Name *

First Name

Last Name

Name *

First Name

Last Name

Phone *

(###)

###

####

Fighter Status *

Debut

Amateur

Professional

Weight Class *

Select your fighting weight

Flyweight (125 lbs)

Bantamweight (135 lbs)

Featherweight (145 lbs)

Lightweight (155 lbs)

Welterweight (170 lbs)

Middleweight (185 lbs)

Light Heavyweight (205 lbs)

Heavyweight (265 lbs)

Women's (105-155 lbs)

Are You Local? *

Do you live/train within driving distance to the NJ/PA area?

Yes

No

Expected Ticket Sales *

How many of your friends, family, teammates, and fans do you think will come to see you fight in Atlantic City or Philadelphia?

0-10

10-25

25-50

50-100

100+