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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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    51a1P4fl59ee7a9dsec 9cle86e1ebaarb tb3fb80ff517c8hai0f7se061 33e7d22f759eiee7e30l174da 7-> * REQUIRED
    2b2ac5Pblea6379df1besfce39576 5cl19e594afr 0thb93is5aea8e0 11fi7ce48e6blddc -6261>4229551a * REQUIRED
    Pb1f5dleac7dasc2084ae12eb 1c0c03e1449l1bcea4c7br t5his156 0c5d38180dfi9c5bee46ld 9e-c0>c09 * REQUIRED
    4daP6c65l5cb6e3eeafsdec fba83767c1le0arddf39 5tec9b8hi7es7 23d24f6eeie0la7d 68bc5a4594d->d * REQUIRED
    d33a60cPlead80c9a8se5f67e bcf42l9ear fthd817fff872a6d623d2ci6e5s fdae5ield86c d->d5ea5dcda * REQUIRED
    b5P9l6e621ead80eab9ds2e cb71leeard9187 b76atdh1a6fc70ce3i8d1d7s05f 99fibdef8edld5 3f6->f3d * REQUIRED
    50407ecPl5ea269s3b3f9eaccd0 e2aa3cal38b4e87308ar0e3a 78a093ffthi3s2b8c cfi186eldd e0-6>a8f * REQUIRED
    da1Pleaseadf 86fdc84lead9fr 5c3ff86thi4s2ae8b 3a89b92fc2b7ci15b7ef32l03dd 38472f9-34>777fe * REQUIRED
    1P2lease1 ec7ela20a45ecad735r9 cc6tdh0is 86f5be2ieleef584d305 627c-eecef>51fa1b4c73b34c0f0 * REQUIRED
    6b29f8P0fl87ee5a1se5a09087413 0a4cla856e470ae8da5b80375r tbchis014 fa2iffedl870d61 ->6021a * REQUIRED
    929ff76Pl3105a92e2055asa806e8 c808l1ea6dfar3 3fe9e2thc0bacaisc36 34c7ffiee9dldf 6b-70916>e * REQUIRED
    02bPl66e3a384sb884ac59a9e0 ecl5a684eaar d8tb1a48fdda42ef3h4i8s 7cfielcd300 4c9852dabc->206 * REQUIRED
    9d976P982le6a3a22b89sb9e919e c3f6643l20e816ar5 0th6isd9d 2a8ffcfc73i9cfelf01e50d3d -e>4d2b * REQUIRED
    6Ple401a6sbc1c4e04431b 1ec024fl6efba56a21ad6arf4f7fc this04a7dd3652d96b dfd2734iel2adf -f> * REQUIRED
    bd074dcPd15l51aeasd85e ccl6ee3b801ar0 adth71c317ias8a 9ffdd9i1e3l8e2b68febf44d c8->4d02fb5 * REQUIRED
    135d19Ple956deedcd4asc2bde795 ca3le8e78a6e8ear1b7cd 9d9t8cd7his c03f6ieee33l0d9 b-2>cfba37 * REQUIRED
    21Pblfbe55ea03sbe75fb 4c11l93aa33d7d8e9beea7fcr0c ta5hc47316i1c2s f27i6e8l7dcc3e1 -2bb>bf1 * REQUIRED
    a2d00Pc2lfacea9983se0 c53lea1r6 dbf88thb922if8s99a887f1b fid8e04l779ed -21>0514141897d273f * REQUIRED
    2b241P4l0e62a61e5e81bse cclec8ddbac51bc221dcr9 tbhis6 faieeedl83bb0a8a7d7 ec8c-af4>30fe224 * REQUIRED
    27cff21Pl764bbe4ads0e34 e64b61acalea92aarf 4aef8tc1hisc4e341 9518104f811iel5f33ea192d e-4> * REQUIRED
    f618ePlc788cebasefe bc30lde66fb1e47a0r9d dtc6d58ah7b11b5e915ifs7e 66bfff63dffiefl8d7 -92>9 * REQUIRED
    954Pal0eabs0ee28c c94ble7ee56arb29 42cc51c4t9ac7eh2131i59s146 fd59ielf5fdaa381dcda ff-9>4d * REQUIRED
    a0P40l8a51e8c0case6116 0cbcaclc183eaa7r2d093d9 2et67chis 1f701eaiel4d30ddf7fd 6e89->16e1d4 * REQUIRED
    43e0047f930b233Pl0e04a6fse b3cl18ae9dac1r 9d61ct9h7cia7s d8a583bf0i694e1dldda f-b>23466b1e * REQUIRED
    16cP31c8fle4ase386 7c77lceaaaeb150705r33b80 59b9thiads92 3f2678de028fd70ie7al76dc0 3bb0->5 * REQUIRED
    b4602P44l7eca74se 8fc4c525ael1b81eaa790fc07r68 t19dhi7ds 6794f5fie345fld6 ->1f7590f5ecb526 * REQUIRED
