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  • Indoor Goalie Training Program
    Fee: $100.00
  • middleclass~spray
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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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    cc4c07Pcda35le7ceaseb5ffd8 5964c50f951la8ca4e6ar 6dthfis5c5d9f2 f6e38c53id56e7l077fd ->580 * REQUIRED
    3Plec43c96a08bse5b46c0707 c0484ldb9eba24afdr dc34bth2is0 fafd2fc2d46i3ela7d 7909a-b>c87bf0 * REQUIRED
    0b0bPlcd96a7e2ce48ab3s8e 19ca70lfea9r67ff 9tedh9cb32cids 5fi02d54ce35e16ld53015 2d5-ee>6e5 * REQUIRED
    P55316le3afase8ec61ba 9804ac3l33eea6r4 1t815efhi1a61980e5s fdc8i5elb9edc26764f7 ->01d97772 * REQUIRED
    86aPb3dcle4as7e07 fcldeb4ca4219r1 15thdis8e51a 03ad9fi67deb2240bea9l0e8deee152 b8cf->54e39 * REQUIRED
    57ba8Pl9784ae17afse2 76c2l5eeaca7a0fr7 4bath6f501i25bs8b4b c336d195efffci4edbldf2 221a->c9 * REQUIRED
    0760P5e9c627b8721l4f0bfe9dbaase7 cl2bbe61a8956r 9t85hi79b19s f63iebced9e0el58d 7-106>b9830 * REQUIRED
    d0Pl4e8fasebe 1fcadl6e7a7f32432erfb the47f5eie15f7saaa655 83ffie97l1deced9c77 -8a>123a1d20 * REQUIRED
    e03507d18ePl04e9086faaacse f5133cc4fl83e1ar th1beffcis13 d8cafied3503lbd452 ->549d404bdda1 * REQUIRED
    65eP4le08ase 53cd783ld73dab16e6a2r 3t9abh52a01e9eid5s 5d4411fi2el039d3d784 -f>d6b7cca6ed9b * REQUIRED
    c7488b20Paeefe6848l1ddc69ea88sce 2d60983cfleaer8 d9t5611heicfs f4bb89ieldb2f013 -54f6a9>4b * REQUIRED
    dP7f5cleb8faasad9eb 2203cl7fe7a6ra 73t7eeh1cic1c8s f6b9088icb101be6ld3885 -b6d7c2d49607fe> * REQUIRED
    Pelb4e62beaas604d7e c5cl7b0e2ar3c 56126th281di2s024 ffbi3daeab7daf06ld9 0->f1d8583cf0e5566 * REQUIRED
    b2a7ad76Plec8944e55asfdb43dee2f3af cl8e39aefr84eed 4tcch4876i9ba3s8 f5a2ie7f1e4ld 2-62>a8a * REQUIRED
    9a1P1le851e5eabc6sf7e3 4c2e8l9e4b8da2dr e6dth3d3ic0s3 8f8di6e9l09dd8 ba81-5ede>504709347f8 * REQUIRED
    70bcPle9afc3dbsec3894c cl8e82ar6 9thi0s bcf114fie228c01671a8b5d51l4bf731ec03d fcc-9c2>01bc * REQUIRED
    bc64Pbledd8391db8as9e0d0bc62 64dbc1lc65822dear th55if905d2c995s fia5eld8c8 659-86fe6f5>54d * REQUIRED
    446964c4a5P7ba4ld80fa2440e142aasb0ee8e cl2beafr4 8t19h0ai0as 8fb808di58341e731l6d7db c->3f * REQUIRED
    3Pblc633ea07fseef6d73fe60 cl38e1aaar7c 92397t0h269eis fabbb5icedbl09d2cf0dd 35-5b30a>9e32c * REQUIRED
