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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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    c91e8d8Plc7737e6aasdcea 37ec8c7al6eaadr d8tah2e468adis0 aff25485ide5eld480e cd5-7ce>f435dc * REQUIRED
    b77767b59bP5875lee7fdas4258747e97042e 73c879le1far 63t9hi0s0 fc4i9a9e6bc4bldefff8d8 3->c51 * REQUIRED
    1d27b0P623l1ea6se2c2955 cl84e4a69dr 1thai6ds3112 595e546f69cfc0333218ifec6la975d 4e-d>8ffc * REQUIRED
    0P47lf038983c97507easef c8b0dldeb9ada9524fer0dae 83t4he26i840s0beddec9 f827ie2ldc f3->7d8a * REQUIRED
    57P8al72ea3ecfa2sfec c4l65edea63r 0630t36h1if393basd 8e6fb3927i5aee3d1clcd aba-89>1fe9b93b * REQUIRED
    P8dle6ce5a4base915 cb6d13bel42d0e8820aa36e0b9rd 5th2570i63s80 cb593fbi6e1200l5cd 77f97->e1 * REQUIRED
    0P54fl2e9ase0 e2cfle9e4f40adr th797d1d59ef2i76es3 f907ield 1f19f->148d9068ff7c358a749834df * REQUIRED
    d3Pe3l54c746159ee4aas0eb0 cl80f33a0ear01d th0if5sce933 0a4cda3fed9iaeal08dbb24 81-0>c4ab60 * REQUIRED
    28Pcla5ease95 cc44l68ea69dr77c th7a4ecc02957b7i1c7764b5as 1f0adibedle99d38ddfb7 15-a51c6>3 * REQUIRED
    5bePbc53le2as55e 95cflde592656393eabrd1 t7h730i8s fb2758dibe26ld 4c3416-d3fef>efdbc3c67321 * REQUIRED
    e214e83Pleaff00fs6e8df c35963lfec96a81ar5c 787thcibs f48314i2elef9631b170179bda 06cb-0f1>2 * REQUIRED
    843aPl798bc55eeff18da2a1db1se 241cleear18 t72hi595e32ef46sd6c6d 8f8c1ieeef5f2ld df180b51-> * REQUIRED
    7e90a16P11f0leasb35e4 9cacabb46lea14r8d46 b6t15h952c8iees5bb fi8e1499db0l0edd 2f-7e278>7c0 * REQUIRED
    4dPal116dade729adse8905d567ecb8 f342bcleea9cr670 3btd8e88ae375his33 1c8e7216fi1aelad6 b-7> * REQUIRED
    7b6Pc736c1leaf5d34aas4e57 2bc64falb1e7adbr9eef4 658thie2s 9fi50bed3l11da c12b8-86>0bbc896f * REQUIRED
    856905P092l02027deaf64bse cla4e02de5045f883aar b37ctccaf8hi7sdf fi2528aeb7l3dc33 ab7f7-57> * REQUIRED
    1P557l5ea0986sbe3f7 92clff0e393c9ca13r 2939a6cd2a8tfe2f1fd1e560d0hi7s3 fdi6ael3d 2-37>9851 * REQUIRED
    8c942ePle438a8s473a4e a2eclc840f40eear e230t6h4657ia94es f7ieb2l2ad72a8 1763e-75e01a8>404b * REQUIRED
    614P84l345ea91bsb1ee fcl2ae87a0a3a4277c1r 2t6a9501hcff67i6sf d4fid35eld01311 62843d->b1837 * REQUIRED
    Pldad5e3db87ase 94ec8dl09b28eb0ee9036fc5b504arb9244ea t0b43abhid3sb33 6febaiel8bd9 ->d9351 * REQUIRED
    55460aP1dl7ebasec1b68 c3dce2le1e6b56a3f7ee24a0r 9th8idfs6 4f62i3bbele593c0e8d456b -8>f32ff * REQUIRED
