Professional Boxing and Combat Sports Amendment Regulations 2013

Authorised by the Chief Parliamentary Counsel Authorised Version i Professional Boxing and Combat Sports Amendment Regulations 2013 S.R. No. 154/2013 TABLE OF PROVISIONS Regulation Page 1 Objective 1 2 Authorising provision 1 3 Principal Regulations 1 4 Definitions 2 5 Regulation 5 substituted 2 5 Promoter's licence 2 6 Promotion permit 3 7 Division 2 of Part 2 heading amended 3 8 Regulation 7 substituted 4 7 Licence to act as a trainer, match-maker, referee, judge or timekeeper 4 9 Regulation 11 revoked 7 10 Conduct at promotions 7 11 Forms 1 to 7 in Schedule substituted 7 Form 1—Application for Promoter's Licence 7 Form 2—Application for a Promotion Permit 10 Form 3—Application for Licence as Trainer, Match-maker, Referee, Judge or Timekeeper 13 Form 4—Application for Registration as a Professional Contestant 16 Form 5—Certificate of Fitness 19 Form 6—Professional Contest-related Medical Examination 20 Form 7—Blood Testing 22 12 Form 9 in Schedule substituted 23 Form 9—Results of Medical Test Required by Board 23 ═══════════════ ENDNOTES 25 -- 1 of 26 -- Authorised by the Chief Parliamentary Counsel Authorised Version 1 STATUTORY RULES 2013 S.R. No. 154/2013 Professional Boxing and Combat Sports Act 1985 Professional Boxing and Combat Sports Amendment Regulations 2013 The Governor in Council makes the following Regulations: Dated: 3 December 2013 Responsible Minister: HUGH DELAHUNTY Minister for Sport and Recreation YVETTE CARISBROOKE Clerk of the Executive Council 1 Objective The objective of these Regulations is to amend the Professional Boxing and Combat Sports Regulations 2008 as a consequence of the enactment of the Professional Boxing and Combat Sports Amendment Act 2013 and to make other miscellaneous amendments. 2 Authorising provision These Regulations are made under section 22 of the Professional Boxing and Combat Sports Act 1985. 3 Principal Regulations In these Regulations, the Professional Boxing and Combat Sports Regulations 20081 are called the Principal Regulations. -- 2 of 26 -- S.R. No. 154/2013 Professional Boxing and Combat Sports Amendment Regulations 2013 2 Authorised by the Chief Parliamentary Counsel 4 Definitions Insert the following definition in regulation 4 of the Principal Regulations— "National Police Certificate means a certificate issued by Victoria Police or CrimTrac in respect of a person specifying the criminal history of the person;". 5 Regulation 5 substituted For regulation 5 of the Principal Regulations substitute— "5 Promoter's licence (1) For the purposes of section 6(2)(a) of the Act, the prescribed form of application for a licence to act as a promoter, or the renewal of a licence to act as a promoter, is Form 1 in the Schedule. (2) For the purposes of section 6(2)(b) of the Act— (a) the prescribed fee for an application under subregulation (1) is $225; and (b) the prescribed certificate for an application under subregulation (1) is a National Police Certificate in respect of the applicant issued no more than 3 months before the date of the application. (3) For the purposes of section 6(3)(c) of the Act, the prerequisites for the issue of a licence to act as a promoter are that the applicant has appropriate knowledge of the following— (a) the Act and these Regulations; (b) any relevant rules made under section 23 of the Act; r. 4 -- 3 of 26 -- S.R. No. 154/2013 Professional Boxing and Combat Sports Amendment Regulations 2013 3 Authorised by the Chief Parliamentary Counsel (c) any conditions to which the licence would be subject if issued. (4) For the purposes of section 6(4)(c) of the Act, the prerequisites for the renewal of a licence to act as a promoter are that the applicant has appropriate knowledge of the following— (a) the Act and these Regulations; (b) any relevant rules made under section 23 of the Act; (c) any conditions to which the renewal of the licence would be subject if renewed. (5) For the purposes of section 6(6)(c) of the Act, the prescribed matters for consideration by the Board for the issue or renewal of a licence to act as a promoter are— (a) whether the applicant is an insolvent under administration; and (b) whether the applicant is disqualified from managing a corporation under the Corporations Act; and (c) any information relating to the criminal history of the applicant contained in the National Police Certificate accompanying the application.". 6 Promotion permit Regulation 6(2)(e) of the Principal Regulations is revoked. 