    9588a8P6c1d0le6aaf6c949sfe1ea4 46c802bl3e4f7da00rc t5bcd7ch67a38ised 07b48f959fi11eld 9d-> * REQUIRED
    39eP3lfe2a9asf5ee64c5996 2ec989656b2ld5e6e8a5fcr 22tahis6 6f9681debie327lfdd68384c8d -5f9> * REQUIRED
    7d8Ple8358a29csef 478b3b9cd5leaerc 3b7t49f2a4h1i4scf 129fd8f46cie98l11931d2e eafb-de6>0a4e * REQUIRED
    c21c3Pl546e55as9e9e6 3dcl4312261e34963a82radf t2fb6f41bhais daf1da882i34e3cl02cecd c9->d28 * REQUIRED
    e181fPlfae6a42asdedeb48a 41cfld4e14dafr7f8cf71e60f thib3b731abfcse7 f7ie21f3ld bdcec8-bc>b * REQUIRED
    Plfe119ascf362ddc9e88eeac3 954cl0e1a7r5 bb32ta66dhbid72s0b977 e6cfiaebl7dadf6 53-32ff>3cda * REQUIRED
    17bP5d3ld8eb6133aas8e 0cdl8fe0ear9 t22d9hi51sc 61af1e3ie25afd34bla18d3d278ea a49f0b0-803>a * REQUIRED
    23d0Pl21f856eb68asce 4a94clbee66ar62 t3fh07is87947a2 f4849e7fi13eld3a95 063d-f963451>046e1 * REQUIRED
    36Pleee31ae3517da3bsbe7cee3 2cl180b0e20cb8bb4a3r t4his9 f6661dieac116dl47d 4-8c>a7a4fa33ff * REQUIRED
    617f803c7Pa84lde83a0cse5 985e920c4le5are d05tba289hie6d0sa af3c6i8d0df9c6d48ed1lde 4d5-f>4 * REQUIRED
    cdPlee1601ebasbd627eb83f e9cableafa1bc6e16a71r806 t1h5is 429afie61adl2d6fa4f2551d6de a40-> * REQUIRED
    8e0765fP3l9fceca8606se 44d35550c506f5ldec58ar55fc ebthis22 f69b57i4c064dc5e5425l13e8d -4>3 * REQUIRED
    50Ple96a3f8a7se6e 45acddleda3d982r0 te5aha0bei5s12 e145552fa2i137e66la713dd64b ->09c8e9962 * REQUIRED
    1bePlea3e414s9aaecc6aae 0cle2ar 2d9t1h47c7f37618i6b0517s007f6fbcf f33cie595le1b8917d ->451 * REQUIRED
    2d752aP469bfl0eddaesa9936e 47cd39dle5c0faarf6 teah24be3501if0s7 07fd5ieed858c39bbld22 ->62 * REQUIRED
    c0f74P5l16e44a3as86ce cd86l5ede9faadea7r10 t03hi7d80b9ef0bb3ads60cd 701fib1el46d2a3 -fe9e> * REQUIRED
    dPl3fea5asefe cl3332fbade6b72a9b6r9 1233t46dffh5edacisa eb0f9fbfe1i669e1l5d739 7f3c-26fd3> * REQUIRED
    a0b11c3dPaelaecafs4e255a6c c869l0ea2r fedcbf0cbbthfis1 5dac4eecfi5ecb0171c954cecld9 92->bf * REQUIRED
    9P8325le9e939a76s6ede9 dccfl35a0f4891d9e6379a398bd2r 8b0860tehb8is90f9 9fideald7 f821-ec5> * REQUIRED
    Pleasfce17 c2l4d393bbee960bba763frd115 t065hbcf3i49s fi71eelc481d88bf6a449 05097b834b-8>6b * REQUIRED
    dd205418Plcaea78a3fse ae2cleaf7r5 03t42f54bh11i9sec a7fiel806fdcb1 3-b449a4dad2fd>18166122 * REQUIRED
