WKF (WORLD KICKBOXING FEDERATION LIMITED) Serology Testing for WKF Professional & Amateur Combatants, updated 16/03/2017.
WKF WORLD KICKBOXING FEDERATION
Serology Testing for
Professional & Amateur Combatants
Medical Practitioner to Complete
A person is not eligible to be registered or have their registration renewed if the Certificate of Fitness is not accompanied by a negative serology test result for that person that is less than one month old.
Combatant’s Name:____________________________________________________________
Combatant’s Address:
__________________________________________________________________________
Whom I identified from: NB: The Combatant must provide at least one of these forms of photo identification for the WKF – World Kickboxing federation to accept the tests.
- a) Photo Drivers License No: ___________________Country:____________________
- b) Photo in Medical Record Book of Combatant No: __________________________
- c) Photo Passport No: ___________________Country of Issue_________________
- d) National I.D. Photo Card
Presented themselves for:-
A HIV test and the result of the test carried out is that the above named person is: (tick as appropriate)
Classified as HIV negative:-
A Hepatitis test, the result of the test carried out is that the above named person is Classified:
Hepatitis “B” Antigen Negative or Immune Status
Hepatitis “C” Negative
Other Comments:
___________________________________________________________________
RELEASE OF INFORMATION – Combatant to Complete
I _________________________________________(Combatant’s name) hereby authorise the release of these results of the tests set out above and any further information required to the WKF (World Kickboxing federation) Officers that assist administer the Act.
Signature of Combatant : _______________________________________________
Signature of Doctor:___________________________________________________
Registration No: _________________Stamp:___________________Date ____/____/_____
