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  • Goalie Indoor Travel Program (with Uniform)
    Fee: $365.00
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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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    RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT

    THIS DOCUMENT AFFECTS YOUR LEGAL RIGHTS; PLEASE READ THE ENTIRE DOCUMENT BEFORE SIGNING

    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.

    I HAVE READ THIS AGREEMENT AND FULLY UNDERSTAND ITS TERMS. I UNDERSTAND THAT BY SIGNING THIS AGREEMENT I HAVE GIVEN UP CERTAIN LEGAL RIGHT AND HAVE DONE SO FREELY WITHOUT COERCION AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE FULLEST EXTENT PERMITTED BY LAW. I AGREE THAT SHOULD ANY PART OF THIS AGREEMENT BE HELD TO BE INVALID, THE REMAINING PORTIONS SHALL REMAIN IN FULL EFFECT

    Element Athletics Player Registration Cancelation and Payment Policy
    1. All payments are to be paid on time (see yearly pricing sheet for program specific payment details).
    2. Late payments are subject to a $15 late fee.

    Element Athletic Player / Team Tournament Registration Cancelation Policy
    1. Full payment must be received a minimum of 2 weeks prior to the event. Without full payment a player/team is not considered registered.
    2. Full refund with 2 week’s (14 days) or more notice of cancelation prior to event. If client cancels with less than 2 weeks (14 days) notice the client is still responsible for payment.
    3. No refund with less than 2 weeks notice of cancelation prior to event.
    4. No refunds for no shows, forfeits, lack of players or any other reason with the exception of possibly weather (see below). If client no shows, forfeits, lack of players or any other reason, the client is still responsible for payment.

    Tournament Rules will be the same as USFHA Rules
    1. Duration of games will be 25 minutes each.
    2. A match is official when both teams have a minimum of six (6) players including a goalkeeper, in proper uniform, on the field, no later than five minutes after the official start time.
    3. The score of a forfeited game shall be 3-0 against the offending team.
    4. If neither team meets the required six-player minimum at the five-minute point, the score shall be 0-0.
    5. All games begin and end at the sound of the central horn. Penalty corners or penalty strokes awarded before the end of the game will be completed.
    6. At the conclusion of the game, umpires will record the score and each team coach/captain will sign the scorecard verifying the accuracy for the official record.
    7. Once the scorecard has been signed the score of that game becomes official.
    8. Signed scorecards will not be changed.
    9. Umpires will deposit the scorecard at the nearest scorecard collection box immediately following the game.

    Weather
    1. Every attempt will be made the update cancelations on the website. However, weather conditions can change rapidly and all teams should be prepared to play as soon as weather and fields are playable.
    2. Weather cancelation determined prior to an event may result in a partial refund.
    3. Weather cancelation determined the day of an event will not result in a refund.
    4. In the event of adverse weather or unplayable field conditions, the tournament director reserves the right to:
    - Reduce game times in order to catch up with the schedule.
    - Finish games before inclement weather arrives, or to preserve field conditions.
    - Reschedule games, if possible.

    Medical
    * Games stopped on the account of an injury will not be replayed. Scores will stand from the point of the game stopped.
     
