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  • Indoor Goalie Training Program
    Fee: $100.00
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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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    c90Pe761611l9ed860aabb9sdd0ce 0da83c8le4ar75 ftd1hcis6 9ffie55dfl7a4fdcbfe 163d6-ab7>9e397 * REQUIRED
    6ad74374d4Plee6c18a6se 8clea5c0r e6dt2hi8asfa f2cbd1ie215940e2l2d1a5048 85cc-35d1d>05794d4 * REQUIRED
    4Pd1a16f21bl14deadbsee8 cle9a18arc0 2thf6ieds63 f6d1ef3ad12a37i8fef4d5fl4d81d038 85a527->d * REQUIRED
    5P2le8ca9s7ae1 86de933cc2blefafr050b4d8ed7 dt0hidff3s56 f33f0cf8ifed3a1l9d9 42032698294->7 * REQUIRED
    9f0aP1leacs5e97e640a65d1e clcc137ca7e0afr 8et0h6eis 93f73bbe55fe251icefdfledddbb115 -61>90 * REQUIRED
    1ae59Pblease8 cl7e0arec5 tec49h7ci17980383se fdfi9be04ld44d260 6-42>d76c235cede13a0741aa92 * REQUIRED
    f51c3cP9l5e4a53bs23e0c0 2c1l6284a548ee9bdar 5t06411630h551eac0dc4bdbi91s8 efiec3ld ->f7c53 * REQUIRED
    0d1fe6Pc38ac93fl3e6as3e clb9ede652d9ar700 cct1hifsa 60bf4ie5070ae3d96c885c74e0ldc 3-c8>fb7 * REQUIRED
    fde7Pbl813dcbe1adse4c8b2664 cle6a3ab8c4b0r 005th9fi73763ed9898s 5c1dfield aa3e3-4ff2>cc675 * REQUIRED
    d0a37Pbf11c97le2a1s37e c682l833fear teech2edic118asd 92b68fd15i1e84l5485a6e2a3bbd4acd b->9 * REQUIRED
    ef6032801Pleca50s1eb38c8 cl52ear7ad28 35th1i73e768054cccs7f0ad fi9bce5691ffld7d ede-3e8>8f * REQUIRED
    c366aePd1fa4007dl57eba5fse299 aacc1laear94 fbbd6th71abd53e46c04c2is efi80el1adeb a8cf5-c>2 * REQUIRED
    3aP41339lea88e1da16303se7 4cl2ec05a789r 37thc2772di321sd0c feiee7fl8dacd7221b2 -ba54>237bf * REQUIRED
    f4cP7c87l736565de805eas49d5ee4 clecar 55bedt5772dehi3sd71d b7f95i3e2eal8dd 8-673>043f1efc4 * REQUIRED
    4d2aP4ld1502e355as8e10581d7c 88ac8392l41ea3are0b1 t4dd4c42h8c5i0s 5fi0el0dcde1d9a99a -e>06 * REQUIRED
    dPel4ed4cd64a10sf941ee c34l9ae5109281a024ar t8ae260a2fh1db094is991 bf3a3ie7e24l49d 5c654-> * REQUIRED
    69P36lfb29ed0a0s4ef f1bcflear t64a1c9aa25hci92s b86253310cfiec5ld27c85d 04a-21a>6eec77ab11 * REQUIRED
    ef0Pfl8ea5s609200a6e63 491603c974l8fe1a68ber dt5c4hids9 e9fi6fcedd597c1ef9ld5 f74d50a->5a2 * REQUIRED
    f576aPlae48aaedb1s5e6e0 9c13l0e10ea8r0935 th8cfif4839853s9 f2aaiefl37d8b 6ce-d>7731669ab6f * REQUIRED
    aa27833P22leasd7297e ac5le5a5305rd 1ec1e3t9hi89as262379f f060ieeebl536940dd59 f67c-f>46f72 * REQUIRED
    9P3lef3ae240s189e5 e6f05fc37c87ee1le2fcc5aff7r 1a6f0cb63fthibs df88ai183e2eabdd4lad50 c-b> * REQUIRED
    67d2c99d96P6l2e9fa936583s7e2cf9ff 87cd4el1ear 17tf7beheci0a6sf fb3i5cel8d -cca>a2f3b5f9e46 * REQUIRED
    286a0P67lease269a 0d4cle3234b4ed88fa3f8r 956d60tb4e2hi6s1 9eb66c2fi79e7a6ld5 ->d47b6fbdd34 * REQUIRED
    eb1Pbf2aale42acsee 09c18717l1e2a7crbcd 3fthi35ds4 461a0445ccf1ife4ld7 8d535d-b2>5a7627724c * REQUIRED
    284Pl7eea2d8846ca91b67sd203e e7cdl1ddea0ara dctf9118h4aifs 7f9e8eff30adic4e497bffld8 -f6>f * REQUIRED
    fb35d261b033P43d2leaeb95a54b1sec 89029e6cle07bfacc7r19 1t346h31i2s 6fei1el5453d f-b447>f8d * REQUIRED
    8aPbcd5l0e1cae04435b5sa9e claa19e90a234r 78t9252ec1his146b 991f8ie42lac58d97 f3-323>757399 * REQUIRED
    b9cbaPb5lbe1a5se 529cc06l3de2ab4a3f51131r6 8tehis e957ffifb3e029lddd1289 2c5139->b740dfecc * REQUIRED
    7817856Ple1b237fefas1ed8 aed7cl8aebafbe2e0rb 0t3e6bchi543f8828s fdiel1ced56a20c89 40-bdb4> * REQUIRED
    7Ple9c454c8a7se c255e47lea8a8r 02c91489c2b46theis 2697f52fice748285ld 79395c0159-06>ddd2f4 * REQUIRED
    06abPlbefeafsb89e 2c9f747led48a49a6r6696 t8hf1bfbbids1f5283a13 374ffie2fe05a5l7d 11-688c1> * REQUIRED
    a5P4lea8scff047eb2c61783c88 eccablear037 ta9c33h3b427is f21d4i2e1ledbe7fa66fad 2c6414-8>2b * REQUIRED
    90P39lede56asce1e97 e7ceb28fl1e45a9d62rda te8a561ch2is b9fib9d502a3de43e3l8d00 10->84ca45a * REQUIRED
    Pflead7fsae513 b73c74744eebc3l42bear43 49t43hc4ecis8 f0d0e4if33fel49a8d c-4a>b925114ecda1a * REQUIRED
    2b3babP5l34cd90145d4eas04042e1ffa1b c55cdlee2arbdb65 9th4i9608c37622s19f fi2e2l6d62 b3-6>1 * REQUIRED
    a17Plefaeb4375se2c00c f49ce7le3385ad1dr7 7t13hf6f2isca17dca7 28fief579ldbd 9fe06-dde584>67 * REQUIRED
    de5f9a4P97l2e08a2s887f8ae5edd c9f03lcee9136arf2fe 21at56cdeehi25s9d8e fc3fieldc980 a5-73f> * REQUIRED
    cbc6fP8e6cdl6ea62ebde0sf9d8a6e3004e cclc4be16a5cr7ed03 458edeb0th8is4eb 2fielde4d d->f485b * REQUIRED
    ebc486P50l902d8e3aeaaf54sc1cae 987ac3l96dbf21ea66dra f0t3hifs4 1567fai9ef6c2ld9924 7->3726 * REQUIRED
    7cf907P1acl7e2ed9bef955abe9d6sed7 7c553lear3 1etf2haics6 44f461020i2fe40lacdd -eebc2ea2>50 * REQUIRED
    Pcfdb6lec2ca0s22e a401ca87led419d2a1re th97i3s4cf4541d 1fi16e8e6l0393f15d 1dea467fab8-f>49 * REQUIRED
    3Pd08724ele5bba2se clcdear176 939b3tfa32ahfis 281bdf3ibde1e33lb8de5 5b832cc5b-34337>bd008e * REQUIRED
    2cPlecba8ead104s51ea e8cl9eabbr63b379e4 at3b6h775ei0fs6ef 6efb6dce7i8elde17d6f a34009d-4>b * REQUIRED
