Coach J Sports Intervention

I understand I am completing an application to show interest in a 3 day QB Camp in Jacksonville, Florida. We are coordinating with applicants available weekends & travel schedule, trainers & facilities. Once everything has been coordinated, we will send area hotel choices & restaurant recommendations.

I understand

No, I do not understand

The QB Camp is designed to mirror a College Student Athlete workout and classroom time. The Camp will include Athletic Workouts, Competition & Mental Training. Athlete will be under pressure to see how they respond and our Coaches will be evaluating their performance. *

Yes

No

This is not a “showcase camp” where you run through drills with 100 athletes and no coaches talk to you the entire day. It’s not an experience where you leave the camp and have no idea how you did. Our QB Camp is designed to be a Game Changer for your family.

I understand

No I don’t understand

Parents education is a very important part of our camp. Parent(s) are included in Friday night Meeting which will include Recruiting, NIL & open Q&A. Parents can be in facility for Training but CANNOT ask questions of Coaches or communicate with their Athlete. *

1 Parent Attending

2 Parents Attending

NO CHILDREN (siblings) (for Friday night)

We don’t want children or siblings in sports facility on Saturday

I will sign all waivers to workout at D1 and any other training facilities included in this 3 day weekend. I will return them to Coach J prior to 3 day Camp.

I agree

I do not agree

I understand the College Prep Camp includes College Prep Coaches, Training, Evaluations & Facilities. Camp does not provide Hotel, Travel or Food. We will provide a list of nearby hotels & restaurants that are close to our venues. *

Agree

Disagree

Additional topics of interest: My athlete needs to hear about:

Better Nutrition

Proper Stretching

Supplements

Info on college recruitment

Managing Relationships

Phone Time

Too much socializing

Better Sleep

Competing Under Pressure

Communicating with Coaches

College Recruiting

NIL basics

Based on Coaches, Trainers you have talked, what level do you believe your athlete will play in College?

D1- Power 5

D1- Group 5

D1AA- Higher education colleges

D2

NAIA

D3

JUCO

GAP Year

Really have no idea

Athlete's Phone

(###)

###

####

Most accurate description of current state of Athlete: *

Need help in Weight Room

Need help with Mental Game

Need Mechanics help

Need better Social Skills

Need More Confidence

Need More Leadership skills

My Athlete is Perfect

Check which statement(s) apply:

We want to play much better on this team

We want to get out of the current rut

We want to play Varsity Sports

We want to play College Sports

We want to play Professional Sports

If anything else, list in specific goals

Is your athlete currently involved with marijuana, vaping or any illegal drugs?

Yes

No

Possibly

Not sure

Sensory Areas of Concern:

Too much social media

Too much video gaming

Too much TV/Movie watching

Too much phone time

Too much time on school work

Managing Parent's Name

Main parent managing athlete. Coach J's parental contact

First Name

Last Name

Managing Parent's Phone

(###)

###

####

Supportive Parent

Managing Parent's Spouse

First Name

Last Name

Supportive Parent Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Payment Methods *

Once a date is set, $xxx down payment 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 45 days before event. 2nd payment of $xxx due 45 days before event. Final payment due 3 weeks before event. Total $xx.

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 months in advance. 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. Just like College. If your child has a bad attitude or does not want to attend, please put notes in section below and we will include him/her in a Boot Camp.

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

Our Camp is focused on Better Performance from Athlete. Our Coaches do have a network & college connections. With regards to Recruiting at this Camp, we explain how it works but we’re not directly promoting players as part of this camp. Our focus is on Development & Maturity.

I understand

I do not understand.

Who participated in completing this form?

Athlete

Dad

Mom

Step parent

Coach/Trainer

Agent

Corporate sponsor

Other