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Fighter Registration Form

****ALL FIGHTERS MUST REGISTER WITH THE INDIANA STATE ATHLETIC COMMISION!****
****PLEASE CLICK HERE TO DOWNLOAD FORM****

****ALL FIGHTERS MUST MUST FILL OUT AND SEND IN A XCC BOUT AGREEMENT!****
****PLEASE CLICK HERE TO DOWNLOAD FORM****

****PLEASE EMAIL A PICTURE TO WEBMASTER@EXTREMECAGECHALLENGE.COM SO THAT****
****WE CAN USE PHOTO TO PUT ON FIGHTCARD FOR WEBSITE AND VIDEOS****

All fields are required. If there is something that does not pertain to you just enter NONE or N/A.

First Name:   Last Name:  
Street:      
City:   State:  
Zip:   Phone:  
Email:   Nickname:  
Team Name:   Coach Name:  
Record:   Pro/Am:  
Weight:   Gender:  
Height:   Fighting Style:  
Last Fight:   Registration #:  
           
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INDIANA STATE ATHLETIC COMMISION FORMS
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