champ-2000-form

	UNITED STATES NATIONAL CHAMPIONSHIPS SERIES USMTA the Official governing organization for American Muay Thai Official member of the WAMTO, WMTC, WMTF, AMTAT
OFFICIAL MUAY THAI - FIGHTERS REGISTRATION FORM I Name:________________________________ Last Name:______________________________ Address:_____________________________ _________________________________________ City:________________________________ Street____________________________________ State:__________________ City:_________________________ P. Code:_________________
Personal Information Color of hair: ________________________ Color of Eyes:_______________________ *Blood Group : (if known)* _____________ Birth Marks (if any) :__________________ Tattoo's: (if any): ____________________**		Professional Information Telephone( work) :______________________ Telephone: (home): _____________________ Email Address: ( 1 ) ______________________ Email Address: ( 2 )_______________________ *Internet Address: (if any):__________________*
(please pin photo's on this page) PASSPORT PHOTO'S ( 2 )		CHECK LIST OF ITEMS TO BE SENT A.) Two Passport sized photo's B.) Video of training etc. last bout C.) Short bio on yourself D.) Check Money Order for $12.00
Signed by: ________________________________ Dated: _____________________________
NOTE * Please note, fighters photographs and videos cannot be returned, The $15 dollar registration fee is non refundable. all retained information will be used for database and website information and other promoters

	UNITED STATES NATIONAL CHAMPIONSHIPS SERIES USMTA the Official governing organization for American Muay Thai Official member of the WAMTO, WMTC, WMTF, AMTAT
OFFICIAL MUAY THAI - FIGHTERS REGISTRATION FORM II Male. [ ] Female. [ ] Age_____ Height_____ Weight: ( lbs - lbs) - ( Kgs - Kgs ) Name of Gym/Camp:___________________________________________________________ Address:______________________________________________________________________ City:________________________________ Street____________________________________ State:__________________ City:__________________________ P.Code:_________________ Trainer / Coach: _______________________________________________________________ Association/Organization: ______________________________________________________
Amateur Record (Muay Thai only) WIN: _______ DRAW: ________ LOSS:______ National:______________________________ Regional:_____________________________ State:________________________________ Inter-Continental:_______________________ International:__________________________ World:________________________________			Professional Record (Muay Thai only) WIN: _______ DRAW: ________ LOSS:______ National:______________________________ Regional:_____________________________ State:________________________________ Inter-Continental:_______________________ International:__________________________ World:________________________________
Office use only: Registration No.___________________
The United States Muay Thai Association is the official U.S. representative of the World Muay Thai Council and the Amateur Muay Thai Association of Thailand, members of the Sports Organization of Thailand, World Amateur Muay Thai Organization. All bouts fought on European soil will be under the Rules and Regulations of the EMTU. International bouts will be recognized if the competing countries are registered members of the WMTC. All USMTA fighters must abide by the rules and regulations of the USMTA By completing this form I have agreed to come under the protection of the USMTA and will pay the standard $12 dollar registration fee.
RETURN		CHAMPIONSHIP AWARDS		PROMOTERS