EmailMe Form - Sugar Bert Boxing International Boxer Registration

Are you an International Boxer? *

Yes

No

This registration is only for boxers who do NOT live in the United States. Do you live in the United States? *

Yes

No

Boxers in the United States MUST register at USA Boxing. Please click this link to register.

USA Boxing Registration link for Sugar Bert Boxing Tournament

Event *

Youngsville, LA -- May 26th-29th

Punta Gorda, FL -- June 9th-12th

Harlingen, TX -- October 6th-9th

Email *

Gender *

International Passbook ID

Country *

Name *

First Last

Home Phone

### - ### - ####

Mobile Phone *

### - ### - ####

Date of Birth *

MM / DD / YYYY

Age *

Weight *

Number of Bouts *

Coaches Name

Coaches Phone

### - ### - ####

Do you have a fever or have you felt hot or feverish recently (14-21 days)? *

Are you having shortness of breath or other difficulties breathing? *

Do you have a cough? *

Any other flu-like symptoms, such as gastrointestinal upset, headache, or fatigue? *

Have you had any loss of smell or taste recently? *

Are you in contact with any confirmed COVID-19 positive patients? *

Is your age over 60? *

Do you have heart disease, lung disease, kidney disease, diabetes, or any auto-immune disorders? *

Have you traveled in the past 14 days to any regions or countries affected by COVID-19? ( as relevant to your location) *

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