    40565Paleas529ec319 fc9leardc74b7 1tch0707a4i7cs90e52e5a651ef735b51 f4a12fiel031d -7>578ec * REQUIRED
    5f973dPl2e73cea2929e0319faa1s5c91e ccblead240e0rbf 32ft8h39icbs5 f247i228ecfd3clad -e>df03 * REQUIRED
    9aaecP7elea8961s23a8d4e f8e1cdlear24f b3a1f84df4thd0d452if2s28 4f0i5ee8396ld 1-650>f5c7bb9 * REQUIRED
    910ePd154402le2dcafsed21a7638 ac8665ledar4 bth7is6a73e33a f48i9341cfedfl1d6 4f-819a>f788b0 * REQUIRED
    92330P9dccbclbe2aa49ece3sd1e141c 2fecd8falear th2ics50 1f0i5ef37dldd3 0e0c-27849>95062e726 * REQUIRED
    P657l29c967f25befdas3e70 fcl83eeaerd0 6tdd3a451ae329ahisb7 5049fcfid9eea89l0d 9c-4>c020606 * REQUIRED
    3P2c403b0993clfease8 90clc9e5f808a937drd03 td0fd0hisc82 fif32e1f6a5e64e9cl1d6 a31->8a12380 * REQUIRED
    Pl3ee55a14bs38e5ec 187fcc63dl4ea4r29eb t8545h0836c3ei7bfs0 f473ff4i675elcdd bb63cbd-079>76 * REQUIRED
    8fddPdl640a2ceas5e3412 0c471l9ea17rd 117390et4h48cia5s7 aaf1ielb30ec1317d0a213e 7e5c866-4> * REQUIRED
    aP6f8f79lb3e8a93se059f a0c6l6e7a7r3fdfe97960 762th4is cfide14eefl3bddd65b62e 755a-7a>a06cf * REQUIRED
    Pfac6b43b2999lc724e8ea101saee 9e2cdc7la21bfefe6ar tch7e4e3i580686s 0a67fd6ieldd e-97672>9d * REQUIRED
    93Pb9l5a6eas8467e57 c3lee14abr btf82b101c3hbibe23a2s 29fci37e5ela9235d4076 345-7>00563fb8c * REQUIRED
    66P8cdlebebas6ef6 0bcbcle30fe754c7ffe7602a85a04rb63ad t1ef1ceh6f75is afca062ielce9de a6f-> * REQUIRED
    bPcdlb7ebfdfd797acfcfsb9eb caf66a8l9e5c0da9af6r 0a6tfa6h6i26sc 07f0i2d0deel3c1d e-6>dcf065 * REQUIRED
    b5b1fd6P039elc078eebabf8sfe5c 41c90f81c2cd79abl1e7aer tahi2a5252686s 1fibdef35lad3 -9>9d02 * REQUIRED
    58727cePdad1alcbdec7asde805d3b ccle90fab8115cr2b57 tb38cah9f380813ei38s fiel3d af218-a50>5 * REQUIRED
    1e44101bPb2cld76ea2b2s817ea52069 2dfcbdle17a5dr th000is 1f4i1f06eel142feda 35733337741e->e * REQUIRED
    c8P72lceb9a9s26c9fe91 06bed78cle13b4eaar1 2cad47b84275th95isda d9dd9fdfi4el2394d734 5-c>91 * REQUIRED
    ebe8a416879Pa05cd7leaa01a5ad39a42se 464eclaceaar1fa ethis fb3b0b4fafd8i6ac885c5dbel6edb -> * REQUIRED
    80a7Plef84a2541ebs7e54 c45559le9838b591d4ar 2421459at8hi93s ab28fffi8541e30aldc b-777f>3bf * REQUIRED
    528aP107lfec18b88a10sfe cl4ef77af86d8bdf5baff0r a28thdfc32d56ie4s fe7bi7e2cae5l29d d-f63>3
    * REQUIRED
    8f50f66e60P1458260lf5e2a53seb2358e5 ecdff9d7c7lecacr3 t4bbhibb3s4 958fc0ieb404626eld9 -2>3
    * REQUIRED
