Nominate - Adults — Siam 2 Sydney Muaythai

All fighters are required to complete the form below prior to weigh in. Once this form is complete, please click on the link to sign the waiver. No fighters will be able to compete without reading / completing / signing both.

Which show are you fighting on?

S2S 18 Adult Development Day (Padded)

S2S 18 Adult Pro/Am

Name

First Name

Last Name

Name as it will appear on the fight card - leave blank if the same

First Name

Last Name

Age

Weight Division

Fight Name (if any)

Gym Name

Trainer's Name

First Name

Last Name

Fight Record

Total - Win - Loss - Draw - KO

Titles Won

Only include major titles E.g WMC, MTA, WBC or major stadium titles (Thailand)

Instagram Profile

Siam 2 Sydney Waiver

Warning: This is an important document which affects your legal rights and obligations. Read it carefully and do not sign it unless you are satisfied that you understand it. If you have any questions, please ask the promoter. Promoter: Andrew Parnham TA/ PTJ Muaythai Gym: including any aspect of participation in a Siam 2 Sydney Event. PROCESSES AND PROCEDURES REGARDING THE EVENT I hereby mutually agree that: • I will be prompt in attendance to the Official weigh that shall be held at time allocated and at a venue of the promoter’s choice and. • If overweight the Boxer will be allowed one hour to make the limit. If, after the one-hour period, the Boxer is still overweight then the Promoter shall have the right to cancel the bout or may impose a weight penalty to the overweight boxer. • The Boxer agrees to arrive at the venue no less than one hour before the advertised starting time of the promotion for medical check-up and briefing. • The Promoter shall provide the gyms with three (3) Officials passes to the event. That being, Boxer (s), 1 Trainer and 1 corner men. No plus one’s. • I agree to adhere to all of the COVID 19 processes in place for the event. • I do not have any cold or flu like symptoms and I have not been advised to self isolate or quarantine by any of the relevant authorities. • In the event that Promoter and Boxer have any disagreement, both Promoter and Boxer understand and accept in good faith to be bound by the Rules and Regulations of the NSW Combat Sports Authority or Muaythai Australia under which this contest shall be conducted. WARNING AND ACKNOWLEDGEMENT OF RISKS, INJURY AND OBLIGATIONS I acknowledge that the activity I am to undertake is a dangerous recreational activity that may involve a significant risk of physical harm (the “activity”) and that by participating in it I am exposed to certain risks. I further acknowledge that I am not required to engage in the activity. I acknowledge and understand that whilst participating in such activity: • I may be injured, physically or mentally, or may die. • Other persons participating in such activity may cause me injury. • I assume the risk and responsibility for any injury, death or property damage resulting from my participation in the activity. RELEASE OF INDEMNITY TO THE PROMOTER In consideration of my payment or participating in the activity (and except to the extent that the same may be precluded by statute), I agree to release and indemnify the Promoter as follows: 1. I participate in the activity at my own risk and responsibility. 2. I release, indemnify and hold harmless the Promoter, its servants and agents, from and against all and any actions or claims which may be made by me or on my behalf or by other parties for or in respect of or arising out of any injury, loss, damage or death caused to me or my property whether by negligence, breach of contract or in any way whatsoever or any liability that results from the breach of an express or implied warranty that the recreational services or activity will be rendered with reasonable care or skill. 3. In the event that I am injured, or my property is damaged, I will bring no claim, legal or otherwise, against the Promoter in respect of that injury or damage. 4. The Promoter shall hold all intellectual property rights and any other rights in the name, autograph, voice, picture, videotape, radio and television broadcast, image and character of the Boxer when involved or associated with this contest. Before signing this document, I have read and understood it and know that it affects my legal rights.

I have read and understood it and know that it affects my legal rights and I agree.