2019 Revgear Tournament of Champions
PLEASE, ONLY SUBMIT THIS FORM ONCE!
If you have already submitted it once and need to make changes, please contact us. pam@tbasanctioning.org
Email address *
First Name *
Your answer
Last Name *
Your answer
Sex *
Additional Names you have been known by:
Maiden Name, Birth Name, etc. If not applicable, put "N/A"
Your answer
Age *
Please list age as of October 12, 2019
Your answer
Height *
Please list your height as x' xx", i.e. 5' 6"
Your answer
Walking Weight *
We need your CURRENT walking weight, not fighting weight in POUNDS. This will help us if we need to adjust any brackets with single fighters after the closing date. Format is whole number. i.e. 250
Your answer
Birthdate *
MM
/
DD
/
YYYY
Email Address *
Please list the fighter's email address. Trainer's information will be entered in another area.
Your answer
Email Address: Confirm *
Please re-enter for confirmation
Your answer
SSN/SIN - last four digits *
This is to verify identity, if we would need to do so.
Your answer
T-Shirt Size *
Please double check your size
Country you reside in *
Mailing Address: Street *
Your answer
Mailing Address: City *
Your answer
Mailing Address: State/Province *
Your answer
Mailing Address: Postal Code *
Your answer
Your Phone #. Format: xxx-xxx-xxxx *
This is YOUR number (or parents if a minior), not trainers.
Your answer
DIVISIONS:
BREAKDOWN OF EACH DIVISION:
Novice 0-3 Fights (See above for variation for Novice Juniors.)
Class B 4-12 Fights
Class A 13 & above. Class A is also an OPEN division. Those with 'pro' experience may enter. No purses paid. Amateur tournament rules in effect. Your bout will be listed as an AMATEUR bout with the TBA-SA..
*Please count ALL ring experience! If you are unsure if it counts, ASK! We include in-gym smokers, "sparring nights", sanctioned, unsanctioned, boxing, mma, etc etc. There will be NO excusable reason for not counting everything. If in doubt, do NOT ask your coach, a friend or a teammate! ASK US!
Age 17 CAN fight in the adult division.

"Senior" fighters, age 40-50, will be required to complete the additional 'senior physical form' and submit it BEFORE the final week of registration.

**If you have competed in a legitimate 'pro' fight in Thailand, you MUST register in Class A. If it was a lower level am/pro fight, you may still qualify for Class B. Contact us for confirmation on division.

**If you are a head trainer/coach - you cannot compete in the Novice division! If you are an assistant coach, please contact us for approval for novice division .

***Note! If you are a previous Novice Champion and have 3 fights, you MUST register in Class B. You cannot register in Novice again this year.
Division: ALL Fighters complete this! *
Novice 0-3 Fights, Class B 4-12 Fights, Class A/Open 13 & above. If you have 'pro' experience, you MUST go into the Class A/Open division. If you have fought in Thailand, please contact us to determine the correct divisiNO purse or Monetary compensation will be awarded. Amateur rules. .
Required
Weight Brackets: Select ONE *
PLEASE READ BEFORE SELECTING YOUR WEIGHT BRACKET: PLEASE double check the weight you are registering for AND check your listing once its posted for accuracy! If it is incorrect, contact us immediately so we can get it fixed. If you have not double checked the online post and you registered for the incorrect bracket or need to be moved later due to not being able to make weight, you will have to pay a "Transfer fee" to have your registration updated. If you register in a 'full or closed' bracket, you will be placed in the next logical spot. This may be a higher weight bracket or a higher division. No Refunds. You may be able to transfer in later if there are enough drops (no guarantee). You will not be required to pay the transfer fee. "Overflows" will be moved back in according to their registration date. * We reserve the right to combine brackets or create 'catch weight' brackets when there are less than three fighters.
Required
Have you ever competed in Thailand? *
Have you ever competed as a Professional? *
If you answered "yes" to either of the last two qeustions above question, please provide information. i.e. Date, Location, Promotion, Opponent, Outcome *
Your answer
TRAINER INFORMATION : *
We need your trainer information to confirm your fight record and to discuss transfers. If you have no training and/or do not train at an actual gym, you may not compete in this tournament.
