Name
Address
City
Zip
Phone No.
Age
Email address
Fight School
Association
or Gym
Male/Female
Height
Weight
Fight Weight
Fighting Sytles

Trainer(s)
Phone No.
Address
Glove Size
Notes or
special
requirements:
Detailed Fight
Experience
Record
History


Superhero
Alter Ego
Applicants will be rejected if   DETAILED FIGHT EXPERIENCE   is incomplete or missing

Privacy Disclosure: All information gathered through the Fighter Registration process is strictly confidential and will be used solely by BINA and TKONA for fight card purposes only.   Participation Disclosure:    I understand/agree that by submitting this application I may be contacted to fight in this, or future events and that if selected to participate, I will notify the promoters and their staff should I be unable to fight due to sickness or injury, within a reasonable amount of time for them to replace me with an alternate. I also understand that should I back out of the card that I will not be invited to participate in any future BINA and TKONA events.
Birth Date
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Tickets for Events
OCT 24 2009 FIGHT