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  • Goalie Indoor Travel Program (without Uniform)
    Fee: $250.00
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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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    00ePl750c61d4c8454e6a9as85e1 b0cele3a42r6 th293143b6e714i2sc608 field2f96b0 a0c8-03754>060 * REQUIRED
    dP7l0e890fa1ds2e488fb98 4dc17b8lec5da168r2 d9689tdfhdi8ad585s f5i43fc419ef582bld967da 0-e> * REQUIRED
    1bc77aP18a3d7lcea71af8se dfc5l8e7ebarad64 cacdth3a3c19i690s fi32e16686c9edddc4ld 187-8>bc8 * REQUIRED
    993d72P4l1992eads9e ce3ld3e1a73268r9ac3 this2043 728a9fa8bi33065e6eeld6b22 f->f729f1912ebf * REQUIRED
    ccPbfl5e292a5s2f5e616 685ccle3f16aar a4tb9eh4bics6aaf04c 8dfif2be8887e4lb421d 9a8-ecc7b>39 * REQUIRED
    fP1a1blefa51d2d05s28e0e325e34 9d8c6bleac53r1b2 fdth2820fd07aid1de0bs2 4a2cfie499lda1 -f5>b * REQUIRED
    b8b5cdPlceea8asabfee58 4cae2c9lb98eac8a5br 16b3815tahc0i8s80 fi7c3ccdeb359l62c8fa9a2d79 -> * REQUIRED
    P8a78l1e5ase 88191cl7dee42feae22er2 t2ehee8aaef7aiad9s f6bfi78a8e31a2cl3d87928 def-cb77>c3 * REQUIRED
    4c08Pflfea9949f4af4db67121scbe 9cclaafe9a53fff2a9rcf ee2dt4333hi674s5fd7 fdide59lda ->ab67 * REQUIRED
    fPlbf3d3edaaa6sde6 cf58l7b9e4d9e979a69arc3712 tc1341c7his 0fci3e846b2l0bd2 ef4e752->c960d9 * REQUIRED
    3a79P5aleea9sf7b67160360e4 0c77fdlee5ar1 t80f2h1is20c30 fide6ldf9c5bd94ec1a7 cd6-6c0687>64 * REQUIRED
    d5aPblef16a6ad26se 12d2cfleae5514ebr6 0aa0dth8ba16i2s9abb 2034b7f3i8eel95db37b e-2d>2bd54b * REQUIRED
    ae2fPl8e6b7a2b6dsd3ed6e 0cfaccdcl8deb8dee12ar3 tff3360h7c33i4s45281 fi8697ef9d45c7ld ->078 * REQUIRED
    30b11219P6cclcaeb2a9636a530cs1ef1 0c5362a1le4ar284b9 718f47this4cf 59f0i1e6l0d78 59-55>573 * REQUIRED
    P6leasefbaf c0l8f61f0e62db474ad27f2r t93a52h871e0isd0de597819235 c6b391fcid01e863ld 7->c49 * REQUIRED
    c8b03e9d38Pl05eff9eeafc000sef11f cblabefd072ar6e d96b5a5t5hdi97fs01 6fiel060fda 15-ec>2de8 * REQUIRED
    1b325194Pl23eas5b9ce 6d412cflea1671325re 53d7a455c7tf6049139ca3his 4afi5el41c5bd4a50 ->f30 * REQUIRED
    dbfP41ffl18ee8cb3ae9bf0265s71e60c9 e3aabc1leb8ar241 t86hc9fiebs7 5fi0el1d0 d-61eb76>803aab * REQUIRED