7 Division 2 of Part 2 heading amended In the heading to Division 2 of Part 2 of the Principal Regulations, for "and judges" substitute ", judges and timekeepers". r. 6 -- 4 of 26 -- S.R. No. 154/2013 Professional Boxing and Combat Sports Amendment Regulations 2013 4 Authorised by the Chief Parliamentary Counsel 8 Regulation 7 substituted For regulation 7 of the Principal Regulations substitute— "7 Licence to act as a trainer, match-maker, referee, judge or timekeeper (1) For the purposes of section 6(2)(a) of the Act, the prescribed form of application for a licence to act as a trainer, match-maker, referee, judge or timekeeper, or the renewal of a licence to act as a trainer, match-maker, referee, judge or timekeeper is Form 3 in the Schedule. (2) For the purposes of section 6(2)(b) of the Act— (a) the prescribed fee for an application under subregulation (1) to act as— (i) a trainer is $70; or (ii) a match-maker is $70; or (iii) a referee is $100; or (iv) a judge is $50; and Note A fee has not been prescribed for a licence to act as a timekeeper. (b) the prescribed certificate for an application under subregulation (1) is a National Police Certificate in respect of the applicant issued no more than 3 months before the date of the application. (3) For the purposes of section 6(3)(c) of the Act, the prerequisites for the issue of a licence to act as a trainer, match-maker, referee, judge or timekeeper are as follows— r. 8 -- 5 of 26 -- S.R. No. 154/2013 Professional Boxing and Combat Sports Amendment Regulations 2013 5 Authorised by the Chief Parliamentary Counsel (a) that the applicant has appropriate knowledge of the following— (i) the Act and these Regulations; (ii) any relevant rules made under section 23 of the Act; (iii) any conditions to which the licence would be subject if issued; (b) for the purposes of an application for a trainer's licence—that the applicant has a current First Aid certificate; (c) for the purposes of an application for a match-maker's licence—that the applicant has sufficient experience in the industry as a trainer, contestant or promoter and has a good knowledge of professional contestants and their relative skills; (d) for the purposes of an application for a referee's, judge's or timekeeper's licence—that the applicant has adequate eyesight (whether natural eyesight or with the aid of glasses or contact lenses) to act as a referee, judge or timekeeper at a promotion. (4) For the purposes of section 6(4)(c) of the Act, the prerequisites for the renewal of a licence to act as a trainer, match-maker, referee, judge or timekeeper are as follows— (a) that the applicant has appropriate knowledge of the following— (i) the Act and these Regulations; r. 8 -- 6 of 26 -- S.R. No. 154/2013 Professional Boxing and Combat Sports Amendment Regulations 2013 6 Authorised by the Chief Parliamentary Counsel (ii) any relevant rules made under section 23 of the Act; (iii) any conditions to which the licence would be subject if renewed; (b) for the purposes of an application for the renewal of a trainer's licence—that the applicant has a current First Aid certificate; (c) for the purposes of an application for the renewal of a match-maker's licence—that the applicant has sufficient experience in the industry as a trainer, contestant or promoter and has a good knowledge of professional contestants and their relative skills; (d) for the purposes of an application for the renewal of a referee's, judge's or timekeeper's licence—that the applicant has adequate eyesight (whether natural eyesight or with the aid of glasses or contact lenses) to act as a referee, judge or timekeeper at a promotion. (5) For the purposes of section 6(6)(c) of the Act, a prescribed matter is any information relating to the criminal history of the applicant contained in the National Police Certificate accompanying the application. (6) A licence to act as a referee also authorises the person who holds the licence to act as a judge. Note A licence to act as a judge does not authorise the person who holds the licence to act as a referee. r. 8 -- 7 of 26 -- S.R. No. 154/2013 Professional Boxing and Combat Sports Amendment Regulations 2013 7 Authorised by the Chief Parliamentary Counsel (7) A licence to act as a referee or judge also authorises the person who holds the licence to act as a timekeeper. Note A licence to act as a timekeeper does not authorise the person who holds the licence to act as a referee or judge.". 9 Regulation 11 revoked Regulation 11 of the Principal Regulations is revoked. 10 Conduct at promotions In the note at the foot of regulation 18 of the Principal Regulations, for "Sections 9" substitute "Sections 9A". 