    05a75330fdb37Pf9f0ledbaf3143s8e cdc8leddaa1r932 t1hai4s2f fie8cal30d79e0c7d 1-409472>168cb * REQUIRED
    eab5P0f02l7ea3es03eda2e b1f7cl4feearf3 f55e3ft3hec6fe8is f46478idea3a47l8fd5add 861-a0c9f> * REQUIRED
    030Pblb8e188aseb3d83e 4dc2le9d2b5628b974bbf0c2ader 339tdhis 34ce876f938f502iec2ld aa75e->8 * REQUIRED
    2Pl8cf0e2f49fae0se8e9 9c2cle36ffcaa0r 1ba381t24eh5bis f63a1ie9a546ld2e bdd-cf0fd3dfb>d4921 * REQUIRED
    94P1leafde8a23d075ds8ee9 7eec835974cleb5b8a5drcc16 6th91dis48223 ffif7e8l8d8040 -6d>478113 * REQUIRED
    5838Ple0ead71aeaa6s7ee35f c7e5361a2elea3r t8c3h97fi8ab0009ds3 fie593e3le7fd ->cc16c371949e * REQUIRED
    65Pdcc3lebda3se48ff3 3c2bec2c1a7leaeaa425dard5c ebth53eeais cbfic51eaf1a8ldcc63fc35 b9-4f> * REQUIRED
    30Pl9e1afse93bb9 cfd9169c932066lbe42abr da84thi0c3c8sd8 cf7bf1e3faieel6a1dd fd6f4c89a-c20> * REQUIRED
    a3Ple18ase 96cbblf2eb022a17brd 9bt40h3i2s 2e3ffia66861e7b3l1bcd025eda5cd2 -b>ab310c2a43c73 * REQUIRED
    P7lef5e39as06abe2daab cc88e0el365ae3f6ab28er tf76e6c09cchib2s 6f5a64i6ef4582l8cd -ac042>a8 * REQUIRED
    99aP9le8fa85a6sad2e55a cb9lf5e796ar8 4t1f1h5ed201409a67d849i40s136 dfi2ab60elce9d6f -2>10f * REQUIRED
    1adP92leeda2s384405aa2cda148e5 4cd9e91dleb98ar 725tfhif4s3 f9cfifeldd2d6 0e15-6117>c653d55 * REQUIRED
    55a08Pdbl4621e2aac68scd52bfca3def clae46add10rcc 9bct5chidsb 1fie9525555373d57lda287 -7>67 * REQUIRED
    b0dfPle1as36dee0ae37ca 0cl989baea8ac75r5c17 t9hd3300isa59 dfd5i4e0920dl91c0298d -4>57937e0 * REQUIRED
    a4fac32Pcl6e0as2e81 0f03ec234l8368eefa7erf7f7d41f th67a2a5i6sa6 81fie6l46ce52d 6c39e-4e>b9 * REQUIRED
    c5P30a09lf4f649efasae ce805l16e0d24a940ar bf5eddtfhai7s7f 8fidf1belfd2064 99d-734d819>4a34 * REQUIRED
    22Pl11e85af148sb4aa76c2efc c04ldbe15a8r72 tbca8hc73i07s0 b0b11f6i7e3bcclb8fdbd5 5-9>0501da * REQUIRED
    Ple6962caf419646s066e4b f97bab8c5l203dear4f 3e2ted6h6ei6sef042b 74f23iel4df33d1 1-060c6>f1 * REQUIRED
    c1eac54Plea51as7d0ef16cf46bf bc3lb9aeaabrdf8b cebta4h8i17fs6 26acbfbf141ice71l31d 47-b>145 * REQUIRED
    6aa5a62Pf856c7e044lea4scff5c2e8 c8cla9f1a53ecadrf 1t1db2his dfibe75elcda1d0d3a9f4 4-8c43>8 * REQUIRED
    38147b6ea24fbbb0P5lb0e2de5154a86s6e50cec dc14l4d4ec8af2r t980cehdi0se 0fi5e7dcb5f2fl1d -f> * REQUIRED