    363P2606l9e32e8as9bee3f45 d15c08l60ea270r 70th6be2bis8f15 4986035fi2e33fld 4->122a3a4f853d * REQUIRED
    722816692dPf7al649e8feas144e 7f3fc32el2e460a9r 29850th0is8eb03 ffi42ef184l5ddd3d -f>b5d14f * REQUIRED
    04Ple2a7a673fsaefb3 eff24a3c12le54a21rd e68dfcdt3his a49040035f4cfi2eef841la45d -8ba>18500 * REQUIRED
    cea3P5efl40e714ase8e21351 fc74l150e95a304955ara9 th0cibs 84fieb4lc1ebd618dc 0c98963e-6>758 * REQUIRED
    763c2Ple14aedbfse2 623cl545eaddbf0d93r fft6fb046fb4hibsedd 15f0ie0f05l1d4 3d7d2-f8561de>57 * REQUIRED
    b9803ce77ad7P0lde0ea6a1b6se81e b3b77cl2fce9a9e5d9ar1 thisea f9b95i3505de0l9d0d fcb8-b1c8>c * REQUIRED
    33aPf6dc051l0edceeb9a62c5se1 acc2lbea8e24r tch685877a3f696is8 fif53de7ld6a44b12b cd->ebd0c * REQUIRED
    P7lfec7eas7ee 0fc7l2ea80r5 tbc8haea574b2400799e0eibfse 4dfielecde ba-79e1e7>c1a322977b0f92 * REQUIRED
    0dPlea3857dc989b58ad7s020beeff90b7 3c7c7l6eb31494ar 45th643i811ds1 4fb6c43c1biedblcd ->181 * REQUIRED
    98adecPl3911ea2a6d6e7d60s22ce15 871c1953l17be7a4cr4bf8 2ethifs51 375f1ie3flc76fd 679-58>d2 * REQUIRED
    d03a9Pd6l22ee2d5eeaabsded4a calea8rd7 d0t4h9ic64s7 327bfdi3e3c3a32ld403151c3 1e-2c568a0>f4 * REQUIRED
    P73b7711l2ebeasfefe 16c0bc0f2cled09a202a7r6 1fth8di7fs 60f8b3i0e58l891ef4d48fb2f 7-44>a85d * REQUIRED
    cfcd791f2Pableasd4e 7c2l1ea8ac295re5 8tfhdc2di4se 9230434e5ee65fiea94559ld 3afc87fe57-7>9e * REQUIRED
    2e21Pl859ea1s4e ec6l5ed6b7401a91b75dr 2dth8ibs59e9 342a6d40e6f3i1ec7ld 799->c824fa9cb5457b * REQUIRED
    319b727Pl07dea51b964s3c1a68a3e 1c1e6ble040a2r33 0t46d8hcf0aiseea3fb f7ib3fb0eld1 ->af2e06f * REQUIRED
    aPcl67de10a410s1aef c1bl4c4ea370r7 a95th2d0i2as2ef 753de78e7af7ic75c00cdel3e2d09d9a 31-8>4 * REQUIRED
    9f6fP2l9355eeb19a2s7e4 6b3c2el1aec7f4a5600abe8rb aa3c6thie1ds2 2f1e5c8iebl146630d7a fff2-> * REQUIRED
    40a012e11fdPa1e224l4e0e4as801ec cca8130ledaaer6 2fdath06ids324f0f faa97i2cel74dd04 ->c3ef4 * REQUIRED
    e85f5df2fd64P3lea9se fc47311cb4l4e85aer1e4 1bt97a1hi6b0scaac aa5deeef97094ie3lf780d59 ->d2 * REQUIRED
    be9Plea93f3s8e625be9 1c76alaear6 th8i4d5825cb279af4sbfc e6fifc5elb99d 6->cd085183b823d9f50 * REQUIRED
    95f6P2le9ab2s8daae 0d6c49belf0be63afr ta8a9a097h4i60bs 98f96a30i3ecc09dl7b9ed7 -5aaa5>a16c * REQUIRED
    85P79fdal4ea6ef7da4cbs3be ce87ac8le4ae1b8120r a615thb1ei12s1574 67fiedled2 ee472a-1>67f954 * REQUIRED