    903Plaefba9dsccfedce 2fecc0l2e6a8r24470 b6679b2bdd976thbe36i7f8s 3fi2fe6al8013d6f 1-1a856> * REQUIRED
    a8cP1laeda3s8ec7a187d 1fcl44ear01 t5567dh85aeisb3b37065b 580ebdfi5025e0fld 9867-2669386>95 * REQUIRED
    1e608d313f782d3Pf3alea05ease20 c9l0a4ea4r9 t0he61ia7bf4d0s8c d65fi57e4ce5le5d9c7d0a ->8be5 * REQUIRED
    8b3Pl9becdasc3cfcde0 7eec4le5a5fad2are268c9bf thfiesd294c90 fc332i50058e46lac1bd 7c->ce3d6 * REQUIRED
    4ab227Pl121e0cac531sfe 2c83l87ce94aar 1567t8fdhic04c0006s fd0250iec500lda938b b8ffb62-b9>6 * REQUIRED
    1d0d8P14cb832a6le8ea0ese fbc4l1e55e9b6c5ef6eafrb81f bbt2ch230i1s7b2e40 f0cfie6ld285c ->b08 * REQUIRED
    7a94Plebd8ad17sdec86f3c 0671c56dlebae5652a1rd1 th1i8cs c2f8938e47f3ieela0cdcf c8bc->b4f6b7 * REQUIRED
    9aPc3489elfbe6b0af36as7ce 5c55eb3lfe66a42r t7fh02239e2i6s3e9 fef1fi880b2eldcd7 813c->b0b05 * REQUIRED
    c4a6ePl85ae068a60s3fe c2fle93facr dt3his cf43iad942a121deeaac7dlbd3980 1099b9ccbf-eb0577>d * REQUIRED
    7bPl9ee2as3248e6ae88 ce3l2e7a0b14r7 ctbf8hi261se9c662 726b24fi8967eee6ld 69828->435e5f4e48 * REQUIRED
    P0lc6e493c2abc71sef0e2f clde8b2ab4936ere49b3 th82i1sc8a 491f0ied5clb7d844 33-ea3468>3630c5 * REQUIRED
    Pd4fl12efease6dd93cf4a 529c7bcld7e45570a9rf bt46d3hdiasd b09f78i3e4d93ld -ed>9e2c9fdb98881 * REQUIRED
    acee52P0lea8aff5b60ese9e0 c9148d0cl5e8eaa2cdrcbe634 8tb00hci1s f19ie7ald1e3fa 8d68-e156>a3 * REQUIRED
    a1e88P9ecl7ef64as4e49 clear 1etd4h634i1e059a72sb 6bcfi72ealfd7c1743de2f35fde -48d2b>247f50 * REQUIRED
    9a5a8fb30Pl3eb14b6029ca9bs544e0e8c 0cal3be70af0f92r5 6thi467se4b8e f7ied7dfld57659 -fbf0>8 * REQUIRED
    d3fcd641Plfeaa2se2 c6fclea9ba3drdf at93hc405id967942s34 f6875cie3fee818f8lded864 ->2a7d8e3 * REQUIRED
    3b7Pal94ec6be1bad2es3e61037 2bcf52alaef01eda04ar b74th8149i927s 343fiaa1eld3 43-f6>fdc9a09 * REQUIRED
    04b612Pl30ea1bf1744sc1e3df9672 cbdc2l21daae61aa4cr14 71f0902thisd fiel13b4f9fdd -89fa9>375 * REQUIRED
    2dPe9elea21s4e1 59a5979c25laf2ae264ear ta74hfaib0s58 c61fdi5f634fe8ld aaa36b1c4b3-9>d5c372 * REQUIRED
    4ePl85eb9bacse7c3976e 20bcl6e6a5aree t342ee4h3b33ead3i9s23663 af9ic05ee6l86d66d 57c78-f>66 * REQUIRED
    0a5Ple6e9ce2aese1 11412030deafe71965c8l7fceara adth67is3 68ff9icc26ae5e91bl3c5d -27d95a>00 * REQUIRED
