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Fighter Application for the Battle of Brooklyn

Please fill out all fields. All information MUST be given in order to properly process this application.

Name:
Email Address:
Mailing Address:
Mailing City, State, Zip Code:
Fight Weight / Height:		/
Fight Record:
Birthdate:
Birthplace:
Do you have a no pro license in boxing, kickboxing or Mixed Martial Arts? Yes No
Coach / Trainer Name:
Coach / Trainer Email:
Coach / Trainer Phone:
Gym Name: