For consideration please complete the information below.

Name: Phone:		E-mail address: Confirm E-mail:

Fight Record: Win / Lose / Draw

Please provide a detailed bio of yourself:		Enter any additional questions or comments in the area below:

If you wish, you can also attach up to three images as part of your application.
Accepted formats are JPEGs, GIFs and BMPs.

Terms and Conditions By submitting my likeness, I hereby grant XFAlive.com and Reis Sports Entertainment, LLC, an irrevocable license to use my likeness now or at any time in the future, throughout the world in any manner it so chooses and in any medium now known or later developed. This includes, without limitation, use on XFAlive.com and Reis Sports Entertainment, LLC, TV, cable, magazine advertisements, corporate brochures and any other promotional material it wishes. I acknowledge that XFAlive.com and Reis Sports Entertainment, LLC, are under no obligation to use my likeness. I agree that there are no fees, commissions or royalties paid to me for the use of my likeness. I acknowledge and agree that I have the exclusive right and authority to grant this license to use my likeness.

I have read and accept the above terms.