Registration and Payment

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  • Indoor Travel Program Tryout
    Fee: $45.00
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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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    f8e819b4Pleae0a2a6se6236 2c3eaclfba7e2caaac9r2 8c2t5bhis8 f4i1e2899cleb549ed84 d0c-16>e7d9 * REQUIRED
    0980b7c7P880ee4482e11fcl0c1eabs32e cle1e2d6ea9fe9r ab4teh5d5id2eb58sb fe78ield57a bcf37->7 * REQUIRED
    89516Pa2le050eb6a90e0bs890e e91clearff6b tf8c6h24433ic03as572 f4ieb29d45lb10fdb444b 91-c6> * REQUIRED
    a580P9l5e4as7c284315e1b clbe72bafc9r6feb4b 2d60t867heis f90208ieec5c2458fbdld 730-f4>d34df * REQUIRED
    c457Pl84c3e3927afa3se2 2cb2l3ead7r93 8fffth1822i9d2s fi51ed572617fl612945d9 8cce-30bb>7ccd * REQUIRED
    642Ple0d5a279d19sae 57ce3l5d866ebeaebca2ra58 af4th134is73 bc09f8id513e2fcefld327 ->51a457b * REQUIRED
    9a2Pd5l3e3a9a581afs72a1e ece2l5e9c9ar cth1i922866sdb03c91 1f6di3eee00l51806692d6 a45-86>ed * REQUIRED
    1cefPe077l2e20391ae25ed40689137easce34 cclef3a7cacbr 71tchis8 aefie9bl2284e73d -2>e11dd574 * REQUIRED
    b1Pa3lc7ec4cab8b6c4s67770e5 c0c4le2caar da72dtceahf4ie6bs489e69bf5 ecfiel7d7e08 -b0f20>535 * REQUIRED
    8c64d08d2Pl21c2e6b65a06s19a290de19c1b cl8ce4bd9aa2re7 t407h2is3ece1f94 b2bfbai48e84lad 1-> * REQUIRED
    fP8901dblefa5easae8 8edclf4beaar138 88d20tbe8b0e0hi69a4s bf66cdi3e8650elc6539d 0d-d3d>e186 * REQUIRED
    855b6bP970l4ea379fd82a6s4ec0b fcc66l1e0a331b8935erf684f 5this 0407fbi65f68e835lcd 4d34->2b * REQUIRED
    197dd1P21l0cbea75s1be cl67ecar dt5a6h2iec1984ccd927s42cdb2b7 6fic719d4eld81 6-e2>1a95bee6f * REQUIRED
    5afb1d1Pbledasc9eb66 cl1eeaf6cbr ta9f1hfc26ifcbs71 01fcb7cd96ide05d5278ld7936f1f3 6-e>e128 * REQUIRED
    13aPl8easb30e4e44 418ebd3a41cle1c77cf00ar f2b2t680fe98dh61ise925 1f76i7eflf2dac5 87-9>b0ba * REQUIRED
    adaP0a6lb87ea5d1sc49e1 c03b3095l5e16car 38c3ted76h20b7c03eiscb 4b4ff6die1e50f0lf17df f-f>1 * REQUIRED
    0554eP03le0abd6f4d5s6342e8a 676cceldd374b8e0d8ab4r4a859 9fethffiascd77 9ff7ielda3 52-c>8ae * REQUIRED
    f3P2l8c5ec2aa1se47 fcc5cl80d3bce7aa3acfr 36th3f6i5fseb fe666abeiel49ed 1b-e42>1ef5acb4c752 * REQUIRED
    1ed4223ac1P0la27e1eabaf5s79915e 0clb7aea5ar9a7 det7hbb8f98ibds2af df3i0e9l58d2123146 1->d4 * REQUIRED
    8Pl25e0a7ab4867d6b1s1a4c2e88f78 f53dcl8ebarf 3046fcdtb3dah26is 8feib3d4el2d a9983dfb0bd->9 * REQUIRED
