State Champs 2025 – Victorian Entries

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Gloria Pyke Netball & Sports Complex
Greaves Reserve, Bennet St, Dandenong VIC 3175

Sunday 21st September

Competitor Check-in: 8.30am

Events Begin: 9.30am

COST: $35 First Event, $20 for each Subsequent Event

NO ENTRIES WILL BE ACCEPTED ON THE DAY
All fees are strictly non-refundable.

Spectators (payable at entry): Adults $12, Children $6, Family (2 adults & 2 children) $30 (children under 5 yrs free)

Entries CLOSE SUNDAY 7TH SEPTEMBER 2025

Entry Qualifications

All Victorian GKR Karate students are invited to enter the VIC State Titles.

Additional Tee's*
Competitor Details:
First name*
Last name*
Phone number*
Address line 1*
Address line 2
Address line 3
Town/City*
State*
Postcode*
Competitor information:
Region Number*
Dojo Location (suburb or city)
Age at time of competition*
Please enter a value greater than or equal to 5.
Age group*
Sex*
Your grade*
Grade division*
*14 - 17 yrs Black Belts MUST enter Junior Open Division
**18 - 34 yrs Black Belts MUST enter Senior Open Division
Which event(s) are you entering?
$35 First Event, $20 Subsequent Event / $55 both individual events
- Individual Kata +$35
- Individual Kumite +$35
- Both individual Kata and Kumite +$55
Which Team event(s) are you entering?
- Entering Team Kata (3 to a team)
- Entering Team Kumite (3 to a team)
Team Kata Age and Division
Team Kata competitor two
First Last
Team Kata competitor three
First Last
Team Kumite Age and Division
Team Kumite competitor two
First Last
Team Kumite competitor three
First Last
Please check the boxes below if any of these statements are true:
- Do you have any allergies? e.g. aspirin, antibiotics, foods?
- Have you been in contact with any contagious diseases in the last 3 months?
- Are you taking any form of medication at present?
If the answer is yes to any of the above questions, please give details here:
Doctor's details:
Doctors name*
Doctors phone number*
Doctors address*
Emergency Contact Details:
Contact one name*
Contact one relationship*
Contact one phone number*
Contact one alt. number
Contact two name*
Contact two relationship*
Contact two phone number*
Contact two alt. number
Please select...*
I confirm that my child will be attending the tournament with:
Parent/Guardian's Name
Declaration*
- By checking this box, you are agreeing to the Terms and Conditions.
Subtotal
$ 0.00