Roster Information Form
Please complete the following information if you would like to submit a roster for the upcoming LBC event.
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Email *
LBC Event Date *
MM
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DD
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YYYY
Coach's Name *
Coach's Contact Number *
Registered USA Boxing Gym Name or Unattached *
Athlete's Name (No nicknames) *
Athlete's Date -of-Birth  *
MM
/
DD
/
YYYY
Athlete's Age *
Athlete's Weight *
Number of Bouts *
USA Boxing Registration ID# *
A copy of your responses will be emailed to the address you provided.
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