    48Pe272l6ea47es7a962ebc 09849cl957ce289ar 9t8c66428df1his4 32fi454el81cad b-f>7031df734c2b * REQUIRED
    0b8Pb0le26af0se1e 53cl0e47b6793aab52r488f3 fthisdf 97fe52bi82e9delcd -780>05c55942463d6c03 * REQUIRED
    dP4fle5629169ca5353s3c3ee 8aclaeba679ar t7hi575es2ef0d861b d5f6c9i9c1de2l8609ddab e->0b7d2 * REQUIRED
    cPle3cb0ase3 c7751lf6188ear9 t79c3fhif1d381c372s fei698d7e074a9led8 53f70906-8d>a90176f26d * REQUIRED
    7b5f30dePelea8e69527sfdee85 cle942afebe0a8a74def5r 522feft9hics83 7650fi8cbeel4d b-0a>29fe * REQUIRED
    9P6l36eeaa3s5cace170 c618l263e8ee45983cf1a09bbcc9r 0th0i62ad2das4e9ed3 f4ie18b11ld -cbb5>0 * REQUIRED
    8f868552P2ale23ad5s2e3 clf04a6eead9cr41 5t63h3is3b577 74f431fi2eld 1-5b33b53239f5>c3f427b5 * REQUIRED
    Pf480cb7l7ea9sacef4af cle66b45adrb7 14addbt0d654c15dee0hic7csa01 51fielb9c2b98dbbd 13-975> * REQUIRED
    639P65clee89aa00se5d250e clcfdbe5e78952acr4 332t5hi298d115845sb f668fc6i9eld -91>9aea1dde1 * REQUIRED
    Pb2182laef407deasefea0ca cc995l2a3b13fefar 7eath8is9 f3ied00253le5c95cbda e0afd-74f17980>c * REQUIRED
    335b181f17222P7ldefda8d2734591s5e0f 1c4l42ear72 t76409hidbsd 5fide2al0efdc4 -3ec54>ccc70a1 * REQUIRED
    76c1Pf9la553e8ff0fa29s103e c88bl0e9a8a9r4f te0hi40594sf4 4c1badd3782f294idel3e45d52f ->13c * REQUIRED
    7b4Ple9a6897ef546563dsb2bef8605c 4fcld1fea90rf7b1 d1b9149tdbh656i0s6 3df30i52eb8l3d 4-988> * REQUIRED
    8127P4l40ea39s5e1c ecdcl3cea9685r thi8s13706973692067dfd46 94fadf4cf0i741efal0d1a2dc b20-> * REQUIRED
    56P9lea0sef a40cleb2cd52ear 3ca1t6434c3hisca fi6c5c96fe53c3e7f34ld9d9f318a9 f9c-f995d5c4>9 * REQUIRED
    5Pa3leaf0f6sc01ede clea5r3f87 0ffath76ea3a2i6ddab4sb f142ie8lfc6c28a443d1 5dc18-fe>a9ef04e * REQUIRED
    dP5d9lbcfee1aseb2348 c33db4d1a0ele46d4a6a642ab4a473c8r fcthceb7i0s 7c9f89i541el781d8f ->34 * REQUIRED
    b37P4l8ee5302a2166s4e22f 406119c391l0ea7e0ear a859ethe4id4s7 f81bba0ie0129ld3 8df->fd198cc * REQUIRED
    a5965a25e4560Pl4a823eeb2asf6ce 9c4alear theddi0ds 30f5dai057eblcd5d9fe5ec46 41c3cf-9>66661 * REQUIRED
    dc19Ple8beaf1sd8ed7ca57 7cflefa72ara5335c1 7t2e7b1hf64b86d3i2s6ce159ca1 fi8e33cl4d9 5c-c>f * REQUIRED
    0213dP73le31a7dsd30e a00c5l9ebar 5t164a68h4i82e11s f4ci98a0e5bldce90d0c58ad 8a5f8a2-2>d971 * REQUIRED
    4634850ab2Pl62ce0bcasdee40 c846el5eab04r 8ct452hdi3s 6fdi5el8d60 095ed9fc322476-5>71604b8f * REQUIRED
    Pl1ea6s259ee650 9c41el5dea2fr208 c55f8tf4d47021a02dh82is6b 837ff0dc24i5de26flb1fbdc c->dc3 * REQUIRED