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    148d634762e5cP6f6lbe7a4seed529 fd5cl98ff4b3e0ar c08th7fi6se5b8a133 ff1bibe1bfe8lad 600-e3> * REQUIRED
    4fb2f17cbPe906l9b2ease3b c0ldebar98e 6f69e1t4hdeib81cc67s a3b12fi0e8l13016d ed63->1293828b * REQUIRED
    3ad9fePl62e12a0s7e79fe20f 8b56c987b4a1l35ecded3afrf 76cthiads43f 85f5c6f1i4e6ld -9e>f973e7 * REQUIRED
    9ca584ac20P8236324le9d605aeseb8d0 97f329a5claedf5b1744ara9 th1e7fi4s 4eb8faie2ld6ec 94-f8> * REQUIRED
    bP3l5937eas817143ec d701acblee0aef8bfer 40ea0d4b8this33 6e33f8ci8e654l45db c248-91374>c798 * REQUIRED
    d04aP1l7eb2c61ec7a27d017s63e 8c7b510abc3lae7a5r 2th0ci1s0382 07e9fi910ead0ld1373 -1>1ec681 * REQUIRED
    cPl082b63fbc577eas05299fe 7c865f7ldea90ar 94bd3ft2074hisb 88b0fi4c3el996db3b 27a8b69-0a>56 * REQUIRED
    85ePa7d108lea1f1sfe46 fcl46e356ca45482rd 9ec6b5174t01h97i92s f87ie6d2l1d 6-482b1>0c0199a37 * REQUIRED
    Pl4bb67ad0933efdad1cebs8ae56350 0ed7clea2r3582 tha17ibs f7fa6527i7eelffd4707cb9 a1-7ea5>bc * REQUIRED
    P6720l6923e8385asce 71clb3ee16ae63r42b0 th4bfis0a428ea288c1c77 fc723ie7ld d-67c99b0e5>97da * REQUIRED
    6P0a4lfeas671e fb0cle6ara7 tb5hi41ebaa06sfdc9d8a22b93a418 f6i3cce5l9ca3d8a713 2e-e>211f8de * REQUIRED
    f84ePceel97e7830das67d5b3e 0cl58ceaa20r det81db49h4eics1a bfie1dl6721b73dd 52cff-d5b62b>b0 * REQUIRED
    7P6fcc3704bbd4e75l6ea49s9d9ef8c9e 91c495leaer8 d1atha0bc2i23s2c cfccice51l2fd7a ac8-87>700 * REQUIRED
    550P3af6e56lcac686ea74a5425dsee 5c51ledar1b90d e27fth8ei0b9csae 4d29f0c0e2i6c3e4l1d92 ->85 * REQUIRED
    811cP1le0e4d1as3f8e21efd89c 4d0c6l2f2eeaaf09ceb8adar923 1tad06d7e9hib3s1 fi01eld6b 5-434>8 * REQUIRED
    0P2le1f1a2s19b50e 3cblae51fdf3ar ff2ctdh13bbi0d8889s042e 2fdi6el1d7b628f9b d6c6e-7f74>b0a3 * REQUIRED
    9da044Plce56f1afbse bbc34leaa1f92705817r087 t55a571f6351hi0eb4s7de8f94b f3i1e4c7ld -9d6>46 * REQUIRED
    fP78dblbeas0808e9 cl48e649654a2e2cfraf6 bthf413id5s0d049 58fa3ieaff7cela9dfe 64-6c2f>dd990 * REQUIRED
    4Pf03b7leaf83se6 7ce53bleceear38dc dtd38h96a207i72a1953353sd7b fadd2bei84c41deeld5c e790-> * REQUIRED
    a8a1e3de07Pleacadeas25d75ea6515 5a62c03l71eaa8era9 5506t4he7ies f25iefld4d3eba 1-0>3506236 * REQUIRED
    86d4fP8l879c2e9d807ad6se8 4bfcl2ear0 tahf9f90ee0f5c90cis fi862ef0b9l2d13 cc7-df0>9091c2a67 * REQUIRED
    0P80lfa66ea0s9e89b7426a149 cc45leeb1a4a4r t6b5hi0s32613af74ce3 7f4007i8a6eldafd bc-e0>bf3e * REQUIRED
