Professional Boxer License Application Form

Name*

First Name Last Name

Gender*

Date of Birth*

Home Address*

Full Address City/ Town State ZIP / Postal Code Country

Do you have a Professional Boxing Record*

Please Share Your Boxrec ID*

Name of your Fight Promoter*

If you do not have a fight promoter, please do not proceed with this form

Date of your fight*

If you do not have a fight date confirmed with your promoter, please do not proceed with this form submission

Your Mobile Number*

Your Email Address*

Name of the Boxing Club Where You Train*

Your chief coach's name*

Chief coach's contact number*

Weight Category (Men)*

Choose from drop down

Weight Category (Women)*

Choose from drop down

Height ( in Cms)

Example: 165 Cms

Body Weight (in Kgs)

Example : 65 Kgs

Blood Test Report - HIV Test*

Drop files here or

Accepted file types: jpg, png, pdf, jpeg, Max. file size: 4 MB, Max. files: 2.

Report from a Recognized Digital Laboratory only.

Blood Test Report -HbAsg Test*

Drop files here or

Accepted file types: jpg, png, pdf, jpeg, Max. file size: 4 MB, Max. files: 2.

Report from a Recognized Digital Laboratory only.

Blood Test Report - HCV Test*

Drop files here or

Accepted file types: jpg, png, pdf, jpeg, Max. file size: 4 MB, Max. files: 2.

Report from a Recognized Digital Laboratory only.

ID & Address Proof (Front)- Aadhar/DL/ Passport*

Accepted file types: jpg, png, pdf, jpeg, Max. file size: 4 MB.

Any one of the Above

ID & Address Proof (Back)- Aadhar/DL/ Passport*

Accepted file types: jpg, png, pdf, jpeg, Max. file size: 4 MB.

Any one of the Above

Please upload a recent photograph*

Accepted file types: jpg, png, jpeg, Max. file size: 4 MB.

In case of Aadhar & Passport - Please upload Font & Back

Consent*

I agree to the below Statements

1. A Boxing License doesn't guarantee me fights on Professional Boxing Events. To get a fight I need to get in touch with Pro Boxing Promoter.

2. I know that Boxing is a dangerous sport and chances of injury or death are high. I wish to acquire a Professional Boxing License from the Indian Boxing Council.

3. I shall submit myself for all mandatory medical checks as suggested by the Medical Commission of the IBC and results for the same will be submitted with 7 days of this application.

4. If I am given a Professional Boxing License I shall follow all rules and regulations as mandated by the Indian Boxing Council, its officers and other Technical officials pertaining to the sport of Professional Boxing.