    723cP803l0eadfc9casce 3a13c3ce9e1lf01a5ce5dar024 t0fd7h8ies fi07f3e0l5d 5a579-fb49>4c1a56c * REQUIRED
    85288a6Pfl5eas8490be cl2cefa044r 6tfc4d220h5bba673eisde0 50d80f25826d333fi1fel9dd d40-7>ab * REQUIRED
    cPl8eeas0e7c 4fd44ecdlee8adf5r4 at09he15is900a06fbe2 890ff507i12c222ee7e9ldd6f5 -483>b76b4 * REQUIRED
    21Pl4c6ea66s86d707979e71a3 d12ecee5afcb7e261dl8bdedar67 6t047h3dfis 191f28i26576e1ld -2>10 * REQUIRED
    61f5Plfee7dbda60s26805ec3 11celced2a9rc81e1c 1c3f6t485ah7fi7s ca2c47fi8cdfel8dc a4-91>1a37 * REQUIRED
    27188cc4fPl1133eaes9e07eb59ff e0c2al7ea16rf at77hb6is14dc341d 6fie3ld6fb8347 -5>fc4bacda06 * REQUIRED
    3eac9P1la827de0e42bas81eb 79e1cleca80rc972 0d9t3dh4ei3279s60ed2 9fi0ee4l779d ac22b6d4-5>05 * REQUIRED
    0P9l9ae2aacsc4e4 7b4cc6cfl7deea2db5d8a701f6cb02rc 19t579a2dh17eis b9fi970el45ba02d -89c>1c * REQUIRED
    62a8e6P85c0l6e0f268a343a6s247c6b6d26ea6 1clea29acr e2thi32dfs e6b7f823i6elbcdf1f 8-79f04>1 * REQUIRED
    19f8ec289e7Pl6aeaf6sfe4182 f33ccffle1aed8fr 0ethisd 2abf6d3iee0l595d5 5774cd-a>90faba6247e * REQUIRED
    e240d16aP4al7d5e9asebe72 cc2036dl4e5aar1015e a0thaid5s6 f0b9ieldd be18369->a2dbf64723ae7e8 * REQUIRED
    P1leea9c9s15d78f105c85eb3a5 c333elea0r8 8tdbhf0d5b6fisb 5df9i5e6al3176283f6dc8c4e 7-e6>ea0 * REQUIRED
    a38af58Pl6890dead6s9dacd2ae6e65b9 c50c2lc8e78914a9fa209r th05i6s4 15fcie9l61d c5-0d>aca52c * REQUIRED
    5fPl80e87a58sef63af341 cfdfle06349e9a2rebe c66bbe22t885ehis 16a1fi4f9elc69ed46 2c-6980>9c0 * REQUIRED
    17fbfPlb64e0a7f7se8 a4a4e3dcf5106lde9abda9r34390f3 t792hic8s 2fiel00f110df 2099d9-cc>844a9 * REQUIRED
    74P373e5lead1e710fse6bf4d 1cle9ad7eabrf3 f5et98c82bchfis0e5 cfci0eclbd15 272-a>8041c3bf1db * REQUIRED
    b72cP4d7d7cl2edaa5sea5 cfleea9a640r3d4637 2tb3511h8a5is 65ef93iecc2l3efe412db 312b6317->80 * REQUIRED
    c1f69P013ef52lf5de9as0941e 6c8lc7e6cb6d3ceba57b33rc83 t29h8is fab7i0ea2ld3 bb389c32bd9-2>c * REQUIRED
    aPlf742ecfe81ea81e9se 07cf08a45l3d330c8e208ar0f2887 tb67his 2e8cfb4i90a9eld184 b9-d>c23007 * REQUIRED
    27d119dca1aPlea3s33e30 f6cle0afr074aebe c1e0fb7thise99b1 7ffieclde 21-2>fde14fe6995459b3a4 * REQUIRED
    0ed3P65l6e1c372baas13e19d34 00529649clear0 d2t1afdeh3123id5796as bf3e9ib14e07el09d33 a6->a
    P7378leasfd77e56 39f575c8l4e0arf t149hied6f28161s 96ffb0240703iel9a7ed23 8a0cb7f91-c8326>6
