| Athlete's Name | Jax Kelsay |
|---|---|
| Athlete's Birth Date | 09/06/2012 |
| Entry Date | 10/20/2024 |
| Insurance Provider | Aetna |
| Insurance Policy Number | W215810050 |
| Primary Contact Name | Dan Kelsay |
| Primary Contact Email | Email hidden; Javascript is required. |
| Primary Contact Phone | (406) 580-9777 |
| Alt Contact Name | Kim M Kelsay |
| Alt Contact Email | Email hidden; Javascript is required. |
| Alt Contact Phone | (209) 200-1819 |