11 Forms 1 to 7 in Schedule substituted For Forms 1, 2, 3, 4, 5, 6 and 7 in the Schedule to the Principal Regulations substitute— "Regulation 5 FORM 1 Professional Boxing and Combat Sports Act 1985 APPLICATION FOR PROMOTER'S LICENCE Applicant details: Name: Address: Postal address: Business telephone: Mobile: Email: Date of birth: r. 9 -- 8 of 26 -- S.R. No. 154/2013 Professional Boxing and Combat Sports Amendment Regulations 2013 8 Authorised by the Chief Parliamentary Counsel 1. Have you previously held a Promoter's Licence, in Victoria or elsewhere? *YES/NO 2. Please provide details of your experience in promoting or assisting in promoting: 3. Are there any matters the Board should consider for the purposes of determining whether you are a fit and proper person to hold a promoter's licence? *YES/NO If YES, please provide details: [Your name will be checked against the registers administered by the Australian Securities and Investments Commission and the National Personal Insolvency Index for the purposes of determining whether you are a fit and proper person to hold a licence.] 4. Do you consent to the Board providing your contact details to other licensed individuals for the purposes of organising professional boxing and combat sports promotions? *YES/NO 5. I agree to be bound by the conditions attached to this promoter's licence, if approved. 6. I enclose evidence of my identity (such as a certified copy of my driver's licence or other government-issued photographic identification). 7. I attach a National Police Certificate. [The attached National Police Certificate must be issued no more than 3 months before the date of this application.] Signature: Date: NOTES: Applicants may be required to submit such further information as is considered necessary for the issue or renewal of a licence. Under section 6 of the Professional Boxing and Combat Sports Act 1985, before issuing or renewing a licence to an applicant to act as a promoter, the Board must be satisfied that the applicant is a fit and proper person to hold such a licence and that it is not contrary to the public interest to issue or renew the licence. A copy of this application will be given to the Chief Commissioner of Police under section 6A of the Professional Boxing and Combat Sports Act 1985. r. 11 -- 9 of 26 -- S.R. No. 154/2013 Professional Boxing and Combat Sports Amendment Regulations 2013 9 Authorised by the Chief Parliamentary Counsel The licence fee for a promoter is $225. Payable by: Cheque Money Order Credit card/Debit card NOTE: Cash payment is not accepted. *Cross out whichever is not applicable. __________________ r. 11 -- 10 of 26 -- S.R. No. 154/2013 Professional Boxing and Combat Sports Amendment Regulations 2013 10 Authorised by the Chief Parliamentary Counsel Regulation 6 FORM 2 Professional Boxing and Combat Sports Act 1985 APPLICATION FOR A PROMOTION PERMIT Applicant details: y Name: y Telephone: 1. Details of proposed promotion y Date: y Venue: y Time doors will be opened: y Time promotion will start: 2. Details of proposed contests Type of contest No. of contests Rules used Boxing Kickboxing Mixed Martial Arts Muay Thai Other (specify) 3. Details of the main event y Contestant 1: y Contestant 2: y Gender: NOTE: Both contestants must be the same gender. y Number of rounds: y Duration of rounds: r. 11 -- 11 of 26 -- S.R. No. 154/2013 Professional Boxing and Combat Sports Amendment Regulations 2013 11 Authorised by the Chief Parliamentary Counsel 4. Proposed Weigh-in details y Date: y Time: y Place: 5. Key personnel involved in the promotion y Name of the licensed match-maker: y Name of the medical practitioner: y Name of the licensed timekeeper/s: 6. Do you propose to provide any other form of entertainment at the promotion (e.g. singing, dancing) If Yes, please provide details: 7. Please provide details of insurance that you intend to provide for professional contestants and officials, and public liability insurance (e.g. name of insurer, amount of cover) y Promotion participant insurance: y Public liability insurance: 8. Costing Details Proposed Seating Prices Matchmaking $ Ringside $ Purses $ _____________ $ Advertising $ _____________ $ Venue hire $ _____________ $ Officials and doctor $ _____________ $ Tax (overseas contestant) $ $ Other (airfares, accommodation, etc.) $ $ $ 9. Details of security arrangements y Security firm y Number of security officers? y How will security officers be identified? NOTE: All security personnel must be licensed crowd controllers. r. 11 -- 12 of 26 -- S.R. No. 154/2013 Professional Boxing and Combat Sports Amendment Regulations 2013 12 Authorised by the Chief Parliamentary Counsel 10. What steps will be taken to ensure the protection of officials from verbal and physical abuse and threats? (e.g. it will be a condition of entry that persons behaving in an abusive or threatening way will be ejected from the venue etc.) 11. I attach the proposed fight card for the promotion including the name and gender of each contestant and the name of each contestant's trainer. 