    8bPleaea961abase4227fec5 eeclear t45hci8sb8c 1dfd2afcfcfc4ie5edl9d583 50825-7>98a19a593d81
    646dPldcea5b0924s183de 4cfl6dbcear 3ce7ad020tbb6614hi443csd025 9fiebbl5dd 4e1c0-dff45cef>6 * REQUIRED
    7db7c4Ple1as08e8 7507cffefca4ld12ceb9a4aer 87t8h6ia210esb0 92fi5fc1eab68lfd7 0eb98->f51e6e * REQUIRED
    a5a14474P9le2aca4sb84260e9 5b310clf7e340a99a004r5 thd5aid526cas 8efi1f8e614lf4d1 69696bf-> * REQUIRED
    c1432Pc73ld36fe1accb911e9as6e47 bf9c4a9aflebd8afr 77ea15t5hias 51f12ieb9lcd bd407224be9->d * REQUIRED
    1965P141leb27bead38basee06 c164b7bbflec4aa9r taf37h5i530s8f8 9fei6f02aeblcdb2d 2c-85>67157 * REQUIRED
    398f69Plfeaad45s89fa95ef 1cl31e747b74abc79ar15cf5 d2t41hisc f66f5ielbcd3b 5-9388>14b854c7b * REQUIRED
    cf62be1983e01Please635d cle8a98f2a7are th6i42bb7s d86dfd5b72051ei4820ecc243ld4 -f651>e61f5 * REQUIRED
    e51a5e1aea9Plecf765a3s1ef17eeae 2clea93r0 2thb3isaaff1ea8 290f0fie2610b225ld8d1 -d9>0ec4c3 * REQUIRED
    907f1e0f175Palcecf6a3a28690dase663 c772c69lcec6a3r97 t99hib8s4 ca63fi8eld8df1d97 d-e6>4cdd * REQUIRED
    b6622P5leasf9e c8228l32ea6r0a77 1c6tbcc47hi9s6 4f707ibbe6l510dbe5bdc9 c3fe724f14dee1-a07>9 * REQUIRED
    bPaleas7eee ed3cal247ea8886437dr th0i68084c0c160c799s 928463f20c1bie4ld fd91-bfb1>79a5326c * REQUIRED
    Important: Y8o9u4b may 2b2e ma2k3ibng useb 8coff autoamated for0m-fifllbaing soft7war68e. 6T6his typ2e of softfwfar4e 1can trigger eo56ur hidde8n sp9a5m-de5tecd4t9aio4n s8yaes1tem, whichf will blocck you fro3me4 68submi2tting4 this f8aeorm. Pleased aselec2t cFix Th7isbbea562c3b84e20 6cbf3efa250o224ef76fecfr1b25cace452aaa6e87 8eb4812c88cc70066d3cbofam8epl3etinfgd 2th57ed 4faodrm48eb5ba b1iec1nc o6r6dcera2e 8te1733o e2corr7556cdec8tc82 tahbe7 9pere1oble4m.d
    Important: You 6maey be 9making u7see o9f autofme49ate6d form-2fcilling fsoftwarfe. This type of softweare c4an t9rigger our7 hid0den spam-detec9tion syst4em, 2which will bl4o5ck you from9 submiat31tbing this 6fform. It3 appear2s2 that the procb39lem ccou09bld not fbe automatically corfrected. Pl5ease clear77 a3bny field wh05ich appd02ears above wdd5ith c4orrespobnding ei4ns8tructionsad7ad5413a5 5cfbeee83df63o77b92raeabb4d8d 051fae5c6ea48e15a18666f07e067d18comcp4le1t2ing 2t8hde46 faor5bd7mb 4i3na order toc corred3ct6 920tahe pr9oblc1em. We apolbogize7 for f3tfhe 2in6c8obnv4enience afnd we 3app8fre5c25i3849aft09e y5our under539sdt9an9d2i0n7gb.
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