Sports Intervention

Athlete Phone

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Preferred Communication

Phone

Facetime

GotoMeeting on Laptop

I agree to counseling services at $120/hour, $75 1/2 hour to include Athlete Counseling, Parent Counseling, and attending events if needed. Time is prorated. Payment due when services rendered. *

agree

disagree

I understand that every phone call is pro rated billable time and will make every effort to pay within 24 hours. .Coach J always bills immediately after call. *

agree

disagree

Same day cancellation is full fee.

Agree

disagree

Payment Method Preferred *

Venmo (send venmo friend request Coach Jay Holgate)

Zelle (send $1 to Jay Holgate 404-597-4247)

Square (will use email address above)

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'm interested in::

check all that apply

Weekly meetings until we hit our goals

More frequency initially, then weekly

48 hour Intervention so I can get my Athlete back in the game

I understand that all information completed is confidential.

Yes

No