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AMMASA
UWC Fight Night

AMMASA / PGMA

BOXING

Event Fighter Registration Form

27 April 2025 @ Lights Out Liverpool

Gender:
Weight Category:
under 30kg
under 35kg
under 40kg
under 45kg
under 50kg
under 55kg
under 60kg
under 65kg
under 70kg
under 75kg
under 80kg
under 85kg
under 90kg
under 95kg
under 100kg
over 100kg
Are You NSW Combat Sports Registered:
Fight Stance Photo
Club Annual Membership
A$30

Direct Bank Deposit

Name: AMMASA

BSB: 012 292

Acc. No: 186 821 296

Please State Competitors for Reference

Declaration:

I’ hereby the applicant AGREE and release AMMASA, PGMA Board of directors Officials, Event organizers and any Individual, Clubs, Organization connected in any way with the Event / Tournament and any injuries which could be sustained by participation in such. I 'fully understand that if any medical treatment is given to me will be of first aid type only unless attended too by a medical practitioner. Am in good health, and having trained for this type of contact competition sport with obvious risks. I voluntarily accept this risk of injury and I shall not hold anyone liable for any injury or damage to me or my property either during or after the competition and hold no one liable for any injury or damage I might suffer from being on or leaving the premises where competition / tournament is being held. I also agree for anything of me including been filmed or photographed to be used for promotional purposes by the above mentioned organizations.

Date:
Day
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