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BOXER REGISTRATION

ICB Boxer Registration

£35

ICB Memberships start January 1st and end 31 December

Full Name*

Date of Birth*

Day

Month

Year

Full Address*

Phone*

Email*

Orthodox or Southpaw*

Orthodox

Southpaw

Current Weight*

Boxing Weight*

Boxing Record*

Include all boxing experience: White-collar, Amateur, Semi-Pro & Pro

Date of most recent boxing bout*

Result of most recent boxing bout:

Held a boxing licence previously?*

Yes

No

If yes, name of sanctioning body

Are you currently signed to boxer/manager contract*

Yes

No

If Yes, name of manager and date of expiry

I agree to adhere to the rules and regulations of the ICB

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