Fizz Buzz Cola

Fighter Registration

Fighter Registration Form

A full eye exam and all bloodwork must be submitted within 30 days of the event.

Examinations needed:
(1)  A full dilated eye examination performed by a licensed ophthalmologist and submitted on a form provided by the Division within the past 12 months.

(2)  HIV within the last 180 days.

(3)  Hepatitis B surface antigens within the past 180 days.

(4)  Hepatitis C antibody.

Mailing Address:
Amateur Fight League
216 N. McMorrine St.
Elizabeth City, NC 27909

Fax Number:
252-331-2856

 

First Name:
Last Name:
Fight Name:
Address:
City:
State:
Zip Code:
Home Phone:
Cell Phone:
Email:
Amateur Record:
School or Team:
Height:
Weight:
Birthdate:
  Bloodwork Completed
  Eye Exam Completed
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