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  • Goalie Indoor Travel Program (with Uniform)
    Fee: $290.00
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    Registration and Payment
    Important: It appears that you are accessing this form from an unofficial third-party source. Submissions originating from such sources will not be accepted. Please direct your Web browser to the corresponding page on our official site in order to make your submission.
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    I, the above named individual, being a least eighteen (18) years of age, or being the legal guardian of the above named individual who is under eighteen (18) years of age, inconsideration for the use of the facilities, services, equipment, programs, and or activities provided by Element Athletics, its owners, partners, successors, assigns, employees, and/or agents (hereinafter the Releasees), do hereby agree, acknowledge, promise, and covenant on behalf of myself, my heirs, assigns, estate, personal representatives, or the like, as follows:

    POLICIES: I UNDERSTAND AND ACKNOWLEDGE that Element Athletics hereby reserves the right to dismiss or prohibit any participant from the premises for disciplinary reasons. Such reasons may include, but are not limited to: unsportsmanlike conduct; possession or consumption of drugs or alcohol on the premises; violence; posing a danger to others; any illegal activity; or violation of any rules whether stated or implied. Such dismissal or prohibition shall be at the sole discretion of the Releasees and failure to dismiss or prohibit and individual for any above reason in no way constitutes a waiver of such authority or discretion. Should a participant be dismissed or prohibited NO REFUND will be given.
    ACKNOWLEDGEMENT OF RISKS: I hereby understand and expressly acknowledge that participation in the events and activities and the use of the equipment and or facilities offered by the Releasees bear certain known and unknown risks which may result in INJURY, DEATH, ILLNESS OR DISEASE, PHYSICAL HARM, MENTAL HARM, OR OTHER DAMAGE to me, or the minor identified above, and/or my personal property. I DO HEREBY UNDERSTAND, ACKNOWLEDGE, AND ACCEPT that such risks may also result in claims against the Releasees and/or claims against me, or the minor identified above, by spectators or other third parties.

    I DO HEREBY VOLUNTARILY AGREE AND PROMISE TO ACCEPT AND ASSUME ALL RESPONSIBILITIES AND RISK FOR INJURY, DEATH, ILLNESS, DISEASE, PHYSICAL HARM, MENTAL HARM, OR OTHER DAMAGES to myself, the minor child identified above, and/or my personal property arising from, directly or indirectly, the use of the premises, facilities, equipment, activities, and/or services provided by the Releasees. I understand that the risks associated with sports include, but are not limited to, sprains, cuts, contusions, abrasions, concussions, broken bones, bone fractures, and in some extreme cases long term scaring and/or death and hereby state that the undersigned is participating at his or her own risk with full knowledge of the dangers and risks associated with such participation. I further acknowledge that Element Athletics strongly recommends the use of any and all NCAA approved protective equipment and that failure to use such equipment may increase the probability of the above mentioned risks.
    RELEASE: I, FOR MYSELF AND/OR THE MINOR IDENTIFIED ABOVE, DO HEREBY EXPRESSLY AND VOLUNTARILY AGREE AND COVENANT NOT TO SUE THE RELEASEES AND RELEASE AND FOREVER DISCHARGE the Releasees, their agents, employees, affiliates, sponsors, or partners, from any and all claims, liability, actions, demands, causes of action, or damages which are related to, arise from, or are in any way associated with my use of the facilities, premises, equipment, activities, and/or services provided by the Releasees, INCLUDING, BUT NOT LIMITED TO, ANY AND ALL NEGLIGENCE OR FAULT OF THE RELEASEES, THEIR EMPLOYEES, AGENTS, OR AFFILIATES.

    I FURTHER PROMISE AND AGREE ON BEHALF OF MYSELF AND THE MINOR CHILD IDENTIFIED ABOVE, TO INDEMNIFY THE RELEASEES AND HOLD THEM HARMLESS from all costs, including but not limited to, defense costs, attorney’s fees, medical bills, pain and suffering, damages, or the like, incurred in connection with claims for bodily injury, wrongful death, or property damage brought by me, my estate, guardian, or other party on my behalf.

