WV Fighter Sign-up Form

Fighter Sign-up Form

Please fill out the form to register for Charleston, WV on Sat. Dec. 13
Full Name*

First NameLast Name
Ring Name
Nickname
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone*
Please enter a valid phone number.
Email Address*
example@example.com
Age*
Height*
Weight*
Gender*
Place of Employment
Street Fight Record (Example 1-0)
List record.
Have you had any sanctioned/organized fighting experience? (A sanctioned event is by a State Athletic Commission or an approved sanctioning body like the ISKA)*

YesNo
If yes, list your 3, one minute round, 16 oz. glove fight record (e.g. Redneck Brawl)
If yes, list your Amateur Boxing (USA sanctioned) fight record
If yes, list your Amateur MMA fight record
Have you fought in an unsanctioned backyard style fighting event? (bars, outdoor fields, etc.)*

YesNo
If yes, list company or person organizing
Have you ever fought pro?*

YesNo
Hobbies
What do you like to do for fun?
Grudge?
Do you have a grudge against someone that you would like to fight? Tell us about it.
Comments
WEST VIRGINIA RULES:
- Fights are 3, one minute rounds with a minute rest between rounds.
- You only fight once.
- 16 oz. gloves (provided by promoter).
- No headgear.
- No entry fee. Promoter pays for boxing license.
- Must be 18-39 years old.
- No professional fighters allowed.
WEIGHT CLASSES:
- Bantamweight up to 139 lbs.
- Welterweight over 139 to 159 lbs.
- Middleweight over 159 to 184 lbs.
- Cruiserweight over 184 to 215 lbs.
- Heavyweight over 215 lbs.
PRIZE MONEY:

WV rules allow fighters to be paid prize money. The winner of each fight will receive $500.
Pic/Selfie Upload*
Video Upload

MP4, MOV, WMV, AVI files. Max file size 1 GB.
Cancelof
Are you redneck enough to fight in this event? Do you have a grudge you want to settle? Let us know about it. Tell us what hobbies you like to do for fun! Submit your video (approx. 1-2 minutes). VIDEOS SUBMITTED MUST BE NON-PUBLISHED ON SOCIAL CHANNELS.
I agree to the consent. I agree by submitting this form, I am giving ACR Promotions Inc. and its affiliates permission to use my photograph and or video imaging as part of their printed material, social media, website and any promotional marketing advertisement. I also agree that I own all rights to the photos & videos that I submit.

YesNo
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