Athlete Application pay outs for submission wins:blue/purple - $75brown/black- $150 Name * First Name Last Name Weight (lbs) * 70-85 86-100 101-115 116-130 131-145 146-160 160-170 171-180 181-190 191-200 201-215 216-230 231+ Belt Rank * White Grey Yellow Orange Green Blue Purple Brown Black Years Training Gender * Male Female Birthday (AGE) * MM DD YYYY Match Preference NO GI GI NO PREFERENCE Phone * (###) ### #### Email * Gym & Affiliation * Facebook Name Instagram Handle Checkbox * by checking this box, you accept that if chosen for an invitational match you must sell at least three general admission tickets or pay the $100 registration fee to compete Accept Thank you for submitting an athlete application for Grappler’s Den!