    I hereby state that I am in the best position to determine by physical abilities and limitations, or those of the undersigned minor identified above. I expressly acknowledge that I, or the undersigned minor, are in good physical and mental health and have no condition, disease, disability, or impediment which could impact my participation in the activity or which may increase the risk of harm or death to myself or others.
    LICENSE: I hereby grant Element Athletics an irrevocable, royalty free, worldwide license to use my name, image, or likeness for advertising purposes including, but not limited to, photographs, brochures, videos, electronic media, promotions, publications, or any other trade or advertising materials published in and medium.


    Element Athletics Player Registration Cancelation and Payment Policy
    1. Payments are due on or before applicable due dates (refer to pricing sheet for programspecific payment details).
    2. Late payments are subject to a $15 late fee.

    2019-2020 Element Athletics Program Specific Pricing
    1. Travel Indoor Team
    a. Tryout fee of $45 due before or day of tryout
    b. Season Fee $650
    I. $200 due Nov 16, 2019, plus $85 uniform fee (if player doesn’t have one)
    II. $200 due Dec 15, 2019
    III. $250 due Jan 15, 2020

    2. Turf Travel Team
    a. Season Fee TBD
    I. 50% of total fee due before or on day of first (1st) practice – early April 2020
    II. Remaining 50% due May 15, 2019

    Element Athletics Player Registration Cancelation and Payment Policy
    1. Payments are due on or before applicable due dates (refer to pricing sheet for programspecific payment details)
    2. Indoor Travel Program
    a. Cancelation notice (written) received prior to Dec 1, 2019 - amount due prior tocancelation notice being received is non-refundable and responsibility of theclient.
    b. Cancelations after December 1, 2019 – client is responsible for full season fee.
    c. All amounts due prior to cancelation notice being received are non-refundableand responsibility of the client.
    d. Any player not current with payments forfeits right to participate in practices.
    3. Turf Travel Program
    a. Cancelation notice (written) received prior April 15th - amount due prior tocancelation notice being received is non-refundable and responsibility of theclient.
    b. Cancelations after April 15th - client is responsible for full program fee. There areno refunds.
    4. Client Late payments (payments received after applicable due date) are subject to a $15late fee.
    5. Alternative payment arrangements are available by contacting and if authorized byElement Athletics.

    Element Athletics Player / Team Tournament Registration-Cancelation Policy
    1. Local Tournaments
    a. Full payment must be received a minimum of 2 weeks prior to the event.
    Without full payment a player/team (client) is not considered registered.
    b. Full refund with 2 weeks’ (14 days) or more notice of cancelation prior event.
    Cancelations with less than 2 weeks’ notice, the client is still responsible for fullpayment.
    c. No refunds with less than 2 weeks’ notice of cancellation prior to event.

    As of August 1, 2019
    d. No refunds for no shows, forfeits, lack of players or any other reason with theexception of possibly weather (see below).
    e. If client no shows, forfeits, lacks sufficient number of players, or for any otherreason does not participate in the event, the client is still responsible forpayment.
    2. National / Regional Tournaments (e.g., RCC, Beach Bash, 4Goals, Shooting Stars)
    a. Player cancelations (written) received after initial payment due date and prior tofinal payment due date– initial amount is non refundable and responsibility ofplayer.
    b. Player cancelations after final payment due date – player is responsible for fullpayment amount.
    3. Player Late payments (payments received after applicable due date) are subject to a $15late fee.
    4. Team Late payments (payment received after applicable due date) are subject to a $50late fee.

