I understand I am completing an application to show interest in Quarterback 2 day In Season Tune Up Camp for Quarterbacks in Jacksonville, Florida.

I understand

No, I do not understand

Athlete's Phone

(###)

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The QB Camp will include Film Review, Athletic Workouts at D1 Training, Group Q&A, Turf time throwing, Evaluations with players, written evaluation and eating out with coaches for QBs and parents.

Yes

No

QB Tune Up: Weekend Plans

Send Updated Hudl highlights before Camp

Saturday 2-5pm: D1 Training Work out, Group Discussion

Saturday 6-730 pm Eat at Local Restaurant

Saturday 7:30-930 pm Hyatt Place Pool & Deck area

Sunday 9 am-12 pm: Group discussion, Work out at D1, Encouragement

Monday: Written Evaluation

Parents participation is a very important part of our camp. Parent(s) are included in Saturday night dinner. Parents can be in facility for Training but CANNOT ask questions of Coaches or communicate with their Athlete. *

1 Parent Attending

2 Parents Attending

Parent will sign a waiver to workout at D1

I agree

I do not agree

I understand the Quarterback Camp includes Coaches, Training, Evaluations & Facilities. Camp does not provide Hotel, Travel or Food. *

Agree

Disagree

QB Tune Up Camp weekend:

October 19,20

Managing Parent's Name

Main parent managing athlete. Coach J's parental contact

First Name

Last Name

Managing Parent's Phone

(###)

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Supportive Parent

Managing Parent's Spouse

First Name

Last Name

Supportive Parent Phone

(###)

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Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Payment Methods *

$500 deposit is required to hold the spot or can be paid in full. 5-10 spots available, once full, camp is closed. It is refundable up to 14 days before event. Final payment of $500 due 7 days before event. Total $1000

Venmo (send venmo friend request Coach Jay Holgate) @Jay-Holgate-1

Zelle (listed as Jay Holgate 404-597-4247)

Send Invoice (will use email address above)

Health Savings Account or (insurance debit card)

Credit card on file

Coach J Does Not Accept Insurance

I understand that there are limited spots for these camps. Facilities have been rented, Coaches contracted & commitments made to accommodate your athlete. If you do not make the payment deadlines, If you leave the camp early or quit, no money will be refunded. If your Athlete is disrespectful, we will give 1 warning & then they will be dismissed for unacceptable behavior or attitude.

I understand

I do not understand

After event, parents can have access to Coach J, I understand that every phone call with Coach J is billable time ($120/hr, $75 half hour).

Agree

Disagree

I understand that Coach J cannot be held liable for any future actions by my child that result in injury, damages, financial and otherwise *

Agree

Disagree

I understand that this Camp does not discriminate to different categories of people, especially on the grounds of ethnicity, age, sex or disability.

I agree

I disagree

Who participated in completing this form?

Athlete

Dad

Mom

Step parent

Coach/Trainer

Agent

Corporate sponsor

Other