12. I attach evidence of my capacity to pay for all costs associated with the promotion (e.g. bank letter or statement, supported guarantee, bank records, or other satisfactory evidence). 13. I agree to be bound by any conditions attached to this permit, if approved. Signature: Date: –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Promotion permit fee: $100 Payable by: Cheque Money Order Credit card/Debit card NOTE: Cash payment is not accepted. *Cross out whichever is not applicable. NOTE: The Board may request supplementary information from an applicant in support of the permit application. An application to register or re-register a contestant should reach the Board in reasonable time before the date of the contest. International and interstate professional contestants must arrive in Victoria 24 hours before participating in a professional contest, unless the Board approves arrival within a shorter time period. __________________ r. 11 -- 13 of 26 -- S.R. No. 154/2013 Professional Boxing and Combat Sports Amendment Regulations 2013 13 Authorised by the Chief Parliamentary Counsel Regulation 7 FORM 3 Professional Boxing and Combat Sports Act 1985 APPLICATION FOR LICENCE AS TRAINER, MATCH-MAKER, REFEREE, JUDGE OR TIMEKEEPER –––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––– Type of licence: *trainer/match-maker/referee/judge/timekeeper Applicant details: Name: Address: Telephone: Email: Date of birth: 1. Have you previously been licensed, in Victoria or elsewhere, as a *promoter/referee/judge/match-maker/timekeeper/trainer? *YES/NO If YES, please provide details: 2. Are there any matters the Board should consider for the purposes of determining whether you are a fit and proper person to hold a licence? *YES/NO If YES, please provide details: If applying for a match-maker's licence: 3. Have you ever competed as an amateur or professional boxer or combat sports contestant? *YES/NO If YES, please give details of your experience. 4. Please provide details of your experience as a promoter or trainer: If applying for a trainer's licence: 5. Do you have your own gymnasium or dojo? *YES/NO If YES, please give name of gymnasium or dojo and street address: 6. Have you attached a current First Aid certificate? *YES/NO If applying for a licence as a judge, a referee or a timekeeper: r. 11 -- 14 of 26 -- S.R. No. 154/2013 Professional Boxing and Combat Sports Amendment Regulations 2013 14 Authorised by the Chief Parliamentary Counsel 7. Do you possess adequate vision? *YES/NO 8. Do you wear glasses or contact lenses to correct any problems with your eyesight? *YES/NO Please give details: [This information is collected for the purpose of determining suitability for the role identified, thereby maintaining the integrity of promotions and protecting the health and safety of contestants.] To be completed by all applicants: 9. Do you consent to the Board providing your contact details to other licensed individuals for the purposes of organising professional boxing and combat sports promotions? *YES/NO 10. I agree to be bound by the conditions attached to this licence or renewal, if approved. 11. I enclose evidence of my identity (such as a certified copy of my driver's licence or other government-issued photographic identification). 12. I attach a National Police Certificate. [The attached National Police Certificate must be issued no more than 3 months before the date of this application.] Signature: Date: Applicants may be required to submit such additional information as is considered necessary for the issue of a licence. Under section 6 of the Professional Boxing and Combat Sports Act 1985, before issuing a licence to act as a trainer, match-maker, referee, judge or timekeeper, the Board must be satisfied that the applicant is a fit and proper person to hold such a licence and that it is not contrary to the public interest to issue or renew the licence. A copy of this application will be given to the Chief Commissioner of Police under section 6A of the Professional Boxing and Combat Sports Act 1985. A licence to act as a referee also authorises that person to act as a judge or a timekeeper. A licence to act as a judge also authorises that person to act as a timekeeper. r. 11 -- 15 of 26 -- S.R. No. 154/2013 Professional Boxing and Combat Sports Amendment Regulations 2013 15 Authorised by the Chief Parliamentary Counsel Licence fees: Trainer: $70.00 Match-maker: $70.00 Referee: $100.00 Judge: $50.00 Timekeeper: No fee required NOTE: Cash payment is not accepted. Payable by *cheque/money order/credit card/debit card *Cross out whichever is not applicable. __________________ r. 11 -- 16 of 