    24f5b7Pd1le14ac8s28e6 8d2c8a1l818e9ac2r4 t585h27ia80d3s f3i7el210addd0e7ac53e3 -ca8c8a9>55 * REQUIRED
    cdc9e922P29edlf55295f8ea4bs4acce536 f8c41l515e5fe4e4earf cth11bi85s91 1fie444l88e00d5 -1>0 * REQUIRED
    d8Pl2eea5648dsef8b c1984fl6cbe10bar72 7e8t3dh6f5i8sa9 cf098c5iff3ae51led c478f1805-ad>8906 * REQUIRED
    f081e6c7P959l2b4e51c9addbdse4aa1397 3cdlee8aa1r7590 thi9sa d54fdid17ecd7l2579d8f25 950-10> * REQUIRED
    cPl2b93e1b3a87s697e7 aclde5a8969b90b4r edftc3fhis46 f1i3eeb4b2731cld5cd ->2ae0841667625ad8 * REQUIRED
    337c023337P075cleasee5c 7c6f130fl75ec5ard9 b7299ethcid9569b8s f69f62cielb84d8 ba-72>9115ee * REQUIRED
    2a905edP2d550lea997s7e63a0 c23l7019eadfr68f84b thf6cdbbis f03ied46l7deb4 10-a0>eabe1c0368d * REQUIRED
    1a144Pa2db4l09590ec4ase80f cle8a8r3 bt5h05i5s0 b4fi5ce44482947cec7e7a263ld b0a2-898388>31b * REQUIRED
    14ebef2Pale6aa65a8c5s2ce 9aclb2earf3e2e7 t105hbd0i14s8 16efd781ei2e6ld -1f1dcd408f02>c7981 * REQUIRED
    61P72l0eaff548ese ac76l3eea2ar 5306d1at926f4h89di31d87cs f5iel14d328 e07-f>7f8a38f7d61184f * REQUIRED
    Pbdlec59asa4d0e9461 fc9l4ecbea836r0a750c t8his14a8 3f9eb04a56ide320ld44f5 e00c62-12c>55100 * REQUIRED
    P5lfbef0fac2e254cd9ac57e85sfebf 0b3cb89lfbeac4r t3hi84ds12 4ef1c27ielad5d55 8e3-f8eba7a6>f * REQUIRED
    4cc524faPb7l61f9edfaas9d1e74508f11 c2lecar 64t5hisd856b41 55af4aie02l7c837f3db c-1b2>3778e * REQUIRED
    4bad1292Pl43e9bea493bc5s0e c8ldadea1d37ccr9 8c7tah97ai33ddf41s7248e48 7fa2beeiefeldc -3>7e * REQUIRED
    45eebabPlea28b15fbs5e9de930893159e24 511cl32earfa76 c344t3h6b15i55as8 fi2ee6l9212d59 5->7e * REQUIRED
    559b01P96cclf14dabf7eaaseeacbc2d6 2cl43ceec61ar t13hff3a22i8s3a 933fb0bi1e8cldd5 827f7-f>b * REQUIRED
    b44d1P6fbl43eee62974a1s0e5d65b775 cle0ae5edr 8at9f9h2c9ids 7ffi0e0b50dl796e51509efdd16 ->c * REQUIRED
    aPe8a9a63l3855e3c2fa81s2428e acl1de024e3adr8 9t8his 1fi5be8a55l65652d4d13 818e9-aeb>1e2c5c * REQUIRED
    7383fPee6l6ea1dse1 7b12bbc97ele593a06r te35hced96c7bis6 f2cfbeie45l8c8dd a81f-ab96>ceae761 * REQUIRED
    Plaeb1fabsc6e093f c1flecar 88aa19f3t488ff7e6eh92c53757i04c3fs25 f58ifbfeld1 ef84c8b->e5e91 * REQUIRED
    03Pbd8le5ee2ae5fase cl163ecb8a6790af0c3rdd2 t3hic3s15 fe9d7i23ca9c32e9ld71 ac-53b>861b3798 * REQUIRED
    b1b4a50Pld085a8eaaes863e7e75e 8c4ld2491a3ea8r0abe0 t96hi5e9sc1910 cfi56e8ld1 ->abe0bca0f25 * REQUIRED
