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Registration
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Details
NSW PCYC Campbelltown
Sat 07 Dec 2024 09:00 — 17:00
Campbelltown PCYC, 95 Minto Rd, Minto NSW 2566
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Basic details
First name*
Last name*
Phone number*
Email address*
Address*
Additional information
Date of Birth*
Weight*
Experience (WIN/LOSS)*
Name of Coach and mobile and email*
Club or gym you are from*
Boxing NSW registered*
YES
NO
Combat Sports registered*
YES
NO
Fight Experience win-losses*
Fights in other combat sports MMA-Kickboxing etc*
I am over 18, or, if I am under 18, this registration has been filled out by and endorsed by my parent or guardian.*
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