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Application to Fight

Please fill out the form below.  A packet of information will be mailed to you upon receipt of this information.  Please follow all instructions from the application mailed to your address.  (Use your tab key to get through the form easier)

 		  
     

Tell us how to get in touch with you:

 

First Name
Last Name
Street Address
City
State
Zip
County
Home Phone
Work Phone
Cell Phone
E-mail
Place of Employment

 

Please identify and describe yourself:

Age
Weight
Height
Sex Male     Female

 

Fight Information:

Ring Name
Hobbies
Have you ever fought before?   Yes     No
If yes, when and where?
   
   
What show do you want to fight in? Brushfork Armory
          Bluefield, WV
          Nov. 12-13, 2010
   
  Summersville Arena
          Summersville, WV
          Jan. 7-8, 2011
   
  Charleston Civic Center
          Charleston, WV
          Jan. 14-15, 2011
   
  Williamson Field House
          Williamson, WV
          Feb. 4-5, 2011
   
  Welch Armory
          Welch, WV
          Mar. 4-5, 2011
   
   

 

How did you hear about the contest?:    

Radio
TV
Newspaper
Poster
Word of Mouth

 

Enter your comments in the space provided below:

 

 

    

 

    
     
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