Fill out the fighter registration form below. If selected, the promoter will be in contact with you. Huntington, WV – Sat. May 4 Name First Last Ring Name Nickname Address Street Address City State / Province / Region ZIP / Postal Code Cell PhoneEmail Facebook Handle Instagram Handle Twitter Handle Age Weight Height Place of Employment Street 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 Record Have you fought in any sanctioned boxing tournaments by an Athletic Commission? List record.Amateur Boxing Record If you have fought in a sanctioned USA Boxing event, list your record.Amateur MMA Record If you have fought in a sanctioned mixed martial arts event, list your record.Have you ever fought pro? Yes No Hobbies What 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.Comments Rules 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 – 39 yrs. old. * No Professional fighters allowed. * Weight Classes: below 140 lbs. 140-159 lbs. 160-184 lbs. 185 -215 lbs. 216 lbs. & abovePic/Selfie Upload(Required)Max. file size: 3 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). 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.