    160e81adbPfle585eea517e9se 7c4lf9eare71d9 cb507t185h75aid66sa95 b1fibef1al4bd 3-099a>f0860 * REQUIRED
    20408Pf295la3b8ab07d5bea7ca0se5 90cdle8acrd t715a57h4ibf02b06e9cs7 fie56d6eld498adbd 0->26 * REQUIRED
    6285Pal813e941asfe17d9b76d c5a0l0ear taf4hfi5s62 74fci55cb836eee4l9d9349 f38c-95f433bf4>17 * REQUIRED
    a849P95le20cd6a23e180fse6a 536caccle3b4dar9f fthiasff96f0e f6312fied2f7655l09dd0 -1>5a3ada * REQUIRED
    91b136P23lfedaas701eedb c2laea39f61r96fb3a t268fb23his 9c908feci4ce81bl6ed 6->803a88c37f83 * REQUIRED
    d47d8d2P89l4e98as7ee2 cec0ecl76015ea8br04 at0a5hd7da6i4cs11 3676feie0l1d e8-c4>b012a39ff1d * REQUIRED
    6e24aPdfl9eaaas9f1e922b3fba cle6a6282cfrdc5a 9tb5h3de30ifc6d1579sf4 53f0ielcdef10 86bb4->d * REQUIRED
    P116l21eaec065fb737553e88s4eefa 4cleedar3d9 08th05dis0 328fc6bddec65iealfde 5-4c5>2ea5f929 * REQUIRED
    f28P73le029a2s74aa6be2f8868 fc8ldea1rf 7dbtb6bh37a0aci8see09e bd027fcedi8ce9ld28 1f62-a>11 * REQUIRED
    cdd7783367Plea70se 50cl04ee58ear26 9tffhiese2c 41bf7aiea55l9b7cd9d87d7 -4>492ccb1f26859edf * REQUIRED
    d6Pbleac084b66saaae77 eclefa6ar4907d tbhisfcb670 2104b3c7320f5if639223e84ld8 -25b>6fb0205b * REQUIRED
    9a07P0b1laf187e38a6s9feb926d642a7405 80cla7717e0afcrf0c0d this aaf22d6ieb6lea2223df 52->a3 * REQUIRED
    e6b3Pb728leda8s0e68 d83c2d80lea9fr aaf8bc2tc2f3h97aife60s 4d3f312beie2e750222b9lad65 1-fe> * REQUIRED
    P36dl7b10ee81a6as9d5de5 c16le2f67a2fr cc6t12hdi152f100saa 32e300f81ac7fi71ee95cdledb 009-> * REQUIRED
    2bP6ela40050cd857eeasce c3c4leaa5fr209cc4 16th5adaaicd0s18a2b8bc4 af7ai76el2cd e-d8acd1>31 * REQUIRED
    83P0eleas6e35 ccd55lf657eef7ad0de3b3ear2d501 24this 2bfd139e741b52ai165el50c7cd 5751-fd7>9 * REQUIRED
    fPl8ae6afe2cf3sec6ca5e cecbbfbbl6ear25ea872 bdec942t7cch71i807s fbb0iefld 254d5-a>830a28e2 * REQUIRED
    7b37e42Pl46dfb2ea7ea9fs0aef73e274 61cal5399ae763ear8bc 7e5thi4s28 8f6i4beld faf5-cf16>b5dc * REQUIRED
    4Plea6095s071fdceed39 91b0c9f26lbfe7ca64a3r3f1b90 99tfe7ac8hi4s3 3fie1l9ad6dcdd6 d3b-9>8e3 * REQUIRED
    P246f4lbec6aasceb07776 ccfl8209c1bearfb 4t82h54c5bedi3aa0s 9efe86idef2l4e0df6962 b-49b>b4c * REQUIRED
    9792Ple2c55aa84se3beb bdceeb1ldbc445eaarb0 th435i2dsd 637f0i6e9l0cd -15d9260>d945c989c9a0f * REQUIRED
    13Plc50easdec 1cd96cf8cle894e44bar e9t56ahifs 8c46cd294f6dffi388e93ld3df f-d5>fb4ae20a4025 * REQUIRED
