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Protest Form ( cash only and NON-refundable)

Must be submitted completely filled no blanks and with $25.00 (cash only) protest fee before last division bows out.

PROTEST PROCEDURES: Protests are permitted in tournament play in those rare instances when it is necessary to assure justice to a player or a team. Protests may be made on the playing of an ineligible player or when and interpretation of the rule is at fault and actually affects the result. Under no circumstances will an officials' judgment call be grounds for a protest. Evidence supporting your protest is important and it will be necessary for you to supply "proof" to support your case.

Protests concerning a rule interpretation must be made to the officials and opponents at the time of the infraction. A follow up written protest must be submitted to the tournament director before the last division bows out. Include the exact conditions and sequence of events that prompted the situation. 

Protests concerning player eligibility must be submitted to the tournament director before the last division bows out.  Be sure to have eyewitnesses other than teammates (i.e., officials and supervisor) plus other details that will support your case (i.e., players name, school, coach, instructor, and style.). 

PROTEST SOLUTION: Protest will be handled by a Protest Board, which will be formed and shall consist of a minimum of three (3) members. A representative from the protesting team shall present their "case" in writing to the Protest Board. The Board's ruling to accept or deny the protest and their solution shall be implemented as soon as possible

Date Submitted__________________________ Time Submitted______________________________

Time of Match___________________________ Ring # of Match____________________________

Referees:  Center _________________________   Side _______________________   Side   _________________________

Division______________________ Age Group _________Male _______Female________

Competitors ______________________________ vs.  __________________________________________

Instructors Name / School / Style. _______________________________________________________________________

Rule/Policy Violated__________________________________________________________________________________


Violation Description_________________________________________________________________________________





Attach sheet for additional information, if needed.

Signature of person submitting Protest_______________________________________________________

Name Printed_____________________________ Club Affiliation______________________________


Home Telephone ______________________________Work Telephone ____________________________

Please Note: The Referee’s decisions "on judgment calls connected with play shall be final" and are not protestable