Registration

COACH ZAUNER, LLC - ONLINE REGISTRATION FORM

Coach Zauner Welcomes The Opportunity To Work With You.

Whether you are looking to attend a One on One Lesson, Camp or Combine, Coaching the Coaches or to schedule a 60 Minute On-Field Evaluation with Coach Zauner you are in the right place.

Upon your submission of this registration and approval of requested dates an invoice will be generated and emailed directly to participant.

A 25% deposit is required within 5 days from the date of the Coach Zauner, LLC Invoice to hold your requested date(s). All date requests and schedule changes must be submitted and approved by Coach Zauner.

Safe Travels…

Please Fill Out Form Completely
Select Program(*)

ONE on ONE Lessons
Transportation Arrangements - Additional Fees Apply
2013 Dates TBA - Arizona PRO Development Camp - Punters & Snappers
2013 Dates TBA - Arizona PRO Development Camp - Kickers & Kickoff Specialists
May 18-20, 2012 - Arizona PRO Development Camp - Kickers, Punters & Snappers
July 13-15, 2012 - Wisconsin PRO Development Camp - Kickers, Punters & Snappers
March 2013 TBA - College Senior Specialist's Combine
March 2013 TBA - Evaluation To Qualify For Free Agent Specialist's Combine
March 2013 TBA - Free Agent Specialist's Combine
45 Minute Phone Video Review & Consultation
60 Minute On-Field Evaluation
Coaching the Coaches
Coaching the Coaches PRO Development Camp
Please specify your position in the company
REQUESTED DATE(S)

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ie:6/18/2012 or 6/18/2012-6/21/2012
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)

Kicker
Kickoff
Punter
Holder
Snapper
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Height:(*)

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Weight:(*)

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Shirt Size: (Excludes Evaluations)

L
XL
XXL
XXXL
Evaluation Only
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College Class:

Freshman
Sophomore
Junior
Senior
Graduate
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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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ADDITIONAL COMMENTS:

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Note any pertinent information you would like us to be aware of related to attending a Coach Zauner, LLC Program.
This might include any noteworthy stats or post-season awards in kicking, punting or long snapping you have received.
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?(*)

YES
NO
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If yes, please describe in the box below:

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By completing and submitting this registration you are in agreement and accept the terms of the Coach Zauner, LLC Media Release.
MEDIA RELEASE(*)

YES
NO
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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):
HOLD HARMLESS AGREEMENT: YOU HEREBY CERTIFY THAT YOU HAVE READ THIS DOCUMENT AND THAT YOU FULLY UNDERSTAND ITS CONTENT. YOU ARE AWARE THAT THIS IS A RELEASE AND WAIVER OF LIABILITY AND A CONTRACT. YOU HEREBY VOLUNTARILY SIGN IT OF YOUR OWN FREE WILL. By completing and submitting this registration you are in agreement and accept the terms of the Coach Zauner, LLC Consent, Waiver and Hold Harmless Agreement ('Yes' must be checked by all registrants wishing to participate in any Coach Zauner, LLC Program):
I Agree(*)

YES
NO
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PAYMENT INFORMATION
(check program details for payment requirement):(*)

Check (Returned checks are subject to $25 service charge)
Credit Card (Visa/MasterCard accepted and subject to 3% convenience fee) By clicking the SUBMIT button you also hereby approve and authorize Coach Zauner, LLC to charge your credit card the registration fees.
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Make Check Payable To:

Coach Zauner, LLC

Mail Check To:
Coach Zauner, LLC
15132 E. Cholla Crest Trail
Fountain Hills, AZ 85268

Electronic payment available, UPON EMAIL RECEIPT OF A COACH ZAUNER, LLC INVOICE just click on the Intuit Bill Pay link ON YOUR COACH ZAUNER, LLC INVOICE. It's a secure, quick and easy method to remit payment, no additional on-line fees apply.

Michelle Zauner
612.803.1731
All Rights Reserved - Coach Zauner, LLC
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):
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