    0P4575le3d8ce5da99bse d240fecddl9e7ar 4thi5sec518cfaffa4 4f9eie01caa65bl5edb 0-fd>49795834 * REQUIRED
    ffc5Pa0823f5cleaasbe324cf1 cabea6cl635e032a62ffear5 e3a9t62ehd18ib60s dc0f3i355e2lb5d 68-> * REQUIRED
    4Pl99e980abe6ds66e8c68e cl47eaar42d 3t97d72h8ac74iba77fdsb91 3ad4fc8id73dbelddc de62->d56f * REQUIRED
    e92aPfl8b3e1asabde bccladaffcaeaeac5r6fe5bd7e85 dtd4hbca8is f8d1i9e019celb0d d-a04d5aaa>64 * REQUIRED
    377139aP979l18b2e659a294f63f5eb7se276 cle21b1edeea5rd 14theif9s 9f2ddci5eldd7b fc4b0f-09>0 * REQUIRED
    5Plb8289e9d2asec9 1b81c04leafe1ad246r8c6 cd95t2hi35c58es7 fcad0ece74ie5fb89ld ->03c4dcf17a * REQUIRED
    ce43e9Pl919ease f8cdbbaa1ble8d1fa4a89ddabc4fr3c t3440hia4907sb52 b52f373412bibdeld -9b1>eb * REQUIRED
    7998Pel69af1afease097 9c9l8f7379eara1 2954t6h8cifs70 bffi9b7e4e1c0fl20cad351d84 d8c18-4>ec * REQUIRED
    Plebe67cfdeba47ad9sc5ed7 a4bcald8e0abb3er675bd366 3a7t7e6hise17 afif5b1ae5a5e8490lfd1c1 -> * REQUIRED
    6dP95l37ad9aease60acb 6e8ebc4l0ed49bb10c462c2ea94bcr126ae 88ta3eh8i1bs feield14 -fb>10eeb4 * REQUIRED
    05c8dPl6e64c1cbad9s12e d36a2cbc36l1ae3e4fa92r400 9taechdibs f148047i85fecl30ad4f3 -be45>cc * REQUIRED
    c13Pe76a6l7e2as3de3022ab3e6 cl27b21ae3ad946re dtc1hisfc641e7a17e0a6 2cf716a9ica2e8977ld -> * REQUIRED
    Pab649lf06e5fase0 0c2c0l8ee39a13ra4c t29h7if7bsebf a281d9fi7707el14012d -793fde>dadbca0c1c * REQUIRED
    629a4d3P671clc6e4ac7se8732b 8dcel4aeb476a4fdr thai8bce1sa6a36d feei187e8lb20dde 342559-9>3 * REQUIRED
    71Plc9f3fdece08ab7cse e3575clb834e8a3r1 b4t17hc6aise5f5 6f3b80ielcb6314a9c2dfc2c 84-9>7eb8 * REQUIRED
    4930fP9lfa7feadsed1203 ca96l9328ffcaea48f22r a5ac0tfe5534hibsae12ed1 f6fie69d7l4d b5-4>54e * REQUIRED
    39ac88Pdel1efae0s7d41e4 429c0edle7d0ab0r 0419d42this 5de2f9i31ele3d704 f9->36d226d7f23726a * REQUIRED
    e58f027f10b75e5P4b004edl189d6e74a095s50f71ee c3l5445eb3eaacr5ab5 t58hbis fie384ldfae3 ->a6 * REQUIRED
    913ed437949cePa3lbecba2662da02s4e bb10acl90ea2a9r 1tdh2isd64a2d8f fiel618f5d7 e73-84>5eb50 * REQUIRED
    100cP206l3e537adb1s64ee1a690ea5e cl10eab37c4rb7edd thdi2s fai0fe0ed3el0df4 ->13f57209a5958 * REQUIRED
    0aP14l9eb30ba6dcab5cas8469e ca7le5a09094rfc33 t792ch1is fiee4bcfade35ld2566975a -7e868f>3c * REQUIRED
    92Plebas9e832791b42b0e c99alebad1acf3drae t4his52 5f7ie0l357e138ade431 962c691c-99c9a3>bd1 * REQUIRED
    ab00f1e9Pf8leacsc7f6cecfeae61181aa3dabec 7331d8ccle7ad18r 98t5hi0sa934 af9iel7d 5dcd7->2b4 * REQUIRED
    ecPleadse2ecce40 7c78cla9ed5ba99b2eer6c6b0 28t6465hisa236f4 f4aie31dlaed bc98c-c>726a9a984 * REQUIRED
    e50aP19b8lf5941b87d3a8eaase10 ccle53ara9 t7hi729d31s6 03691199f5eie1l4d108 d5-82c44fbb>4c5 * REQUIRED
    aP1cl9ad9easedec 508cl6feee9d16f9ar ct21eehddfc2ieaecsd 153ffiee1663620l69df4b 6a3-b7>a806 * REQUIRED
    f008b4f5P04ldd8ef89688e014762cca8s8ceb8e cflfe3a1r ddff915ft1ehi7ds5c72 f5b3iel84ad 7b-19> * REQUIRED
    P9le3ba107d9cf7a23aas7eaec02150 0cf4e53c6l9a89510ear0 a8dt8fh2i5s 5f4ffiaefl5d ddb-26e9c0> * REQUIRED
