Athletic Training Coverage

Game Coverage Request

Request an athletic trainer for your event. We’ll follow up to confirm scheduling.

Contact person*

Contact phone number*

Address for event*

Game date*

Start time (Central)*

Coverage length (4 hour minimum)*

Are there any existing injuries on the team that will need treatment?*

YesNo

If yes, please list any injuries including players’ first & last name

By agreeing to this form you are agreeing to:*

Athletic Training coverage is $45* an hour with a four hour minimum per athletic trainer scheduled. If the event is cancelled within 24 hours of the Athletic Trainer’s arrival time, the minimum of $180 will be paid. Payment is due within 10 calendar days. A $10 late fee per calendar day will be applied each day payment is late. *Please contact for UPSL pricing.
The club/league will not contact the individual athletic trainer for separate coverage for three years without prior approval by Katrina Mascarella.
Payment for coverage will be required within seven days of the event or a $5 late fee will be applied to each day.
The athletic trainer is not responsible for terminating the game due to weather; however, the athletic trainer can advise delaying the game due to weather.
Event will provide ice, or it must be discussed previously with the athletic trainer.
The athletic trainer has the right to refuse patient treatment, with approval from KM Sports Medicine.

Yes, I agree

Do you want the AT to provide ice? ($5 ice charge will be added)*

YesNo