NEW MEMBER REGISTRATION FORM 2024

NEW MEMBER REGISTRATION FORM 2025

Please note, all registrations are per calendar year and will expire December 31 2025. MEMBERSHIP FEES ARE NON REFUNDABLE
PLEASE UPLOAD PASSPORT PHOTO OR SIMILAR

Browse Files
A selfie is OK, as long as it is clear and recent. Cancelof
ALL FIELDS NEED TO BE FILLED OUT OR THIS FORM CANNOT BE SUBMITTED.
First Name
Last Name
Street address
City
State
Postal/Zip Code
Country
Mobile Phone Number
Mobile phone numbers only please
Email
example@example.com
Gender
Date Birth

DayMonthYear
2 digit day, 2 digit month, 4 digit year
WHAT IS YOUR AGE TODAY
please note that if registering for an MBA event, you will be asked what your age will be at the date of weigh-in for that specific event
WHAT IS YOUR WEIGHT TODAY
HOW MANY FIGHTS HAVE YOU HAD- PLEASE INCLUDE EXHIBITIONS
HAVE YOU FOUGHT AS A PROFESSIONAL IN ANY COMBAT SPORT IN THE LAST 24 MONTHS. Please note, you cannot register with MBA if you have fought as a pro in the last 24 months
I understand that when competing in any competition for the MBA, I will need the following
PLEASE NOTE THAT THIS FORM REGISTERS YOU FOR MBA MEMBERSHIP ONLY. THIS DOES NOT REGISTER YOU FOR ANY EVENTS THAT MBA HAVE COMING UP.
Below are certificates that can be filled out if you dont want to wait for your book and these certificates can be uploded to the event entry form or sent via this link below.

https://form.jotform.com/242400757693056

Also, heres a link that you can email to your GP to fill out if your appoinment is through telehealth or the likes. The GP just submits the form and it comes strait to MBA.

https://form.jotform.com/242461404948055
Certificate of Fitness
Serological Certificate

ALL MERCH ORDERS ARE AVAILABLE AT THE PAN-PACS AT THE STORE

MBA NEW MEMBERSHIP

This is your 2025 MBA membership. please note, your membership expires December 31st 2024. Please note, MBA does not issue record books. All lisences will be digital and sent out Feb 1

$130.00 AUD Quantity

Total

Credit Card

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NEW MEMBER REGISTRATION FORM 2025

ALL FIELDS NEED TO BE FILLED OUT OR THIS FORM CANNOT BE SUBMITTED.

ALL MERCH ORDERS ARE AVAILABLE AT THE PAN-PACS AT THE STORE *

Credit Card

ALL MERCH ORDERS ARE AVAILABLE AT THE PAN-PACS AT THE STORE