M Health Fairview Athletic Training: New Event Request

School/Event Name
Event Address
City, State, Zip
Bill To Name
Billing Address
City, State, Zip
Primary Contact Name
Contact Cell Phone DAY OF EVENT
Date Start Time End Time Number of Athletic
Trainers Requested

Please tell us anything else you would like us to know about your event:

Guidelines for Requesting Coverage:
One athletic trainer per sheet of ice.
One athletic trainer for 4 mats of wrestling.
One athletic trainer per venue of non-collision events.
Tournaments typically schedule 2 months out.
Last-minute requests may get partial coverage only.
Other criteria subject to discretion of M Health Athletic Training.