26 -- S.R. No. 154/2013 Professional Boxing and Combat Sports Amendment Regulations 2013 16 Authorised by the Chief Parliamentary Counsel Regulation 8(1)(a) FORM 4 Professional Boxing and Combat Sports Act 1985 APPLICATION FOR REGISTRATION AS A PROFESSIONAL CONTESTANT Applicant details: Name: Competition Name (if different from your real name): Address: Telephone: Email: Date of birth: Current trainer's name: Trainer's Telephone: 1. Have you ever been registered or disciplined as a professional contestant in any other state or territory of Australia or overseas? *YES/NO If Yes, please give details: 2. Have you competed as an amateur? *YES/NO 3. Please provide details of your last 5 boxing and combat sport contests (amateur, professional or both): If none please state accordingly: Date Place Opponent Result Details of injuries or suspension r. 11 -- 17 of 26 -- S.R. No. 154/2013 Professional Boxing and Combat Sports Amendment Regulations 2013 17 Authorised by the Chief Parliamentary Counsel 4. *I enclose evidence of my age (such as a certified copy of my driver's licence or other government-issued photographic identification)/I will present evidence of my age (such as my driver's licence or other government-issued photographic identification) to the Combat Sports Unit in person. 5. I enclose a Certificate of Fitness provided by a registered medical practitioner (Form 5). [Note: the medical examination must be completed within 14 days before the date of this application]. 6. I also enclose a completed Blood Testing form (Form 7). 7. I consent to the collection of medical information relating to me on the understanding that it is collected for the purposes of protecting my health and safety and that of other contestants, and that this information will be kept private in accordance with the Health Records Act 2001, except where disclosure to other parties is provided for in the Act and the Regulations. *YES/NO 8. I consent to the collection of information relating to injuries sustained by me at professional contests on the understanding that it is collected for the purposes of informing research into professional boxing and combat sports injuries to promote the health and safety of professional contestants. I accept that this information will be retained by the state and national governments and may be made available to academic researchers under strict guidelines, but that I will not be identifiable by name. *YES/NO 9. I understand that boxing and combat sports are hazardous activities that may lead to serious injury. In particular, successive blows to the head may lead to movement of the brain within the skull of a contestant, rupturing veins, and in rare cases, arteries. The resulting bleeding may lead to the formation of blood clots, causing pressure inside the skull, restricting the supply of oxygen to the brain and causing serious damage to the brain and even death. In seeking registration as a professional contestant I knowingly accept this risk. Signature: Date: r. 11 -- 18 of 26 -- S.R. No. 154/2013 Professional Boxing and Combat Sports Amendment Regulations 2013 18 Authorised by the Chief Parliamentary Counsel Registration fee: $50 Payable by: Cheque Money Order Credit card/Debit card NOTE: Cash payment is not accepted. *Cross out whichever is not applicable. __________________ r. 11 -- 19 of 26 -- S.R. No. 154/2013 Professional Boxing and Combat Sports Amendment Regulations 2013 19 Authorised by the Chief Parliamentary Counsel Regulations 9, 13(2) FORM 5 Professional Boxing and Combat Sports Act 1985 CERTIFICATE OF FITNESS DETAILS OF CONTESTANT Full Name: Address: Telephone: Email: Date of Birth: Sex: Previous Competition History: DECLARATION I [name] certify that [contestant] is *FIT/UNFIT to compete in professional contests. Comments: CONFIRMATION OF IDENTITY I sighted a driver's licence or [insert other] as photographic proof of identity of [insert name of the professional contestant] whose fitness is certified above. Medical Practitioner: Medical Practitioner's Signature: Qualification: Address: Telephone: Date: *Cross out whichever is inapplicable. __________________ r. 11 -- 20 of 26 -- S.R. No. 154/2013 Professional Boxing and Combat Sports Amendment Regulations 2013 20 Authorised by the Chief Parliamentary Counsel Regulation 12 FORM 6 Professional Boxing and Combat Sports Act 1985 PROFESSIONAL CONTEST-RELATED MEDICAL EXAMINATION Contestant's name: PART A PRE-CONTEST EXAMINATION MATTERS TO BE ASSESSED • The contestant's health following his or her last contest • Any significant medical problem the contestant has had since his or her last contest • Any recent infection, cough or cold • Any recent medication • Central Nervous System (CNS)—memory, comprehension, speech • CNS—co-ordination, pupil reflexes, tone, etc. • Chest, lungs • Heart—sounds, rhythm, bruits, pulse, blood pressure • Abdomen • Musculo-skeletal esp. hands • Ears, nose and throat, skin • Visual accuity • Mouthguard DECLARATION I have checked all of the above and certify that the above contestant is *FIT/UNFIT to participate in a professional contest. r. 11 -- 21 of 26 -- S.R. No. 154/2013 Professional Boxing and Combat Sports Amendment Regulations 2013 21 Authorised by the Chief Parliamentary Counsel COMMENTS [Please provide further information, as necessary, to support the declaration above.] Medical practitioner: Medical practitioner's signature: Date: *Cross out whichever is inapplicable. PART B POST-CONTEST EXAMINATION KEY MATTERS TO BE ASSESSED • Any injury that should be reported • Any difficulty with vision • Whether the contestant has suffered concussion or heavy punishment • Conscious state, memory, comprehension, speech • Co-ordination, pupil reflexes, tone, etc. DECLARATION All of the matters above have been assessed. The contestant should not compete in a professional contest *for a period of [insert number of days or weeks] /before [insert date] . Medical clearance *is/is not required before the next contest. COMMENTS [Please list any significant injury, the treatment provided and any factors that may have contributed to the injury.] Medical practitioner: Medical practitioner's signature: Date: *Cross out whichever is inapplicable. __________________ r. 11 -- 22 of 26 -- S.R. No. 154/2013 Professional Boxing and Combat Sports Amendment Regulations 2013 22 Authorised by the Chief Parliamentary Counsel Regulations 8(2)(b), 8(3), 14 FORM 7 Professional Boxing and Combat Sports Act 1985 BLOOD TESTING I certify that I have sighted the results of blood testing relating to [name of contestant] of [address of contestant] . The tests are dated: Is there evidence that the contestant's blood is infected with the following viruses? HIV—*YES/NO Hepatitis B—*YES/NO Hepatitis C—*YES/NO The contestant is therefore *FIT/UNFIT to compete in professional contests. CONFIRMATION OF IDENTITY I sighted a driver's licence or [insert other] as photographic proof of identity of [insert name of the professional contestant] whose blood test results I have reviewed. Medical Practitioner: Medical Practitioner's Signature: Qualification: Address: Telephone: Date: CONSENT FOR RELEASE OF BLOOD TEST RESULTS I, [insert name of professional contestant] of [address] authorise the release of the results of the required test to the PROFESSIONAL BOXING AND COMBAT SPORTS BOARD and its officers, for the purposes of protecting my health and safety and that of other participants. r. 11 -- 23 of 26 -- S.R. No. 154/2013 Professional Boxing and Combat Sports Amendment Regulations 2013 23 Authorised by the Chief Parliamentary Counsel Signature of Person Examined: Date: *Cross out whichever is inapplicable. __________________". 12 Form 9 in Schedule substituted For Form 9 in the Schedule to the Principal Regulations substitute— "Regulation 15(3) FORM 9 Professional Boxing and Combat Sports Act 1985 RESULTS OF MEDICAL TEST REQUIRED BY BOARD DECLARATION I certify that I have sighted the results of the medical testing relating to [name of contestant] of [address of contestant] that the Board directed the contestant to undertake in Form 8 on [date] . The tests are dated: In relation to the results of the medical testing, the contestant is *FIT/UNFIT to compete in professional contests. Further testing is required. *YES/NO [If yes, please specify] CONFIRMATION OF IDENTITY I sighted a driver's licence or [insert other] as photographic proof of identity of [insert name of the professional contestant] whose blood test results I have reviewed. Medical Practitioner: Medical Practitioner's Signature: Qualifications: Address: Telephone: Date: r. 12 -- 24 of 26 -- S.R. No. 154/2013 Professional Boxing and Combat Sports Amendment Regulations 2013 24 Authorised by the Chief Parliamentary Counsel RELEASE OF INFORMATION [To be completed following discussion of results with medical practitioner]. I, [insert name of professional contestant] of [address] hereby authorise the release of the results of the required medical test to the PROFESSIONAL BOXING AND COMBAT SPORTS BOARD and its officers, for the purposes of protecting my health and safety and that of other participants. Signature of Person Examined: Date: *Cross out whichever is inapplicable. __________________". ═══════════════ r. 12 -- 25 of 26 -- S.R. No. 154/2013 Professional Boxing and Combat Sports Amendment Regulations 2013 25 Authorised by the Chief Parliamentary Counsel ENDNOTES 1 Reg. 3: S.R. No. 82/2008. Endnotes -- 26 of 26 --