys Intermediate
14-15 Junior Boys Advance
14-15 Junior Boys Black Belt
Kumite - Children
Kumite-Children-select your division
*
12-13 Pee Wee Girls Beginners
12-13 Pee Wee Girls Intermediate
12-13 Pee Wee Girls Advance
12-13 Pee Wee Girls Black Belt
12-13 Pee Wee Boys Beginners
12-13 Pee Wee Boys Intermediate
12-13 Pee Wee Boys Advance
12-13 Pee Wee Boys Black Belt
10-11 Mini Pee Wee Girls Beginners
10-11 Mini Pee Wee Girls Intermediate
10-11 Mini Pee Wee Girls Advance
10-11 Mini Pee Wee Boys Beginners
10-11 Mini Pee Wee Boys Intermediate
10-11 Mini Pee Wee Boys Advance
8-9 Tots Girls Beginners
8-9 Tots Girls Intermediate
8-9 Tots Girls Advance
8-9 Tots Boys Beginners
8-9 Tots Boys Intermediate
8-9 Tots Boys Advance
6-7 Tiny Tots Girls Beginners
6-7 Tiny Tots Girls Intermediate
6-7 Tiny Tots Girls Advance
6-7 Tiny Tots Boys Beginners
6-7 Tiny Tots Boys Intermediate
6-7 Tiny Tots Boys Advance
4-5 Mini Tiny Tots Boys & Girls - All Belts
TEAM SPARRING
Please enter the names of your 2 team members
Each team member must register themselves individually.
Team Sparring has 3 members and they do not have to be in the same division.
Please enter the name of your two team members below.
IMPORTANT:
Each team member must register themselves individually.
13 & under Children All Belts:
Must have one Tots/Mini Tots competitor, one Mini Pee Wee
Competitor, and one Pee Wee competitor per team
Team Sparring-select your division
*
Adult Black Belts
Adult Under Black Belts
14-17 Juniors All Belts
13 & under Children All Belts
Kumite - Adult Black Belt
Kumite - Adult Black Belt
*
18-34 Black Belt Men - Light Weight
18-34 Black Belt Men - Middle Weight
18-34 Black Belt Men - Heavy Weight
35-47 Executive Black Belt Men
48 & over Senior Black Belt Men
18-34 Black Belt Women
35 & over Black Belt Women
Make a Donation
State Games of Mississippi
click here
, to learn more about this cause
Amount $
The State Games of Mississippi is a privately-sponsored, non-profit organization that promotes amateur athletics and healthy lifestyles for Mississippians of all ages and abilities. Mississippi is one of 30 states that hold State Games competitions each year.
Waiver
*
I have read and agreed to the TERMS
*
CLICK HERE TO VIEW THE TERMS
.
Is the participant 18 or older?
*
18 or older
Under 18
Parent or Legal Guardian’s Signature - By providing your electronic signature you agree that you have the authority to register these participants and agree to the waiver(s) for them as their parent or legal guardian.
If registering a child under 18, you are consenting to the collection of the child's information that you are providing for the purposes of registration.
Parent's signature
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