Challenger Registration

Ready to step up and throw down? Fill out the form below to register as a challenger for our Empire MMA & Boxing events. All skill levels welcome—make your mark and join the fight!

First Name (required) Last Name (required)

Email (required)

Date of Birth

Phone (required)

In What Sports Do You Compete? (required)

Boxing MMA Muay Thai Kickboxing

Are You Amateur or Professional? (required)

Amateur Professional Amateur Looking to Turn Pro

Country

Address Line 1 (required)

Address Line 2

City (required)

State (required)

ZIP Code (required)

Gym Name

Trainer Name

Trainer Phone Number

Height

Current Weight (required)

Competition Weight

Amateur Record

Professional Record (If applicable)

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