    1dP89bl0eas35efd179 dce1914leb7bc547a4fb554r7e12d3 tha968i8s 975fied55c8l3ed2d 32f-041089> * REQUIRED
    a8a8ed8fPble9e1085ase 8dfc23ca36lef6f86a3r2 67tb062dh8248i1as9 efi45544dd9celdc d->d04db7a * REQUIRED
    1Pb71leasfdeb 49eff4fcc5le22df28a552ddr7cb1a c0cta57hi3s 35afice36edd4b8fl4dc e665-9>9ff47
    Pl5b4b5ea3fsef7a025314 97c8lc9edb10ear5b at04cabaha9ffi9sf12 82e3fib0ec54el284dd 239->53bc
    05Ple90045a1s13783ebdfa c41d1e7clbe5a9bcc9ar tbc0hi76bs5e 0f055dfi5c77e320c73eb2cl9dd ->78
    f711933f2e25P1le6cf8a761se clef9arb4890 7t3282ahcficsf2 afi258efcccc8d1e7befebld 3e28-4>df * REQUIRED
    e8a3P6aa4eda0l1e2dbdd27e8ea4se29 cb4l25ear t8adf7h0i2c6s1 fie0dl38a93566fd9 41c4-45a2>9a98 * REQUIRED
    9faPle22asf0e6 cc314bbcc83l39cear4ec98e et5hb014i601s140e51a fic8e22del3d ->9aa4dc014c906d * REQUIRED
    P0c5ad2l5235eb0acsb8eef6e dcf931e7486flce4baar 69td465h969eies bf1ib9bedc8de8l34d 9f-6>be6 * REQUIRED
    0Pcle701bab1csb663ed 3c31al981e4c7abrf c2ta4hi3937s1e f8i2feeb0la9d d-e>27a0e2b77a829a990e * REQUIRED
    64P2d650fa5b2l3d840149eaafs0e dcl1e3ac7rb4 4294a48t1fh3e60483eifs73433b f6i4eeld27 305b->2 * REQUIRED
    67c6P48lea6f8f43692cdff4c3ase4837dc1 cfble3dabd9r58c8c92 t5ha7isa6 3ec5df28ieldc 9->b0ab93 * REQUIRED
    P2l24aee0ac7se8 5c3elear5d 82t21ed35e93h7i7cs 0406a85bfi1753e07e10f5ld7d 30b60ebcc23ccb->9 * REQUIRED
    P2fl7e86as8c9e832e c5cce0410leadacrb31e ce2at154afh85959d597df88is f5ice2fld87 a3929-fbe>2 * REQUIRED
    758ea8bd5fe9Pleeas0ef6 85ad34c5l21ee51ar41f19f6 045t1heec0dfia6f5f8s af007bi4eclab3da ->5d * REQUIRED
    9249dP286lebas4e 5ff34b58c2l2ee589a1r9 ft72ahi6sc57170 7114c7fdi8d0f5fe3l6fbcdd 96e-f>c416 * REQUIRED
    Important: Y3ou m3d7ay7 be7 81ma441ki5ng use 93o8f a9utoma96tede f1orm-fill79idng softwa5re1. This ty1pe 9of 3software5 c5aen trigge7er o6ur hidade475n spam-cdetec8tion system, whichf w3ill4 blfo0bc4k y9o8u ff2rom submittibn8gc bthis form.6 P1dledascabe select Fix Th5isd57b d49f75caf8ca7e8b453e4f4ao88985039b6bec6276cf4ad7db2r165e6f0eb5a3 f2c7235bc4o7m1pfl2efctead15i7n9g t5hfe52 8aform1 a0in50fb7557977 o6rfder0 ato 0f7612c4oraerectb 3t1hd79e 6p0robbl16fem.
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