How
to Register:
Your
Instructor must print off the REGISTRATION DETAILS
form at the bottom of this page. Then this must
completed in full and must be posted to the A.K.A.
along with a Cheque for the entry fee.
1.
Print out the entry form, and send it with your
Cheque payment to the
---following address.
Event Coordinator - A.K.A. Kickboxing
C/O. Neil Holden,
Okami
Dojo - Wolf Gym,
Warrington Kickboxing Studio,
Top Floor - Unit 8,
Bridgefoot Business Centre,
Old Road,
Warrington,
Cheshire,
WA4 - 1AY.
2. Make Cheques payable to 'A.K.A. KICKBOXING'.
3. IMPORTANT - Regularly check the Current Entries
Page, to ensure that your details have been received
by the A.K.A. If your details are not on the Current
Entries Page then they have not been received
by the A.K.A. We reccomend that you immediately
text the event co-ordinator, Neil Holden if there
are any problems.
-----------------------------------------------------------------------------------------------------------------------
Please print the
Registration form, from
below the dotted line, thankyou.
-----------------------------------------------------------------------------------------------------------------------
-----------------A.K.A. Kickboxing - Registration
Form:
Name
: __________
School
/ Gym / Camp / Academy :
__________
Representing - Region / Town / Area :
__________
Trainer : __________
Trainers Mobile Telephone Number
: __________
Trainers Email Address :
__________
Personal Telephone Number :
__________
Personal Email Address :
__________
Age :
__________
Sex ( male / female ) :
__________
Height ( cms ) :
__________
Weight ( kgs ) :
__________
Tick the weight division that you are competing
in :
Super-Heavyweight - ----(
---+ 95.0 Kgs---
)-:
__________
Heavyweight-----------------
( 95.0 Kgs MAX ) :
__________
Super-Cruiserweight ----(
90.0 Kgs MAX ) -:
__________
Cruiserweight---------------
( 85.0 Kgs MAX ) :
__________
Super-Middleweight------(
85.0 Kgs MAX ) : __________
Middleweight ----------------(
75.0 Kgs MAX ) : __________
Super-Welterweight -----(
70.0 Kgs MAX ) : __________
Welterweight ------------
---( 65.0 Kgs MAX ) :
__________
Lightweight-----------------
( 60.0 Kgs MAX ) :
__________
featherweight -------------
( 55.0 Kgs MAX ) :
__________
Breakdown
of your competition record.
'No Decision' - Controlled
Contact Interclub-Sparring Day Bouts :
____
'With Decision' - Controlled
Contact Interclub-Sparring Day Bouts :
____
'N' Class Thai-Kickboxing
: ____
'C' Class Thai-Kickboxing
: ____
Note
: If you have competed at 'B' or 'A' class Thai-Kickboxing,
you are not eligable to compete in A.K.A. bouts.
Total of your Record.
Note: The A.K.A. regards Amateur 'No Decision
' Interclub Sparring Day bouts as 'DRAW's on your
record. Please include any / all of these.
---------------------------------Wins____
/ Losses ____ / Draws
____
Additional Information.
Date of last contest : __________
Championship Titles Held/Holding :
__________
Signatures required (
three Signatures ).
I state that all of the information that I have
given is correct.
Signed : __________
Date : __________
I understand that should
I not make the weight limit for the division that
I have entered with 60 minutes of my medical exam
on the morning of the event, that I will not be
allowed to compete and I will forfeit my bout.
Signed : __________
Date : __________
I understand that my entry
fee is non-transferable and non-refundable should
I withdraw from the event, and I agree to these
terms and conditions.
Signed : __________
Date : __________
A.K.A.
Kickboxing - Action Photos - CLICK HERE!
|