    SafeSport Policy and Practice InformationSport should be a place where young people can develop, learn athletic and life skills, becreative, make mistakes and have fun – and do so in a safe place. As members of USA FieldHockey, Element Athletics and its coaches support and adhere to US Field Hockey SafeSportpolicies and practices. For more information please visit the US Field Hockey website.
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    c34edP3fdc9l178ce8a830eb9a5s10e 2f243e7ccd81lce78ar91 t7h1i57dd80s 7dcedfiedl2d 8->ff835d2 * REQUIRED
    4c2755cPlease6 b9cle5da7edb8er 2520342ta368525599his2ec6b 0f74icefe8a75lefbd 7c-e296>9b8a7 * REQUIRED
    a95ad4890c6f43P5leaees685eccef8 cle07ardaad 9t1670dahisb 6f2d1fd65da3i38el3db71e 4->b2213f * REQUIRED
    cPl8fbee7fcd0a8s5e0d6f5 2ecl0f3ef2e9a30822c2559r5 t7h80ai6abs5e00 e16f225dield a8b->46609b * REQUIRED
    0P7laeea7d8e1sae472 7ac7l2de6e5far t52c4ahf6c49i88s0e 6fci5ee81277ld53e2a2a8e 89e-e>e82fdf * REQUIRED
    25b8Pal9eac8c39aad0dsa2e e4943cf8l09fa6beda173c04e9ar80 th3is fe768fib122cabd61eld -a1f>3b * REQUIRED
    133bbP7l2ea73absde aa8cl4ae01d1a5d76rc 0cae02tf3df12h7eisdc 5e1fdac9e6i0el9d18660 09-6>198 * REQUIRED
    faa3Pebl278e0a8e2d6d2sf1ed7 5ac278l7bea6r a67t6hi1899s07 fie46e8l278d0a3b7 28-eb56ad>23d89 * REQUIRED
    faf29P91lea07se029d 13cee4leafa0fr 7ethi7c02sf6d f651bfab2adiaf3ee5l0d8d4b3f659a 0cd-e>a42 * REQUIRED
    9d1555840cP58e204552b97lff06eas9e69231 cl52ef5ara tb52676hisb3 5fibf1cael80de9e74b ->74ceb * REQUIRED
    66bP687l091ee505116fc254as9115985d6ce46 9c4392l57ea19d3r549 0t442his34 fbi77eel0a0d691 ->7 * REQUIRED
    d5P3bel66e01e7a4se cfla4a47e55ca1r92137f a8thdi4saa 1fbc9i93d070fe09ld5 a25051c-43e>391a8e * REQUIRED
    c75f5P0lac64e4e26b7ase76aeee 4543a87bcfeclb081ea78br 6c400t972e6h5i3sf f3iefld0 73d2f->0b9 * REQUIRED
    c0P02a16f7ld71680e91feef602eas76e 0ecblecfa41rd4e5 506139t67h2is7 ficelded4db350 31->437b6 * REQUIRED
    f1ePle7afse82674aef50b78a9 cc5l28b6ee08af6e9r7 5thcis 65f91bie7d4b1f6a14l81954d17671 d->f5 * REQUIRED
    6c73f91665de8a4Pbl2e2as2be 3cl05e6aer91 99f1tcdhc123ed69i3c7s0 2f2b96i8921eldf fc-818c>c92 * REQUIRED
    4dPl3474e0fas1e7 c3defdc53c825l546eee5d3f8ar t6hi8sd 44f9iefl8e9e8da35c4 aa-91>0445bd41042 * REQUIRED
    b47P02lafffc006ea244sf9ece0e5 346c29lbeab92r 3501th25fi4ccas12 fc91ie897l08d1f4 81-3c>02b5 * REQUIRED
    088f487971b32Pl154e6a9se dccld162eabcr 86cthbis7fd edfifc7eld6b 3-a7b9fd42>7799892e83aceb6 * REQUIRED