    cf50fPdle6e3ca2sdee618c9ce9e8e8ca 4cflcdef67e2a0r d1a4th7i343as1 06b4866f4725i0e5le2d 2->0 * REQUIRED
    96Pl9e9490aa6se6 bce47fbb7ce05ff3l1807e5a7r thi66s e6dccfa093i9el2f0c65d5d485fe 0dad->464b * REQUIRED
    1Pbf1l0efas4173be a79cl18eea6a1rcfc t627h983i00s 77f4iaf0ce8becld6da0576 2-7c98fb>5fdf9fd3 * REQUIRED
    3ePledas53eb 7c913091b90d53la5c563be60e3ar t9dhief9acs 8fe4bf17i9de4c8399dld e-51b82b4e52> * REQUIRED
    64511P0l23492ea8bdfsbbe2cb3 27dcc452e3lear37766 t6his24d9e2 fief49e15f05l9ed618 1d-3>2bea4 * REQUIRED
    4bd32P6leafe8fs58efb2 788c55a1aflearca cbce71t2h3is0 95bcc810f0iecla7c4d7246c2d ef-a369>18 * REQUIRED
    e1Plfedase4 a1cle2aer bt84a6d43eh5ab66ei93f9ff4s af6ibef46aae8bb92a8fe8l42dadc31 -73>66b22 * REQUIRED
    31aP6bl46f29eas2172e374ee50 4clce4ar t9eh1c0i77fc39s 41f8b4591id943edled 960adfbe550d4->9a * REQUIRED
    c8f09a3420Pl78cee7aas68a39a9aceb28 0bcfc8l290343ea6ar80 thi81s fcf0416i4elde -c679>97964e8 * REQUIRED
    b62ed3e7e4d5Ple484a7s7b4e0ebd867 a0c832c5l5737ear2 6th3c43i2a83f6s9 e7cd9ffb7eielad6e -c6>
    407e13cdPlceaes813dfde83ee 6c9bl10eaea5rc tff6hia3s 3ffi9be7b04eld 111e0a7->0eac0279a453d6
    ed2Pd4laecf5e87ebb442b569a0cse clearb tff5hc04b4iab47sabac21573 98ccf4f5ia766eclcd 5-d>de9
    P8da80delea7s3c75e 5c5d5ca42lee7car4 51dthbbc7451is5 1d09fiff60d8547eecbl2d9 888-a9d>53a17 * REQUIRED
    21cde9Plea4s017d52e70aa 3ec8lbe9ae3406a034eaarf 2f534thi8ca3s522619b12 fie81e966lc9db ->74 * REQUIRED
    01bc92Peale7da814s61e3 1f6bcl7ea19ar4cb0b00c02f 7352fthi4sd 0f9eiea4581b4dd4l4db -f827a0>a * REQUIRED
    72c4P6369134a9fl3ceasfbe95a c23lea0r 7f92tdh89ida2fd8aas2 f4id5b78d8eb861d8b3el9d6c 2-5>d7 * REQUIRED
    bPl67eb2asb4e3d 87cedl7f3fc6e04d6bar 371tfhfeie2s5 f4ibdealde0c76855c6 88e87-e602>64ff6b5e * REQUIRED
    33340ePd495l7ea5c1se87 c4c2b8ecflea1d379r8 tf8c9his ae1bb1f3fifdeel8ca8d486c69 13->8da1b89 * REQUIRED
    08Pleaa4sf92f9fecf169 dccfl31efea0ra 5dthisd 14f3i9bc7f7d58692e85lfd e-b2>45a24b22285e01fd * REQUIRED
    08814b52723Pb817372eea1dl6eac0s5dee 7cfl9caedard 7etd283hf5is8fdce7 4fdiel81d10 30a8->9066 * REQUIRED
    20Ple9a3bads6bed dc4d9086l78e91637a61r96 3thi00544d8s61360b206f1612 fic354e7l576bdd e->e0a * REQUIRED
    eb0327Pblea2as5ac22ef c8243l346a10eea9r7f t8hicsd0 eb8f78eaie0e8eld9ad8e cb67335-2178252>a * REQUIRED
    14Pa7624dle29a55e09s0e26dc fc2926ac0ca11l3955eebaadr ft039ha7ia595s2 afi0c47el5d -2>f1942a * REQUIRED
    Important: You mayd 4be making 0use eof4 aeu2t8omateed 4f8orm-fillin76dg softwaread.5 Tahis 15dtype of seoft2ware can trigg3efr 0our hi6dden 9sp2am-detection sdystem33, wbhi9ch weill blobckce87 you f3br2om su1bmaitting thias fdor2m.c P3leb766ase 8select 2Fix48 Thfis05104d9eb3af38 b5bf77a95cfb5d46beef6bc06949f73a3d0f201a7060aa0odef6dre104c75 0a4ce626a80dcomp79ale9tin6g t2ah2e f5docr6me74 in466c o43er5der6 tob9a7 99corabrefe5ct 0tfhe69e f67preeob9le4m0.154e
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