Thank you for registering to fight for us. Please fill out this form and press send so that we can have the most accurate and up-to-date information on you. This also ensures you are aware of our policies and the perks for fighting for us.

You must fill out all required fields but may fill out all fields. The faster you get all the requested info, pics, paperwork, etc the better so that our match making and marketing teams, as well as our commentators will have as much info on you as possible so that we can help market you along with our promotion.

Note: VA Law now requires that all contestants, pro or amateur, have blood work and a physical or doctor's note within 180 days of your bout. See below for details and links.

(* indicates required fields)

Full Name*

Date of Birth (dd/mm/yyyy)*

Email*

Full Address (Street, City, State, Zip)*

Phone Number1*

Height*

Walking Weight*

Preferred Fight Weight*

Other Fight Weight(s)* (If you can't fight at other weights put none)

Amateur MMA Record* (if none, type 0-0-0)

Pro MMA Record* (if none, type 0-0-0)

Amateur Muay Thai/Kickboxing Record* (if none, type 0-0-0)

Pro Muay Thai/Kickboxing Record* (if none, type 0-0-0)

Amateur Boxing Record* (if none, type 0-0-0)

Pro Boxing Record* (if none, type 0-0-0)

Gym/School*

Event(s) (check all that you're interested in)*

TCB-16, January 27, 2018CZ50, March 3, 2018CZ51, April 28, 2018

Are you interested in fighting for (Check all that apply)*

CageZillaTCBEitherBoth

Are you interested in (check all that apply*

MMABoonchuMuay ThaiKick BoxingBoxing

Coach/Contact Name* (if none, write self)*

Coach/Contact Email(if none, write none)*

Coach/Contact Phone(if none, write none)*

Please Attach a Fight Pose Pic (should be fight pose or similar for use on fight card, posters and videos)

Last Date Blood Work was done (if never, write "none")*

Please Attach a Copy of Your Blood Work (if you have it)

Last Date Physical/Medical Clearance was done (if never, write "none")*

Please Attach a Copy of Your Physical or Clearance Form (if you have it)

Martial Arts Belt(s) and Discipline it's in (if none, write none)*

Nick Name (if none, write none)*

Background/experience in all combat sports and other athletics and any info you think will help us when match-making for you and considering you for our fight card. Any biographical info that may be interesting about you for our commentators (like life, academic or other sports achievements, relatives that have participated in pro or combat sports, interesting hobbies, military service or anything you think might be interesting for broadcast (if none, write none)*

You are encouraged to sell, but are not required to sell, hard copy electronic tickets and/or get a promo code that will either give a discount to your fans or it can be used to earn a commission (note: restrictions apply. We will give you details in response to your choice (*

TicketsTickets & Promo Code-DiscountTickets & Promo Code-CommissionPromo Code-DiscountPromo Code-CommissionNone

Social Media is an integral part of promoting yourself and for us to be able to promote you and our events. We ask that you like, follow, share, etc our website and social media pages. We also ask that you give us your social media handles so that we can better help you market yourself and communicate with you. We will send you a separate email with our handles, urls, etc, as well as marketing materials. If you do not wish to give your info to us or do not have any of the social media pages below, just put "None" in the space provided.

Facebook*

Twitter*

Instagram*

YouTube*

Snapchat*

Please enter text in box below as it appears in box above.

Blood work must show negative/non-reactive for HIV, Hepatitis-B and Hepatitis-C. You can get blood work from your doctor or an Urgent Care/Patient First type facility but those are often more expensive and take longer than going to requestatest.com. Getting blood work from them costs $89 and results are given within 1-2 days. Please plan enough time ahead to get your blood work in time for your fight. We do not have an affiliation or receive any money from requestatest.com but they have always done a great job. If you do use them, ask for the "combatives trio."

Click here to go to requestatest.com

Click here for Blood Work Form

Normal sports physical or note from physician stating that there are "no known impediments" to contestant being able to fight are sufficient. You must also certify that you have, or will have before your fight, your own medical insurance.

Click here for Medical Clearance Form

Waiver: By your submission, you grant Cagezilla Fighting Championship (hereinafter referred to as "Cagezilla") and/or its parent company, affiliates or subsidiaries a royalty-free, world-wide, perpetual, non-exclusive license to display, distribute, reproduce, and create derivative works of the submission, in whole or in part, in any media now existing or subsequently developed, for any purpose, including, but not limited to advertising and promotion of Cagezilla and/or its parent company, affiliates or subsidiaries, and its website, exhibition, and commercial products. Any photograph reproduced may include a photographer credit at photographer’s request and by permission of Cagezilla and/or its parent company, affiliates or subsidiaries at its sole discretion. Cagezilla and/or its parent company, affiliates or subsidiaries will not be required to pay any additional consideration or seek any additional approval in connection with such uses.

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