    aPdl9ea27sf9ee 101ac7la01ear t0b72hi3f76sf f0aid5e0133e8be1d4bf3el6b6e00d9f 5e-0173>0573a9 * REQUIRED
    0432P088a81e13eel0e97a777s493ee 8ccdl7ebd84a0bd025r fthi7s1 2f4ia7876e85al61df a-28024>bdf * REQUIRED
    678Pfd79099512dcablease910 49bc07lef10d1476d3ec206afdb9297dr th5eis8d dffiel2b6ed 7-a6>a9b * REQUIRED
    6Pd9la59bdfa8e11c0cadf97aa0sd14132eed clcec9aa80rf 6t5h32cdb7i6cf10b7s8 5fie1el684bed -7e> * REQUIRED
    106ePl52ab6ceac5c9se84 c66cl68befc6a7cb2r abt47heaid5s 278f1c992iebld4ac4ed 824->d844172a3 * REQUIRED
    b3P91b97elcd12fea5based8b7 6cc25lecdbar e77th75ibscc fff1i711fa0e0l8d441b57 bcf437f-bb>61d * REQUIRED
    4caP1l6e57ad128fsb36f0ed cle0af5ebrd7 956thi8cs f2iee3c38993ce4l2bce4ed017ecd0 -81b03>cd93 * REQUIRED
    da5fPc1le3cas325e a0cd6f4l1cecb0a8r781 61bfda9ct4hdis 9ff78ie03eled f4c-39>546a2c9cb4708ff * REQUIRED
    f1bb2a7fP877le7aa53sabc9e 3acl4e4ara4 aa0th119104is41a4 00ea3f4i6ebd8el4703d7 326066f5-b>b * REQUIRED
    eP3l80610e57a759s6e 514c5l78ea3r 60t3e2hbi47bac2b9as5 a2f07d93f8i0b6186delfcd5d 1b6aefd->d * REQUIRED
    6d6cc6e00P1b4106le6aeabsdea d4cd2d2dc078f9l1ebar06 3c923t9h3fffc3is9953 f8i55eld5c 06-ca>1 * REQUIRED
    bdPcle9399acbfsaae 6c9dl946eare36b11ae td6h0i7scad9d7 b4649fi1e8blb75f94cddec f12-f>3f073e * REQUIRED
    4dbPle29as94e0b391370 8bd6e3cl1393e6cda6rf thi9028s fi7a64112be48831l10d0105abb 27-7>73f3f * REQUIRED
    ad56f43P885laedff1accse9 clf8aef0ab6r94b92369 7t2eb1390his0f072c3 b3fffield3a247 4->899ef7 * REQUIRED
    P13b1le0a3b17se cdbl8e2d2d2abr5ea23 37tf1h32a2a6d4cdbai914c85s 5dcefif6ee0cl3aeb9d5 -fa3>a * REQUIRED
    235bP3c57le1a541s6e d6e87776cc1blf30aa6dee2e39ar207 0tf5hid6s f9511e47ield 40d2-4e4ce>a401 * REQUIRED
    29P745laeaaes626e 17ae90dc322cfb01c2l5a3feab658bbf3f4br67 d3th3ics1 fif52el5cbedb c0-dc>b8 * REQUIRED
    edPl4ea83bsaed8 7cfc34l9ea4b7d5cc5f04r47c dtfhcd0i4s52d3 30fa4if854ce4le87d 3af8-7e5e722>3 * REQUIRED
    10bPclb561a5eea994sfe3 bc6c5605lebd471e0a81r ft0hbi48s3654412 0fdfic74e75adlccd2 6->4fbbff * REQUIRED
    3P243304lde4fa06se fc62d16le73e5a61r dth642ie89s43 4cff0795i104ee1dbe9elfdc73 8d->5a657077 * REQUIRED
    a4c8bf7327bPf0f58529daldd1384edea24b4s504806e6 2c70elee81ar th4i8s5 7f6d572ie3efl4d c3->75 * REQUIRED
    fd6Pcce10403l3e48ad74s7ed ec899lbea6944rd2 t45hibc400aed7158548sb f5eia5d989eb10ld4 -50>a2 * REQUIRED
    d9c8P28a2f2flea6ee4ase c9da34l90cacc11f4ef4dddc5ar t98h34is1c13 0f04icee3lfd7a34f6e b3->eb * REQUIRED