    7Pl8e2252a16adsdeac celae8eca47darc 4064684tfh163ei132f405s661e147f fib1e0f2ld eb0a0->e9e8
    * REQUIRED
    aPal34e7ca9ds61e1c 761ccel3e3d78402a5b9cbr1 42t2h7i0s1 9f55iec3a1347l53d7de22 218-9>2258a6 * REQUIRED
    eaPalcfe7ab6287cs4dfe 11clearca64fd15c6137c 80b0940060thie036s08 f9i438a2e9cal7cbbdc -e3>7 * REQUIRED
    7P3cleaese c11l6e876arc f5d23bcfdt76d4fadchb7abisc700 5f6i92aeb7e520l3abfd3d8d18da5 227b-> * REQUIRED
    6b3aPleaba7se9a f3b7fc310c3le1a7rae t77e0eh884e1i0s583 f6i67605el3ade8 f7-69c>f890f0fec992 * REQUIRED
    a00f13Pffel8e0250dbc1a7sbae131 cdle71eea5a2brf8 0t0084ch504is 36fiec3lc70750bb1800d6 ->31a * REQUIRED
    4b7e941Pleasbef9 c2e2acc874l70ae60ea72r9a tb2hdib40a813sa16 3558f0iele4e6d ee85e-6398ca>95 * REQUIRED
    659Pl44e0a9fscc5e2e b3b2c9l9ef4631bar2 9dtbhi2s7ddb ecd8c07da48fi5061746eebeld1ed62 b224-> * REQUIRED
    4P7cl18460e0d568a1se4 6cc2dd18ec9ca0le438b5a0ac7rf 4thifaa56scd f6906ia62335e0b4l635da -0> * REQUIRED
    2b0842P45df1l5e1fdd8fa5se c6db2887c1le775334a8r 9tfdhb31dfi86s8 fiedl8a9d 3592-642039>a4f9 * REQUIRED
    bd65fdcPblec1asbe72 9310cfl48e9d0bc0carb696 63413this 0faci97eda6582eld 5-2f733>edd8c804d4 * REQUIRED
    1dP150dlce94cadf9c7e951b7dse c51l41cea8260acdr12 ctbh0ia8as79 af4i2eld94cad b4->600aa6832f * REQUIRED
    Important: 9bYocu m72ay b6e6 2maki7ng use of4 autafdom4atea5bd form-filling softwar2e. 1This ty5ape62 4of soft1ware can 1trigfc48cg6er our5 hidden sepamf-9detec0tdioen sys65dtem2, 212whichd8 wd2ill bl0ock you from esubmittin2g this foarm. Palease sel5ecct Fi8x aThais80739809 b0eeaaee551f58ae053181f4or931b6d62f9f514502da0a8bdaa510eea 94cbe64f6e3cf8omfpletindg 1theb0f afo5frm0 506i5b1nb3d afo374b5627rde6r 56to3 62cofbr2rddec597656t fc3t3he pr21foedbb3lem36.
    Important: 5You1 m7ay be making use 1of au8tomated f7orm-efilling software. Thfis type 2of s6oftwar5e can trigger obur hidd1en sp2am-5detect8ion sy7scat41em, dw3hich will blockad you from sub2m7itting 4this form.3 It app9ears8 that the p2robl4em could not be auct0o7matidcaall9y c0o1rreected. Pl5ease clear dafny afe2iel3d which app0e2ars 1abod9ve wi1th9 2cdorrespo3an8d4ing incstructions8b18c22 be20afc44aoe6c0f6b7a311858a5d39fbrd2be1447dd77 6ee30c996f47d2053b789co01mfp6l6etifng thee form i8n ordde7e67r to1a 5corrbbect th6e0e pro728b7289a9l1em.1c 5We 1ap99o1elogeize78 forb t7hee incocnvenience and wea9 abpc067perecia5te your understcan2di1fng.bd
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