If you are a member, log in for a faster registration. Or, continue as a guest below.

Details

NSW PCYC Campbelltown

Date TBA

Are you attending this event?

Yes No Maybe

First name*

Last name*

Phone number*

Email address*

Address*

Date of Birth*

Boxer Contact Number*

Boxer Contact Email*

Weight*

Experience (WIN/LOSS)*

Name of Coach*

Coach Contact Number*

Affiliated Gym*

Boxing NSW registered*

YES

Combat Sports registered*

YES

I am over 18, or, if I am under 18, this registration has been filled out by and endorsed by my parent or guardian.*