KBL Exhibition Registration Form

KickDoe Boxing Club

Exhibition Registration Form
Participant's Information
Participant's Legal Name*

First NameLast Name
Participant's Fight Name*
This is How We Will Introduce You!!!
Participant's Age*
Must Be 18+ To Participate
Participant's Gender*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Participant's Primary Contact Number *

Area CodePhone Number
Primary E-mail*
contact@kickdoeentertainment.com
Emergency Contact & Health Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*

Area CodePhone Number
Does you have any allergies, breathing conditions , or medical conditions that would limit high level activtiy?*

YesNo
Please describe*
Permission For Emergency Treatment In the event of illness or accident, I give my permission for emergency treatment by qualified medical personnel, and I authorize and I give consent for KBC to contact any and all necessary emergency medical care.
Name of Physician / Emergency Medical Care Facility
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
About You!!!

Below is a chart of KBC's Weight Class & Weight Limits. Please Indicate your weight class upon purchasing your ticket.
Important Notes · Dress appropriately. · You will Be Weighed!!! The league organizers (Coaches) reserve the right to ensure the talents of all participants by categorizing in proper weight class to balance teams.

Boxing skill level*

	1	2	3	4	5

1 is Beginner, 5 is Advanced

Interested in Competiting?*

YesNo
Release of Liability Although the safety of all sport activities is the primary concern, particiapating in KickDoe Boxing Club's events may cause injuries and/or death. I expressly assume the risk of injury, death, and/or illness arising from any cause, and agree to waive my right or my family's right to pursue any claim against KickDoe Boxing Club, Parent company, and the persons in charge.
I have read and agree to the above conditions*

Yes
Confirmation E-mail*
Signature*

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After completing this form, please click "Submit". You will receive a confirmation email. If you do not receive the email within a few minutes, please check your spam; otherwise, please contact us at contact@kickdoeentertainment.com.
Did You Read The "KickDoe Boxing Club" Waiver for This Exibition?*

Yes

KBC Boxing Exhibition Ticket*

KBC Boxing Exhibition Ticket$25.00

Purchasing this ticket will guarantee you the opportunity to compete in this event!!!

Weight ClassQuantity
Item subtotal:$0.00

Subtotal $0.00Tax $0.00Total $0.00

Payment Methods

Credit Card

Apple Pay

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About You!!!

Payment Methods