Information Form

SECTION I. Personal Information

Last : ___________________________________________

Name : ___________________________________________

Address : ___________________________________________

Telephone : _________________

Date of Birth : ____/____/____

SECTION II. Training Information

School : ___________________________________________

Instructor Name : _________________

Address : ___________________________________________

Telephone : _____________________

Website : _____________________

SECTION III. Fighter Information

First Name : _____________________

Country : ___________________

City : ___________

Zip : ____________

Email Address : ______________________________

Gender : ____________

Height : ____________ Weight: ___________

Yrs. of Exp. : ________________ Styles: ___________________

**By signing this form, the registrant contests that all information provided is correct and true to
their knowledge. If incorrect, the participant agrees to forfeit their participation in this event on
prior to, on, or thereafter this event.
 Purse Agreement Form

Promoter shall pay Fighter and Fighter shall accept a purse in the amount of

MYR 250 for the WIN money

MYR 250 for LOSE money
MYR 250 for the WIN bonus

Additional expense:

TRAVEL ALLOWANCE 100 to 200 ONLY

If the Fighters scheduled opponent to participate does not occur, the Promoter agrees to pay:

MYR 200 ONLY

If a CATCHWEIGHT bout are scheduled and both fighters agreed, the contract will be deemed
to as follows:

Fighter made weight:

MYR 250 for the WIN money + 15%

MYR 00 for the LOSE money + 15%
MYR 250 for the WIN bonus

Fighter did not made weight:

MYR 250 for the WIN money 15%

MYR 250 for the LOSE money 15%
MYR 250 for the WIN bonus -15%

If the CATCHWEIGHT bout are NOT AGREEABLE, the contract will be deemed as to follows:

Fighter made weight:

 Guaranteed MYR 200 ONLY

Fighter did not make weight:

Disqualified with NO AMOUNT payable by the promoter

If the Fighter has AGREED and ACCEPTED the offer made by the Promoter and is found guilty
of pulling out of the fight and against the contract, the Fighter will be banned from Ultimate
Beatdown Fight League events unless legitimate evidence is produced to support the reason for
pulling out the bout.

Liability Waiver Form

I, the undersigned (Participant), knowingly and without duress, do voluntarily submit my entry
for participation in Ultimate Beatdown-21 (the Event) sponsored by Ultimate Beatdown Sdn
Bhd (the Organizers).

I know the nature of the event(s) and my own Experience and Capabilities, and, I Believe, I
am Qualified to participate in the Event(s). I will inspect the Premises, Facilities, and Equipment
to be used and that I may come into contact with. If I believe anything or unsuitable or unsafe I
will immediately inform the organizers. If they do not deal with the situation to ensure my safety I
reserve the right to withdraw from the event. I accept I may forfeit any payments due.
I FULLY UNDERSTAND that: (a) THE ACTIVITIES OF THE EVENT(S) CAN BE DANGEROUS
and participation in the Event(s) involve risks and dangers or serious bodily injury, including
Permanent disability, paralysis and death (RISKS); (b) these risks and dangers may be caused
by my own actions or inactions, the actions or inactions of others participating in the Event(s),
the rules of the Event(s), the condition and layout of the premises and equipment, or the
NEGLIGENCE OF THE RELEASES named below; (c) there may be other risks not known to
me or that are not readily foreseeable at this time; (d) the social and economic losses and/or
damages that could result from those risks could be sever and could permanently change the
participants future.

I CONSENT to participation in the Event(s) AND HEREBY ACCEPT AND ASSUME ALL SUCH
RISKS, KNOWN, AND UNKNOWN, AND ASSUME ALL RESPONSIBILITY FOR THE LOSSES,
COSTS, AND/OR DAMAGES FOLLOWING SUCH AN INJURY, DISABILITY, PARALYSIS OR
DEATH, EVEN IF CAUSED, IN WHOLE OR IN PART, BY THE NEGLIGENCE OF THE
RELEASES NAMED BELO I CERTIFY THAT I AM OVER THE AGE OF EIGHTEEN (18). I
HAVE READ THIS CONSENT RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF
RISK, AND INDEMNITY AGREEMENT, UNDERSTAND THAT BY SIGNING IT I GIVE UP
SUBSTANTIAL RIGHTS I AND/OR THE MINOR PARTICIPANT MIGHT OTHERWISE HAVE TO
RECOVER DAMAGES FOR LOSSES OCCASSIONED BY THE RELEASES FAULT, AND
SIGN IT VOLUNTARILY AND WITHOUT INDUCEMENT.

____________________________ ____________________________

Signature of Participant Signature of Promoter

____________________________ ____________________________

Printed Name Printed Name

Date: _____/______/______ Date: _____/______/______

________________________________

Signature of Second Parent or Guardian

________________________________

Printed Name

Date: ______/______/_______