Required
Training Facility *
Please list the name of WHERE you train.
Your answer
Head Trainer's First Name *
Your answer
Head Trainer's Last Name *
Your answer
Head Trainer's Email Address *
Please list the Head Trainer's email address.
Your answer
Additional Trainer's
If you have more than one trainer, please list the others here.
Your answer
Trainer/Gym's Street Address *
Your answer
Trainer/Gym's City *
Your answer
Trainer/Gym's State/Province *
Your answer
Trainer/Gym's Postal Code *
Your answer
Head Trainer's Contact Phone Number *
Please use the following format: xxx-xxx-xxxx
Your answer
Total amount of Training Time (all gyms/trainers) *
Past Gyms *
Please list all past gyms and/or trainers you have trained with and estimated time: (separate names with a comma)
Your answer
Past TBA-SA Experience *
Have you participated in a TBA-SA Tournament before? If yes, please list years.
Required
Fighter's Record: Please read before answering the following questions *
FULL DISCLOSURE! Copy and past this link into a new browser if you'd like a more detailed explanation of what we require is reported. http://www.tbasanctioning.org/REPORTEVERYTHING.htm Our research staff researches fighters. If we discover you have blatantly lied, you will be disqualified without a refund. Include ALL fight experience, this includes sanctioned, unsanctioned bouts, as well as smokers, demos, exhibitions, boxing, mma, any type of experience where there was a referee in the ring and spectators in the seats, regardless of where it is taking place - we need FULL DISCLOSURE. If you are unsure whether to count it, visit the website or contact us and we will advise what needs to be counted:
Required
Fighter's Record: Muay Thai, Kickboxing (all Rules), San Shou *
Please use the following format: Wins-Losses-Draws/Knock Outs, written as 0-0-0/0
Your answer
Fighter's Record: Smokers/Exhibitions/Demos/Etc. *
Please use the following format: Wins-Losses-Draws/Knock Outs, written as 0-0-0/0
Your answer
Fighter's Record: No Head Contact: YDL, PKB, or other similar rules style. *
Please use the following format: Wins-Losses-Draws/Knock Outs, written as 0-0-0/0
Your answer
Fighter's Record: Boxing *
Please use the following format: Wins-Losses-Draws/Knock Outs, written as 0-0-0/0
Your answer
Fighter's Record: MMA *
Please use the following format: Wins-Losses-Draws/Knock Outs, written as 0-0-0/0
Your answer
Fighter's Record: Pankration *
Please use the following format: Wins-Losses-Draws/Knock Outs, written as 0-0-0/0
Your answer
UPDATING YOUR RECORD: *
It is your responsibility to update us if you have any fights (including demos, exhibitions, etc) AFTER registering. Please send updated record via email. An email with just, "I fought and I won or lost" is not clear enough information. We need your current record after that win/loss, listed like this "W-L-D/KO" with the opponents name, and promotion date/location so the research staff does not get your bouts confused. The more information you can provide, the easier to make sure we have your record correct. It is very much appreciated! :) If you fail to notify us so you can stay in a division you are no longer able to be in after your additional fight(s), you will be disqualified.
Required
Optional Demograhics: Occupation
This section is optional, but if you could fill it out, we would greatly appreciate it! It helps us put together demographics of the participants which some of the sponsors ask for.
Your answer
Optional Demograhics: Hobbies
This section is optional, but if you could fill it out, we would greatly appreciate it! It helps us put together demographics of the participants which some of the sponsors ask for.
Your answer
Optional Demograhics: Residence
This section is optional, but if you could fill it out, we would greatly appreciate it! It helps us put together demographics of the participants which some of the sponsors ask for.
How'd you hear about us? *
We are always curious how new gyms, trainers and fighters hear about our tournament.