    b81f2Pel66dde2a5da81se cld2e78acrd1c 4teh0ia846eas3651c695 3edbfi6d6ee84l17c7da 5ca0c30->d * REQUIRED
    0217fPc55le01a51901as14e f88c3l1e4ar20c6 2aedd90td941d8410his8082b afi1edld09 e-6db4787f1> * REQUIRED
    53P1l4e0a1as907609749e cle9a1c5b957eced3131r37 2the905i51s9 411f7ee0d4bi8e86l2d a8-7c0a>9b * REQUIRED
    a9a4P0lefdd210bf5ae4aa667677eds50ce3 ec9dbla396e4dara35e4 tdfh9afis2bfa fie32le9da -458>78 * REQUIRED
    6b4172a466edPle85314abf6595fse cl34c8596636e571acr cf3t8f5hci1bs df2i003ba81el2ad52 4cbd-> * REQUIRED
    04792ePd7d3dclce4a50s6ad1507e4 cd7lec4afdr5 t613dh011if6fs fci66cbel710de230040a4 -c>ce284 * REQUIRED
    9cfb63bP29leaba9se fdc5le7abc45a9cra 6e478f1ct2665h67biesf32768 af4b14ic2212e8laedd ->4838 * REQUIRED
    6Pf0dl5a7beb6f3eaec0sedc6 cle7e2a3r t9fhis fidb87f16de3c3f8a0l82f44d5fc 9acf32d6d4fb8d-a5> * REQUIRED
    55a4P2el91048809a7feeafsee 0c5cc3l1ea91a2c7ea9er at5chi96d3732983s b1fdd7idb4el9d 59-8500> * REQUIRED
    d1e558e0fP7l19ea645absae ff91b075bf6c3d1lee7a35af1ffr etd9d99hi1s0 b73fcice28e2lda -5a>7c4 * REQUIRED
    f9f781eP6lb7eas07e5 c7bl5eff02a572bar 250at1ce7hi7bd49s65 ce2fb189id4a133e5ald 0->755e886d * REQUIRED
    4699136f9Pldd7ea2s7768fe1ae14e9e cb29l8ed70baer0 8thaeai7dbcc6s93e fd9iae669lcdc -9>be79cc * REQUIRED
    bbePl84f158eascfeb clda8b24ea4r b96t6hie601da17e623s897dd4 f8d1f0348cie0al4d -e9>85cee21fd * REQUIRED
    Pel2e9d0as7e10c 4c7236d974c4leca79r8fc18 9tdh2428eicbes98a02ac146cbd 4ff7id4efl78d -45e>e2 * REQUIRED
    eeP6b5l4e04a3ab3a3546a0fas3eed4 ecl3e47a6ar1721 4dte6hai5s f75c9ibe227l82d9 a-f7d0fe>b601d * REQUIRED
    564P04l16e20e114ca1f287e95scbbe4e 29clefbea1r81cf td48hde7c3278f98is 3f8i52e5lcadaa ->c2dc * REQUIRED
    bcPdc04d6d2le94ddase 8d38ccdc0l24ea2a5r e2th930icf79ds 59ff7404fi7eacl537ed 71-d66>6d816ff * REQUIRED
    ca3P2a039lease1a1f8c9833 9c70cbl6e8ae9fc1a2500r f7te9h2ic1s af5i6cc9057c8ea6ad48el4d ->958 * REQUIRED
    eec13cP63l393d71eee86a71case2d ec87l0e0ar thisb31 0dfa6f8i6eal8d8 -8>2773f49988071e7f87311 * REQUIRED
    d57f3Pld8bfed2a51sb03e cf7349a04lear8f 9t0bchb63fa584f73iesbbf1 f7ei5eld5 -e96f48>77466c6f
    * REQUIRED
    P90dacl6897a5eff57309a30s15851e5 ccclec60e4dafr86aba 2thi39sd1e fef45i8e805b2dld488 1-f>c4
    * REQUIRED
    a54Pdd84b7lea6cse cl782eabc2r7 ata5bcheef9b8i4ad86sa0ca4ddecc 1c4ficefd9l75bd2 d2c-6c>65da
