Register For the NBF's 'Road to Los Angeles 2028" ROAD TO LA 2028 REGISTRATION FORMPlease enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Personal Details *FirstMiddleLastDate of Birth *Gender *FemaleMalePhone Number *Home Address *Address Line 1CityState / Province / RegionAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryResidential Details OnlyEmail Address *EmailConfirm EmailPassport Number / National Identity Number (NIN) *Nationality/Origin *Address Line 1CityState / Province / RegionNationality / OriginAge Category *Elite (19 - 40 years)Under 19 (17-18 years)Under 17 (15-16 years)Elite Weight Categories (Men) 19-40 years *47 - 50 (kg) - Flyweight50 - 55 (kg) - Bantamweight55 - 60 (kg) - Lightweight60 - 65 (kg) - Welterweight65 - 70 (kg) - Light Middleweight70 - 75 (kg) - Middleweight75 - 80 (kg) - Light Heavyweight80 - 85 (kg) - Cruiserweight85 - 90 (kg) - Heavyweight90+ (kg) - Super HeavyweightElite Weight Categories (Women) 19-40 years *45 - 48 (kg) - Light Flyweight48 - 51 (kg) - Flyweight51 - 54 (kg) - Bantamweight54 - 57 (kg) - Featherweight57 - 60 (kg) - Lightweight60 - 65 (kg) - Welterweight65 - 70 (kg) - Light Middleweight70 - 75 (kg) - Middleweight75 - 80 (kg) - Light Heavyweight80+ (kg) - HeavyweightUnder 19 Weight Categories (Men) 17-18 years *47 - 50 (kg) - Flyweight50 - 55 (kg) - Bantamweight55 - 60 (kg) - Lightweight60 - 65 (kg) - Welterweight65 - 70 (kg) - Light Middleweight70 - 75 (kg) - Middleweight75 - 80 (kg) - Light Heavyweight80 - 85 (kg) - Cruiserweight85 - 90 (kg) - Heavyweight90+ (kg) - Super HeavyweightUnder 19 Weight Categories (Women) 17-18 years *45 - 48 (kg) - Light Flyweight48 - 51 (kg) - Flyweight51 - 54 (kg) - Bantamweight54 - 57 (kg) - Featherweight57 - 60 (kg) - Lightweight60 - 65 (kg) - Welterweight65 - 70 (kg) - Light Middleweight70 - 75 (kg) - Middleweight75 - 80 (kg) - Light Heavyweight80+ (kg) - HeavyweightUnder 17 Weight Category (Boys) 15-16 years *44 - 46 (kg) - Pin weight46 - 48 (kg) - Light Flyweight48 - 50 (kg) - Flyweight50 - 52 (kg) - Light Bantamweight52 - 54 (kg) - Bantamweight54 - 57 (kg) - Featherweight57 - 60 (kg) - Lightweight60 - 63 (kg) - Light Welterweight63 - 66 (kg) - Welterweight66 - 70 (kg) - Light Middleweight70 - 75 (kg) - Middleweight75 - 80 (kg) - Light Heavyweight80+ (kg) - HeavyweightUnder 17 Weight Category (Girls) 15-16 years *44 - 46 (kg) - Pin weight46 - 48 (kg) - Light Flyweight48 - 50 (kg) - Flyweight50 - 52 (kg) - Light Bantamweight52 - 54 (kg) - Bantamweight54 - 57 (kg) - Featherweight57 - 60 (kg) - Lightweight60 - 63 (kg) - Light Welterweight63 - 66 (kg) - Welterweight66 - 70 (kg) - Light Middleweight70 - 75 (kg) - Middleweight75 - 80 (kg) - Light Heavyweight80+ (kg) - HeavyweightFullname of Coach *FirstMiddleLastDo you belong to a Boxing Club *YesNoName of Boxing Club *Have you fought professionally *YesNoNumber of Professional Fights *Parents/Guardian(If Applicable)Name of ParentContact Number of ParentNext of Kin Age years of Name of Next of Kin *Contact Number of Next of Kin *Relationship with Next of Kin *IndemnityI, (above named) agree to indemnify, defend, and hold harmless the Nigeria Boxing Federation, their affiliates, and staff from any and all claims, damages, or liabilities arising out of my involvement in the Road to LA 2028 programme, including any injuries sustained or caused by me during the course of this programme. By signing below, you acknowledge that you understand and accept the risks involved in participating in this programme.Indemnity *Yes, I agreeI, (above named) agree to indemnify, defend, and hold harmless the Nigeria Boxing Federation, their affiliates, and staff from any and all claims, damages, or liabilities arising out of my involvement in the Road to LA 2028 programme, including any injuries sustained or caused by me during the course of this programme.Signature * Clear Signature Submit