Required
READ AND CONFIRM: Disqualification Policy *
I confirm the information entered is accurate and I have filled in the registration form above with honesty and integrity. I understand if it is discovered that I have listed false information in order to enter a division I do not qualify for or to mislead my opponents about my experience, I will be disqualified and will receive no refund of monies paid. If it is discovered AFTER competition, any and all titles given will be removed, publicly noted, and I agree to return any awards won including but not limited to, medals, belts, trophies. I will be will not receive a refund of any monies paid. I agree to pay any and all legal fee incurred for the return of my belt if I do not voluntarily return it.
Required
READ AND CONFIRM: Refund Policy *
Once I have paid my registration fee, if I decide to withdraw voluntarily, I forfeit any monies paid. I will submit written proof by military personnel for a refund or credit (my choice) if drop is due to Military involvement. If drop is due to severe, debilitating injury received inside or outside of the gym during normal training and daily activities, I will be issued a credit to be used at a future event if I submit valid documentation from a physician and copies of tests to support the injury such as MRI, Xray or CTScan. If I cannot supply documentation, I will forfeit my registration fee and not receive a credit. If my injury is sustained during a fight that I participated in less than 6 weeks prior to the tournament's dates, I will forfeit any monies paid and will not receive a credit for future use. I understand if I am in a two man bracket and drop under two weeks before the event or do not show up ("no show") that I will receive no refund or credit for any monies paid. I will also be marked as a "No Show" on the website and all paperwork.
Required
READ AND CONFIRM: Single Fighters & Match Ups for 2 man brackets *
Six weeks before tournament date, brackets with no fighters and only single fighters will be closed. A bracket MUST have at least two fighters registered in it to be held open. At this time, the TBA-SA staff will begin adjusting brackets with single fighters, if needed. Your trainer will be contacted to discuss possible changes to ensure you have at least one fight and everyone has sufficient time to make new weight. By completing this registration, the person submitting it agrees to the match ups completed by the TBA-SA staff where matching is needed. If you decide to not participate in the match made, the fighter will be dropped and will not receive a refund. If a fighter has absolutely no option, they will still receive their goody bag, weekend event pass, and a credit for the following year if still attending. If not attending, the fighter has the choice of a credit or refund. No Awards will be awarded without competing in at least one fight. **We reserve the right to combine single and two man brackets to make larger brackets where the fighter's listed 'walking weight' allows for such combined brackets.
Required
READ AND CONFIRM: Transfers *
Prior to the tournament, I understand if I need to transfer to another weight bracket, I will pay a transfer fee of $35. (Complimentary transfers until 3 months before. Please refer to website for exact dates). If I need to go up to a higher division (novice to B, B to A) or the TBA-SA asks me to move, it will be done at no charge to me. At weigh ins, if I cannot make weight and a spot is available in a bracket/division better suited, I can move once all weigh ins have been completed by paying the transfer fee of $50. I understand, if I show up at weigh ins and cannot make weight, I will either have to withdraw and receive no refund, or I will pay the transfer fee of $50 and move into a different bracket. If I have paid my registration fee, am listed as an 'alternate' and show up ready to fight, but I am unable to fight due to my bracket still being full, I may choose to move to an acceptable bracket that still has an opening and willl not be charged the 'transfer fee'.
CONVICTION OF FELONY? *
Has the fighter this registration is being submitted for ever been convicted of a felony? If yes, explain below. **Your answer will be kept confidential and by answering yes, it does not automatically prevent you from attending; each situation will be reviewed individually. A safe environment is our number one priority.
Required
If you answered 'yes' to the above question...
If you answered 'yes' to the above question, please explain. If you prefer a phone call to discuss this, please list your phone number.
Your answer
READ AND CONFIRM: Public Release *
I confirm I am an adult over the age of 18 years, or the parents of the junior fighter registered, and have completed the above registration for either myself or my minor child. I give permission to the Thai Boxing Association-Sanctioning Authority, RoundKick Promotions LLC and Pam & Pete Peterson to publicly post my name, my registration form information, any photos or likeness supplied by me, captured by an event photographer/attendee and/or taken at a TBA-SA sanctioned event. ALL of the listed may be used, with my permission, on their website, on their social media pages, and/or on marketing materials and in advertisements.
Submission Name *
Name of person submitting this form. If not the competitors, please list the relationship after your name.
Your answer
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