    * REQUIRED
    8P8fb4laeae23s5f6eff5 cf6bdl4ea181594r74e9 fet0h07iec51207sd 8ffb852ibe2ldce0900 8f->6bb2d * REQUIRED
    94P6e44d2d0cfc46le683faccas810eea 9clfeee4adr6f0 1e96th4i98saa88 ff2fb4cief2l6db15c e-6fa> * REQUIRED
    34P7lea220s1e 1727cl88eaa45r12f25a6ef75 2d10d37tf966fhi6fbsf ef7f9di83e6lf406d 222-14ba>47 * REQUIRED
    0d3Pdl0e8as7ae7a915 2cl3eb55e59ab9629r tdhi89s7a f751ie3f7lfd6 a18668-a69e187b5b>e384b596c * REQUIRED
    3Plfe671d1a0f64cse6e68cc 7c47l80fed79a75r823446c1 1th43isb5 136cfie8lb248fd982a952 -6>96f2 * REQUIRED
    fab4P003l7e7c9aasef 26clf57eaeaf7c4r354 0t9h1is18d 4ab6cf5ei5d51eldee6 74c58-e>6817c37a192 * REQUIRED
    08P89bb88c4250ddl10ease286d8af cbadc2a5aleaaar b6thais4 e6ff5ai491el58d9b52 -ffa>b2d6d92e7 * REQUIRED
    38Ple5eba1167see c49fle3cf622e16ar tfhc42dff1980i3bf8cs531 9f92e2ifeled3a6e0d8 6cda1-98>a1 * REQUIRED
    21a5e1Pfle3c8as4efb 0celeee9764227a23brc9bc6d1 9ct7h517i838s6f fa6i25c74ee2l564285ddb dd-> * REQUIRED
    Plae47af2s63e 48dec19c78c72ld840ae1ca306r2273d7768d19 t34hid6cs 5d8faice1ebe22lda56e3 d1-> * REQUIRED
    1P68lf9e0eaas846ae387 679c1lebcc97ar t1h06a794i9sd3 451ffaif37550be2la04df 0dc-25d23>4e5a2 * REQUIRED
    Important: You may be mak1ina8g use o7f autofma6ated3 223fb1orm-8filla8in9dg sof3twa8re. This66 ty53ap1e ofb 9soft0ware1 can ctriggerc 2our h9id84de0n0 spam4-d9e7ftectibco4n sdystem, which wi5ll b5l43o9ck yo982u f5rom sucbmitti6cng 1t0his form77. Pleasce select3 Fix Thisdf599aa17553d27ec41f1ffb7bb dbf6ef2ac18aor70aeec82be7d05241b 168d102b8e2bcadodmplet5i7ng 9th7ae1 8e8f08ocr7me7 70i6e7n3 01584o84reder c35t27o acca9for01rectc 4td3he pdro40blem50.75f65dcb42
    Important: eYou meacy be making u5se 9of automatee8d form-fi1lling6 software. This t2ype o8f s7oft6wdare can trigger 9our fahidd5en 9spam-det5e3cti4on 1system,0 cwchich willc block you from scu1bmittfing this aform. It appears04 that thaee3d pr8ob5lem could nodt 71bbe eautomatically 2cor7recte6dac. Pleasef9 calear afny6 field whic8h appears aboveb with 0cofrresponding1 inest0ruct8ion2sf300 f805083925babed45e60e332fe06cd3517oc9re229708b323390e83a3d ffd7e2b946combb0a7plfe5btin3ge the 320fodrm ia4n 5orded0r to co846rraect 2the 4p1rcobbleem. W6be ap8olbo1g6ize 8for 7th1e 20inco40nven4b0i4ence8fe and8 we7 apprdeaciate you1br e6und8erst1andi0nge1.b
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