    0Plea6sde 4cle6ba1efr5 96t2bh1disfe77 141fbbdi6e97l6a72d9b6819d0e3d 4-e0a42f>ac9c6ff30205e * REQUIRED
    098Pf4c0fl34dea5fe238a63ee4asbe3 9b3cl3b8e5a57ra 2223cth0i4s87e7cb 17f8e09die5ld c-1a635>b * REQUIRED
    Pldea0ff63adb86de6a4s4a1ea4 6b4c9b7b6l1e04a31e1r0226 3detffhi484s6 18fa4fai9e1flfdd 4e-f>0 * REQUIRED
    e518Pl6214ce1ea120see305 edcle6a6859c5ace40fre the5i8ecs9824 9fca8ie41ld312 ->4e1c995929c8 * REQUIRED
    5P1e46alec26a91719ese e13cf0cfc6l033927eec02e137aae0r 73th8cis f9ielba16c2b6db 68a-32>f15d * REQUIRED
    924Ple39eea7d1fase1b9c01e8 bafcfl846ad47e69b3b5a8r thie1c02s4 33e2e53945f25ie2355ld6 157-> * REQUIRED
    5fP0l3aeas145eaf4b986 5clb2e87adr2e 6bd3bd1b8f8tahde3bi2f3s ffiecld 88707833317e349d9->91c * REQUIRED
    Pac9lefasaabe4ad9 977c3leaer71e ccath76d0835a1i5bsee5f f78b13b45943caf8i4ec4ld 3-175182>03 * REQUIRED
    9Placea7s7eec 2545127ecl0fd5dea4r8 t7h813b07ics85 ef4iefefcabfelfe76df 9912b-3c2>f2266c98f * REQUIRED
    98c27c30Pl844eba38c614as3e8 cflbea93r7 tc5h9a21303dci1afd33ds9af72 8fie1lf1d5d0ec 18df-2>a * REQUIRED
    f38acP190leac1d0sa9e fc5lb50de18ear 8ft473hecaicf55e7bbb0sd13 fi7fe1c2fa5le9d5 6-6>9d03db1 * REQUIRED
    f84Pflefef541118ab6421597sab58e ca0f00el77e4edc4ara8 261et637hifa6sc33 2c786f0idel1d f6->8 * REQUIRED
    40fPef7d3b9laec38c1ca4cse5 2cldeca35r dtf70286hdda0aa7a4i4s29 7f3e29i7eld7 8-f1912f>dfb7ea * REQUIRED
    aP49ed60leca7443sbeaa c8bl7ede8836a5re62 t17h60id2se2 fie2d769f350eel7277dded 0-fda6e>be03 * REQUIRED
    0cP0522laa5e0as1ed7 5clb9f9aea7frdb0c599ded t91his0 bf5a673i1f124e5l54825911d 1128-fb>3e65 * REQUIRED
    60824944de36fP67le6ad3s7fe1f50 c0l7ed6a21r17e56 t6h7is58a a5fidelfd0 2->aa23c8e885847b6502 * REQUIRED
    081Pleab92fcc1a1s35e7 6c841l446ead32r0 89tc7876h0ibs fded15912fiel08039fd8 45->e78d48e5f09 * REQUIRED
    29ce0Pd0116flaeaes22de55156ec11 318bc4lf85b6e6106afrfac bt0h392bdi9s fci86eld8 f-bc688>b98 * REQUIRED
    aa1f10Pl4eab05a740se dclbe0b7ear 46t2ce282209hc2ie8f8s fid9b2deebl3e3457daa1f63360 b5d-ea> * REQUIRED
    7f2f2cP2ele5ase13894c2dbb3ee f4ecelce2ar 1ete85h3b7is 8faicee27led34fa4dbe2 -56>71f830c5d6 * REQUIRED
    d2ab0Plb4ae3a565s66fe5b 5b1ce648479acleac9299a80cr4fe0d 2a3tbdh3i9sa20e8 ffi6cef1lde ->7d2 * REQUIRED
    58P0l1e1a8sb81e9e36 90c96ldf0e3e3a5e1r aat9527he6e9i39s8e7074d f0c18b5iebdl829537ed 3-3>c2 * REQUIRED
    a24cP57152b8fel3cbe092bfaase3ee clea53fc0c1r93 b847et89ah0025ife84741s9b 4f741ice82ld f->4
    4d1aea68e338dec7P7leas296fea7c1122eb7 cl149ear 1b8thi2es e5feiecd7d1balc2d -dfc7e65d>4ef15
