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COERVER PRIVATE TRAINING REQUEST
Please fill out the form below to be contacted to set up your Coerver training sessions.
You may also contact Ken Goodale at coervercteast@gmail.com or 860 - 455 - 5962
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PARENT FIRST NAME *
PARENT LAST AME *
PLAYER FIRST NAME *
PLAYER LAST NAME *
PLAYER DATE OF BIRTH *
MM
/
DD
/
YYYY
PLAYER GENDER *
EMAIL *
PHONE NUMBER *
*
TYPE OF TRAINING *
CURRENT CLUB - YEARS OF EPERIENCE *
AREA OF TOWN WILLING TO TRAIN AT *
DAYS AVAILABLE TO TRAIN *
TIME OF DAY INTERESTED IN TRAINING *
PLEASE ACCEPT AND SIGN OUR MEDICAL RELEASE BY CLICKING HERE *
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