FIGHTER APPLICATION

This application covers the required questions by the North Carolina Boxing and Combat Sports Commission for amateur/toughman fighters. All contestants must be 18 years of age, pass a pre-fight physical, and obtain a $50 contestant license.

PERSONAL INFORMATION

First Name *

Middle Initial

Last Name *

Date of Birth *

Social Security Number (Last 4 digits) *

Physical Address *

City *

State *

Zip Code *

Phone Number *

Email Address *

Driver's License Number *

Issuing State *

PHYSICAL & EXPERIENCE DETAILS

Height (e.g. 5'10") *

Weight (lbs) *

Hair Color *

Eye Color *

Stance *

Distinguishing Characteristics (Scars, Tattoos)

Amateur Combat Experience? *

Record (Wins-Losses-Draws), if applicable

Manager/Trainer Name (if any)

MEDICAL & DECLARATIONS

I confirm that I am fit to fight. I do not have any severe medical conditions, and I am not under the influence of any prohibited substances or drugs. *

I acknowledge that I must pass a pre-fight physical examination on-site and obtain a $50 contestant license from the NC Boxing and Combat Sports Commission to compete. *

I declare that all information provided in this application is true and correct. I understand that false statements can lead to suspension or disqualification. *

Electronic Signature (Type Full Name) *

By submitting, you understand this information will be sent to the event organizers to review your eligibility.