Which fields do you want to share across all registrants?

• New/Renewing Member
• Last Name
• Date of Birth
• Profile Photo
• Street Address
• Address 2
• City
• Province/Territory/State
• Country
• Postal Code
• Individual Email
• Phone Number
• Phone Number 2
• Emergency Contact Name
• Emergency Contact Relationship
• Emergency Contact Phone
• Parent/Guardian Name
• Parent/Guardian Relationship
• Parent/Guardian Phone
• Parent/Guardian Email
• Indigenous
• Military
• Law Enforcement
• Need Boxing Book
• Do you self-identify as a person with a disability?
• If yes, please indicate the type(s) of disability you have
• Medical Form - Download here, fill out and then upload
• Annual Medical Date
• NCCP #
• Coach Level
• Please upload a criminal reference check and vulnerable sector check completed in the last 3 years
• Date of criminal record check
• Official Level
• Citizenship
• New Applicant or Renewal
• What is your gender identity
• Amateur Bouts
• Wins
• Previous or current involvement in amateur Boxing, Kickboxing , Judo or any combat sport in or out the country?
• If yes, # Bouts
• # Wins
• # KO
• # RSCH
• If yes, please explain (*Note, it is important to list previous or current experience to create fair matches)
• Weight (kg)
• I understand I must complete Safe Sport Training, Respect in Sport & Making Head Way before my membership can be processed
• Referee/Judge
• Proof of Age Document (accepted documents include: Birth Certificate, Passport or Health Card)
• CONSENT FOR USE OF PERSONAL INFORMATION, COMMERCIAL MESSAGES AND PHOTO RELEASE
• CONCUSSION CODE OF CONDUCT
• ASSUMPTION OF RISK AGREEMENT
• WAIVER OF LIABILITY FOR ALL CLAIMS AND RELEASE OF LIABILITY
• Boxing Canada Waiver and Release of Liability
• Boxing Canada Code of Conduct & Ethics
• Cancel