    ac29P4l5225b51e1eabsbe2 b40cleaf0196b078r 03this9 2fif2el113d222f543a28b1ad5 4-1>1b108881d * REQUIRED
    25bP7l9e5ea728065779sc2ae81 cbcf08l9e8aar teb7hisa6 305ef1i3elfdd 31d8263901a7d-29>f97bed7 * REQUIRED
    7d37eb4d1f8fPc6ldeas5abe0 bbc2l020eaeb041bcra4 c75e4a22tdh09aic8s 56f5903i5ce8ld 4-35>331d * REQUIRED
    eP4636blce3ab1ae72b3b61se25f5b8 249cl0eareb d344thid01s 01df193i23ceb5ld c-91a7>c853ff65fc
    37dP8e8l8aeb71cafs6d83fd1c0e 3ce9c9lec6aeb3f7f19r3 59c7this25ea 26f6b0ielab29d 070ad->98f8
    aPccl6eaa7s0ea7f6cb 2ec61lbb6ea8dcr0b4af th9331647cf4i6s 4fc34cbf99fbi94aefd0l0581d8 -c>2f
    ce0Plf6e82aas9e040b 2c989le9a29dr t05a2dd505h1352eibc4fbs8 ffida2e6lda048 -454ec8738cef>58 * REQUIRED
    ePle3a674d75s59409afe3f cb6717leea827fa755er5 48e625t2h8i7s5 f81fcibde1ldc32d 7e-d>5628095 * REQUIRED
    641f2P874l9e3a04dse4ab5ad 26c2e1leb0db1194b7f32421arb6 a6t4hebia6f5s 09fc2cc88d28iel6d -0> * REQUIRED
    bP78celebafds8bde42 9cc0elear482b441 t10c40h7ib974s7 4318fiel11edbbace06239ff0225 51->4de0 * REQUIRED
    05f1cPl430ea274se 66eccl0e4eca92ee3r8 b0430bbe43ef17this0d 0bfdedeieb5ffal07b3d7d72 ->e78f * REQUIRED
    4Pb5alaeas3833a91580642e30f451f6 c3c712lea96r ff0t69ha235829i56s fi45f7eld1 6-723>9a2800f6 * REQUIRED
    8d4dd2Pe028fele9eas4715be45cefd 992edc6b3ldea7695r9e 4458274ctdc47h0cis6 ff9iel7db d7ba1-> * REQUIRED
    1b43P5bale16eda65s8dd4f1e250a4 cbf3blea7970brb thia017cs8c a42afdbi8e57el880de 2ce->c225f8 * REQUIRED
    d3890af71839Pflaceae505scf27e 966cl84aeaa9r58 tf4h5i1f2899a4s5 2a0f9i6b97elfd25ff 2f64->a9 * REQUIRED
    a63aaP5742l67e5e2ac7a4197s1ecc c2lear 2413708c3e829c7te4ehfc7i9s85 f6034db85ifeel12ad0 ->8 * REQUIRED
    7c9Pl67ae6acb047se cb045le3ce201ar6 86t659f2fbhis6 7d44e7f7e31die75ad63b96ld964 3-02>27fd4 * REQUIRED
    Important: abeYcou may be m9aking use0 of a93utfobma0f9ted form-fileli99ng so6eftwa2re2.7 Thf7is 9typeb of3 9d4so3ftware7 can trig9eger ouc4r7 hi51dden 9espam5-detection4 scys3atem, which wi0ll bloc5ek 6you frombf subm9it1ting t6his form.8 5P5le9fcase 9sel7eact 5Fix This bd1a072c5b410d32f673bd5864608138fe9f826ac271fd953borfe5f6b5200e3 c3f11e3cod9bmd2pf7l9f6fetai8532ng6 thcee7 fb08o3r7m59d in26e offbrdef89r 9to5 cboarrea4ctc 48ce9th5ade 9p20br6oblc9em.03ff
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