First Name:

Address:

Last Name:

City:

Parent/Guardian First Name:

State:

Parent/Guardian Last Name:

Zip:

Home Telephone:

Work Telephone:

Email:

School Information

School/Team:

Coach's Name:

Address:

City:

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Zip:

Birthday:

Height:

Weight:

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I agree to allow my child to be treated by a physician, nurse, or a certified health professional while attending Team   Kolat practices. I understand that the athletes attending this club are using the  club facilities at their own risk. I understand and agree that Cary Kolat, the facility owner, the club staff and anyone associated with or connected with the club, are not liable and will not assume responsibility for accidents, injuries, skin infection, medical or dental expenses incurred by my son or daughter during training.

I agree to the Terms listed above (check here)

I would like confirmation of enrollment to be sent: Please Choose Email Postal Mail

You will be contacted with further information about Team Kolat once we receive your application.
 

There will be no monetary refund of any kind.

I agree with the terms of the refund policy (check here)