Sud'N Impact Gym

Contact Us: (260) 602-7039

Fighter Application

First Name *

Last Name *

Address

Street Address *

City *

State *

Country *

Postal code *

Phone *

Email *

Date of birth *

Age on April 5th, 2025 *

Name of Gym, Team, or Fight Group? *

Main Coach or Contact Representing Fighter? *

Gym or Coach Phone Number? *

Have you fought on Impact Entertainment Promotions Before? *

Yes

No

Emergency Contact First Name *

Emergency Contact Last Name *

Years in Martial Arts Training? *

Less than a year

1 Year

2 Years

3 Years

Boxing Record? *

MMA Record? *

Kickboxing Record? Including Muay Thai Fights. *

Fight Shorts Color(s)? *

Fight Name *

Fight Weight *

Walk out song? Has to be Clean!! *

FIGHTER PICTURE! PLEASE READ INSTRUCTIONS!!

Some rules of thumb for a good fighter picture! Make sure your entire head is visible and at least your entire torso. Taking pictures from above eye level will make you look small, stick to around chin to chest height. Pose! Don't slouch or look weak, you're a fighter! Please have good enough lighting where we can see your face and you're not in a dark room. Have a higher resolution picture please.

Fighter Picture *

By signing this form I agree to the following: To participate in a physical fitness evaluation and training program being instructed (conducted) by David Hernandez, Sud’n Impact Gym LLC and or some of Sud’n Impacts Instructors. Risks: I recognize that fighting carries some or many risk and hazards to musculoskeletal (sprains, strains), also to some organs and cardio respiratory system, like dizziness, discomfort in breathing, and heart attack or death. I hereby certify that I know of no medical or mental problem or limitations (physical restrictions), which would increase my risk of illness or injury as a result of participating in a martial arts competition offered by Sud’n Impact Gym LLC and Impact Entertainment. Accident and Injuries: It is further agreed that all physical activity in this competition shall be undertaken by me at my sole risk and that David Hernandez, Sud’n Impact Gym LLC, Impact Entertainment and any employees or affiliates shall not and will not be held responsible for any injuries or medical bills arising from training and recommended services. I do hereby forever release and discharge David Hernandez, Sud’n Impact Gym LLC and Impact Entertainment from all claims, damages, actions, causes, and will be liable for any claims, damages, actions, or causes of actions, whatsoever to me for all active and negligence on the part of such activities I will attend. I also understand that when participating in any martial arts or other kind of fight training or self-defense that the possibility of injury may and will be greatly increased and will hold myself solely responsible for any injury or discomfort. I will hold David Hernandez and Sud’n Impact Gym LLC harmless against lawsuits that I may incur to myself or others as a result of using any techniques learned. As a minor or 17 years or younger of age my legal guardian or parent will take full responsibility of all liability and any injuries that may be caused at this event (Kickboxing fight). I have been advised to consult a physician before starting any training program with such said trainer. I have read, understand, comprehend, and agree to the above conditions. By signing this consent, I understand that I am personally and financially responsibility. By signing this form you acknowledge that you (as the fighter or guardian of the fighter) understand and comprehend all special condition. *

Clear

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Contact Us: (260) 602-7039

JOIN MY FREE PRIVATE FB GROUP

Liberate yourself from the all or nothing dieting cycle. Unlock the secrets to a healthier lifestyle with our expert tips, tantalizing recipe ideas, and efficient 45-minute workouts. Overpower the mental battles that hindered your progress, and triumph over your goals every week on our FB lives!

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