Select Program (*)
Please specify your position in the company
REQUESTED DATE(S)
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ie:6/18/2011 or 6/18/2011-6/21/2011
FOR SPECIALIST'S & COACHES:
First Name: (*)
Please type your first name.
Last Name:
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Cell Phone:
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Address 1:
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Address 2:
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City:
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State:
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Zip:
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E-mail: (*)
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School Name:
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CLIENT INFORMATION (FOR SPECIALISTS ONLY):
Specialist's Position (Select all that apply)
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Height: (*)
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Weight: (*)
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Shirt Size: (Excludes Evaluations)
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College Class:
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SPECIALIST'S COACH INFORMATION:
Name (First Last):
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E-mail:
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SPECIALIST'S AGENT INFORMATION:
Name (First Last):
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Phone:
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E-mail:
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SPECIALIST'S PARENT/GUARDIAN INFORMATION:
Name:
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Home Phone:
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Cell Phone:
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E-mail 1:
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E-mail 2:
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SPECIALIST'S HEALTH INFORMATION:
Insured By: (*)
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Policy #: (*)
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Do you have any physical restrictions, medical issues, allergies and/or medication requirements? (*)
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If yes, please describe in the box below:
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MEDIA RELEASE (*)
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TERMS AND CONDITIONS FOR ATTENDING A COACH ZAUNER, LLC PROGRAM:
* Program will be held regardless of inclement weather conditions.
* Program will be re-scheduled if cancelled due to extreme act of nature (Coach Zauner, LLC will offer no refunds).
* Program rules covered at first Coach Zauner, LLC meeting.
* Discipline problems will not be tolerated. Alcohol and all illegal drugs will be prohibited.
* Offenders will be dismissed without a refund.
* Registrants will be liable for any damages they cause while attending a Coach Zauner, LLC Program.
Deposit and Payment Method: Non-refundable twenty-five (25) percent deposit required on all One on One lessons.
Cancellation Policy:
Lesson Cancellation: Client entitled to re-schedule one time during 90 day period as long as cancellations are made more than 21 days prior to lesson.
Combine Cancellation: Full payment due upon registration with 50% refundable if cancellation is requested, received and acknowledged -in writing- at least 10 days prior to event.
Lessons and Combines are held at outdoor facilities and will be conducted regardless of weather conditions.
If you are attending a Coach Zauner, LLC Program, you understand and agree to these conditions ('Yes' must be checked by all registrants wishing to participate in any Coach Zauner, LLC Program):
I Agree (*)
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PAYMENT INFORMATION
(check program details for payment requirement): (*)
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CONFIRMATION: (*)
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Please enter your name in full to signify the above information is correct and you agree to the Coach Zauner, LLC Terms and Conditions set forth ('Box' must be filled in by all registrants wishing to participate in any Coach Zauner, LLC program):
