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Fighter's Registration Form


Please complete the forms below and mail to: The Regalas, 209 Grant Street, South Fork, PA 15956 or print, complete, scan and email to promoter@ironwillfighting.com.

>>Physician's Exams >>National ID Card
>>MMA Professional License >>MMA Amateur License
>>Professional Fighter Experience >>Amateur Fighter Experience

Please complete as much of the form below as possible when registrating to compete in MMA.

First Name:
Last Name:
Nickname:
Age:
Address:

Phone Number:
Alternative Phone Number:


Email Address:
Weight Class:
Do you wish to compete as an amateur or professional?
Amateur Professional
Height:
Pro MMA Record:
Amateur MMA Record:
Trainer Name:
School/Gym Name:
Fight Team you will not compete againist:
Walk Out Song:

States you hold licenses in:
Training History/Experience/Accomplishments:
 
MEDICAL TESTING  
/ /  
HIV Test
HEP B
Annual Physical
HEP C
For fighter's over the Age of 36. Please Complete the following:
/ / Date of CT Scan or Neuro Evaluation:

/ / Date of Dilated Eye Exam:


ONCE FIGHTER'S COMPLETE THIS REGISTRATION FORM, PLEASE SUBMIT HIGH
RESOLUTION PHOTO'S TO promoter@ironwillfighting.com

 

 
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