    954Pl5107e58a3se d27ca3lcea7r28f3 thi0ds79cb3a75 f2db0bi40ce50f0el52d ea4-e3ee>39e69939fa0
    e5Pafe9l8b726fe1f1f217e3fa08s01f06eec 1cle937f8bear 416c5t4a8hci6s fi1e35cl49fda9 b0-73>92 * REQUIRED
    3506a83bb0Please73c5e ccel412e35ar 4t98h337f4ics2f3 d0f4028ie1896clabe7cd 205-f>01a884faf8 * REQUIRED
    e2924bP386cebe86le27adsee0f 0f3833c1l0d83ea7e6r tehi9f8cb80a19sdb ccbf663i191cel35de4 ->b3 * REQUIRED
    12Ple8b3eb15b6a9s6ef d47cbl967ebaba748946r 08fabt2dh14190cise fief3bb90ld 2b-7a487076d>3e0 * REQUIRED
    P3cc3lb21c273be2aes4a8e2 28809cbc0lbec07ar297 e1b31thd9if9s9d f76i76bbelfd0b 81-a>a5408923 * REQUIRED
    2341952P953l220e8bad5s7e1 ec2f50906b9lea136rba1 t9his6 f8b1i18eb529de55ld3b5694dd37 c-b>d3 * REQUIRED
    aP6ledf7a4dd258se dd4c1leffa7r f8958th770a7ci0s5c261bb3b9 8f7icded489f461e3l0db f-3f7>649d * REQUIRED
    1d47ce2093651e36Pl2ea3se9aa7 fc0leac1br thice8s 9e11ef0d3ie2ff4ld9fb7422 89a665-4fb856>60d * REQUIRED
    888ac4b8P1d2658clee2a5seb 8cfa8dabb1ccclb96eara451c2036a 9thfi148sd4878a ffi29e4l1d f-e>6a * REQUIRED
    ec5Pl41e3ascf0eb5d4203b eb825c8fc54ca96610903l6caeear3e th01ias7ea665a 3fiecdlecbd3 ->f00f * REQUIRED
    962fP735577l7c3cbe2adse9 clbe65ead92fr c22t5hc3f1ad4is91 411f817i4el7d2e4e1f9 ad009-c5c>8b * REQUIRED
    Important: You ma2y be 1fmabk4ing use o4f au7tomateed foerm2-fill2ing91 3so0ftw97a9re. Th36is5 t5y0pe 1of5 soft2ware can t0r3igg8e4r our h4aidd6en sp8am-de5tectio7n aasy5stem, w8ehi9ch wil8l b3loc18k youc fr2om0 sdub2mittinbg thci5s for2mb4. 169P6lease select F7ix Tahcis95b59c58d559e798c0048d8 6fd77d15398fb0e469afa1f0885f1edo3a8dfe159c7re0 28c6beo98m4plebatcbi898nbbgc 77fth474e5 7fcoarm7 9i6en 8o6r05d2erab5fa taco64 0co3brc57re2cb82t th5e0d pr1o9ble7m.063
    Important: Y6ou ma0ya cbe4 mafkiang us8e of automated for0m415-filling softwar0e. This ftype6 of software can tbriagg8d2er2 our hiddecn sf4pam-dete7c0tio3n s5ystfem, wdh3dich will b84loc6k yobu from 0s9ubm9i98tti1ng this forem. It appeaars that the problem cocfuld not b6e automaticaf4lly corr5ected. P2lceasea clearb an5y0 fi8eld whi7c4h appears above with corresponding5 ainsbtructi23ons45efac cf214dd7db81f91d5ceaca3fc1ac942080f6d77f2e7bo673fe76re f2089202facompcleet4i91ng e2the fo2cr86m in333 ord8er t3o21 cdo2rrc1eacet8 dthec0b probl9em47e. 4We apo84ldo896gi858zde cfoer the in18cconvendience an9d2 we ap3pr97ceciat50e yoc5ur un2dersactandinga.
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