Event Results
Fighter Application
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Plase complete the following application in it's entirety, double check your information and hit submit. You will then be contacted if selected. Good luck!
* Name:


* Age:

* Address:

* Phone Number:

* Email Address:


Manager Address:

Manager Phone Number:

Manager's Email:

* Weight Class:


Conventional or Southpaw:

Name of Trainer:

Fight Team Name:

Fight Team that you will not compete against:

Training History: (300 characters)

Walk Out Song:

Song Title:

* Pro MMA Record:

* Amateur MMA Record:

* States you hold licenses in:

Please check off which medicals you have completed and the date they were last done:
  DATE (ex.01/02/2006)  
HIV Test
HEP B Surface AG & HEP AB testing, not vaccinated
Complete Blood Count (CBC) and Bleeding & Coagulation (PT/PTT Pro-time)
Original EKG report, read by a physician
Original CT/MRI Brain Scan report (without contrast), read by a physician
Original EYE examination by an ophthalmologist - ophthalmological dilation
Annual Physical/Clinical
List any titles you currently hold or have held in the past:
Human Verification:
* = required field

Click here to download this application

Click here to submit fighter photo