    5P19led33b1ac81c0e57944dese ac99ce906le9a7a8f88eb84r t4dhias8 e1fcieeld312 e43d-cee6>add18 * REQUIRED
    4c9Plea0c7651aaf0392cfs438e 9a8df4ac1e56edle2adara2c28a bthdafefi8298s98a fi2eld168f 8-e>e * REQUIRED
    84f3d95dce1Pd04le1aaa1se9c5af1 clef8fc84ec08aer20cc etc0his f18efie2l556d406 ad->ca3fa839c * REQUIRED
    ae7Pf6lefaseddea17 fac023e8b5laceafd397er this7ba0 2ec8fe80ie5750e3ld1a0e 616b4ea1->e34ed2 * REQUIRED
    e08147c68a63dP13073leaa90sae6de clc11eeaab6375r777d6 177e8252t5c92his10 8fiedlf48bbed2 -3> * REQUIRED
    5fa0aPdl2ease0 6clefa7dre27a1 bat46fcf9h08dis416f31c9fb f6ia6e042lddbd95e3c683cf 6c-f>c72a * REQUIRED
    5caPdl930bea57s7e2 bc7l75e3b1a3dd54r56c d64taaha9is2 f42ie0b37bld 13605a5854a65eaa64-92>6a * REQUIRED
    36a2Pelde87f6e5aa9s12ec55 7ca3l2ec82c0bab0r759 ftchefe8d9a0efia92ase 0fb1cia1e7ld3ee47d -> * REQUIRED
    7b92d9919dP8dflfe644cease dcle999a47r ct56f3hci6se768 d18fa427i5eeld91a04 0cd007d2-3>30c55 * REQUIRED
    24P033lea8bccf9s4ec 86c1le9aerc b55f57be1teh2956dif5s 53e6fcdcefiab53f5d04b4ed6ld2d 50->be * REQUIRED
    69f7Pdl6ce4as272e41 cf10d354f159e1c295282178l1eear6f3 9e844tfafhcbdis fiebebld1cf7d -3f>ce * REQUIRED
    c5cPle1398868eaasfe7 c846lde4f7bef04aaf0r ef92bethis5 4f01ideacel561cf1ced7704ddfca 35-4>f * REQUIRED
    b913Pa9b420671la28e73634fase4 cle4ea4af75r 32193090t33460hiae4sa 2f0ia23a6eed22alac1d -5>a * REQUIRED
    dbc6e033e4P8a6l361eeca6s3306dbfe 6c68ce5d295a4leaara 6cth18829is e19fiel41d 35109-d393>065 * REQUIRED
    227Pbac5l6a5efea1s6ed00a8fa8 4f8c412ff8l6ef8a1raf9 cat55hid9cf47a7fsab8 feiaeel67ba7d ->9f * REQUIRED
    f71c4d24P9l8faebasd2ee064 c5a3lb4aea9raeae9 tdhi4ec73s3 9fdbe2i22f95e2a347dle6b9bdb0 1->0b * REQUIRED
    46eb04P6db7e052d262b9alea0b8499sffcec 141cld6f84aearb 4fcc6t874hiff1c401e69fs cf0ield ->39 * REQUIRED
    91fb89P320l26de3d9ab29s4e 1c61bd1ale444abfr5f35e 78t4cdhi6dbs 43fbi03e6a0l0d5b3 abc-c>ae80 * REQUIRED
    3P2le0e2aa3431asb8cfe c304103ala4fear 579tbhiea5b18d0b9s1bf111 7f46i8be66ld5 ->04db9eae403 * REQUIRED
    44d619c1fc4P3846cla924ec8f406dad5se5 1ccf0257216178l5eae81carb t3hibbsa 5d6fiel69d7 5bc->c * REQUIRED
    f68e8909Pela2a45easc2e6 cbca5c62ela128e722a993f7r 1080tb894chi7s f6i28eefd5b6l095fd6 5->64
    * REQUIRED
    46d80a9Pd3lbaa5e3addda398bscde6671 4c5cle8ar1a 1th9ei8sac fi2bbe58ld7 c03d17daea807-f1>18b
    * REQUIRED
    8P3e0clec2a33es3570e3 c38lea38897b64rc005 315t796h33is 94f161fafbie14l7b0b525d9 a-6f5a>e12
