Fill out the fighter registration form below. If selected, the promoter will be in contact with you. Cincinnati, OH – Dec. 14 Name First Last Ring Name Nickname Address Street Address City State / Province / Region ZIP / Postal Code Cell PhoneEmail Facebook HandleInstagram HandleTwitter HandleAgeWeightHeightPlace of EmploymentStreet Fight Record (Example 1-0)How many street fights have you had dating all the way back to kindergarten? List record.Have you had any sanctioned / organized fighting experience? Yes No If yes, list your record in following combat sports below. 3, one minute round, 16 oz glove Fight RecordHave you fought in any sanctioned boxing tournaments by an Athletic Commission? List record.Amateur Boxing RecordIf you have fought in a sanctioned USA Boxing event, list your record.Amateur MMA RecordIf you have fought in a sanctioned mixed martial arts event, list your record.Have you ever fought pro? Yes No HobbiesWhat do you like to do for fun?Grudge?Do you have a grudge against someone that you would like to fight? Tell us about it.CommentsRules I have read the rules.* If you win your fight, you win $500. * Fights are 3, one minute rounds with a minute rest between rounds. * You only fight once. * 16 oz. gloves (provided by promoter). * No headgear. * No entry fee. Promoter pays for boxing license. * Must be between the ages of 18 – 34 yrs. old. * No Professional fighters allowed. * Weight Classes: Lightweight 100-130 lbs. Middleweight 131-160 lbs. Light Heavyweight 161-185 lbs. Heavyweight 186-215 lbs. Super Heavyweight 216 & abovePic/Selfie Upload(Required)Max. file size: 100 MB.Upload a picture of yourself.Video UploadMax. file size: 100 MB.Are you redneck enough to fight in this event? Do you have a grudge you want to settle? Let us hear about it and tell us what hobbies you like to do for fun! Submit your video (approx. 1-2 minutes). VIDEOS SUBMITTED MUST BE NON-PUBLISHED ON SOCIAL CHANNELS.Consent(Required) I agree to the consent.I agree by submitting this form, I am giving ACR Promotions Inc. and its affiliates permission to use my photograph and or video imaging as part of their printed material, social media, website and any promotional marketing advertisement. I also agree that I own all rights to the photos & videos that I submit.