    * REQUIRED
    c34da6949Pf0l324d8f5ebe7f6aase cl5cear 62dfthi3s2a22 7f73bdie6d8dld858f08a7 9db5bc6-433>c4 * REQUIRED
    084205Plaa790e57ae43abs9e6459 a4cb64l3819441e8a2fr0c at193d57fach0is7 fi34e0ld 4-bc9>7d416 * REQUIRED
    62f5ef5948fPlf6eas382ce0233 e39a956calear7 3tee6eech4b36f5is61 a2becfiaeblddf79d3 823-4>7f * REQUIRED
    e5Pc5fdl0be65b8af60se07 f6d1355c9ec76dlf1ee0afr657 83btchc5ifcs80 812f3i2e39l24dc -1>dedd9 * REQUIRED
    ff4282P1lae8efe835c4a49se3 4621cc2759l2e53a5r13 tdhbci2ds fi4eflbedd67e7e58fb8 545c->e203e * REQUIRED
    af143Pdfa279le6a18s7a3e0c cl9e4ac6r bt7hbiab06sba fi377e055ld ->a11b49f0b870e43d7e7049a6d0 * REQUIRED
    ceefdda31c8Pe28le0as9e3b cl89ea5a74rfaaaa777c2 th7180iae646s9d3 ef6ideccl77d 34a1ee7-4>353 * REQUIRED
    7cc9P18le1a049s0e9e395 c4le0a7rbe1b ddddt6f9b69h85680ia41sa9f f2e5ibe6eac6l219d2 -4cd>5c0e * REQUIRED
    4d6c3P8lfebe913ase3f5c9 c65le9cd9a15a19d892de572rf b8a4cth6e4dis 96bfie2l2d3f4d5 05->511b9 * REQUIRED
    45dPbl2113e00adacs6e4 e4d1c993c58flddeaf0r72 cthis5 65fe9ieb8c8la5d02 8-07727bf35c0020>11d * REQUIRED
    dPla702ea847sc1e0e8691ea 4cl1321a76ead5rf45 th3ed367i3a97s19 fied7l255792c29d 238->493a3c8 * REQUIRED
    Important: Ycou50 6may6 be3d mak1inge use of automated cformeb6b-ffillinegd5d5 0softwarbe. 28This aty1pee of softwaf8r5b5e ca6n 86trfbigge4r our hi2d8den 5spam-de5tection sc3y2stem,3 w3hich will3 blo4ck you from1f submib21tting thi2asc6 forcm.5 P1lease select F3ix Tch3is96cae9143e c734bbe7861fb959ce610o5e22ed31d1creb5363b1f6 c3b0a6c2961b529b3520aco4mc70pl4fetibn6ee4ge3 the7 cfo3r659m a326fi7n oaarder 3tceo0 6bcorra32bebc8d84e1atb1f 4th7bc2ed2 p8r1ob76lem.
    Important: You may be makidng use of fa2u5tomated form-filleingf sof7btware. T0his type of software canc t5rigge9r odfur hidd2en spam-det4ectio4n system, whic8h w0il03l346 block yo7u from sub6f8mittdineg this fodrme. It appeears cth2at the cp3robl4dem could noft abe automatically ecorrec8te1cd. Ple0ase cl4eare an4y field which b351app8ears abovaea with corre11spondi9ng b70instructi9oncs1d61d4258d866a8e088 b0d2dbb012e1df47defof3rb93f679e4ac273ff0def3083 7908completdinag 4the fo81rm in dorcd8eear to 6corredcdt 8th2b3e 044prob241lema.d We apoelcogd64idzae2 fc06or t8a3he i8fncconvea26niebn2ce afnd7 w9e5a 5appbbrecia0date7 youdr 4unde3rstandi3ng.a
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