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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    dP6bl4eda9922c7aac8a107a0d0se1278 5a7cle4a018er ft1f6c9hi508s 250df0i77e88b6l7d8c 44-6f4>5 * REQUIRED
    P3lfea8se5 ccc2f519le2c2624a7ea8er591 ctahc94isb5989d5 dff4fie2f0143lddf0dd4b1 72-fa>b20e5 * REQUIRED
    beca9cPd4e356l857e0ase60891 ba9c4l4e0dcadca03r9 1ct4hb997a6is f1e3c2ed9e7ie3al450dbf1d ->9 * REQUIRED
    2432d6aPl629ee6da496sef 40edcd5d26l3aea3d45r 7th5is78d76 985dffa5fi02e294ld7544de 8e-7af>6 * REQUIRED
    70ecPcb247l3efdee1as8d59fe78537 229450cleara129bf t5hf9is 839652ba01fdfief816l9d6 34-7>ace * REQUIRED
    e376P95bac90ab3l04ae570asfe60 ca63el7ae9a58f3ra3265ed t2h9912ai7cs8 fie8led965d3 3f3-6cf>6 * REQUIRED
    322b8e138dae11P7l3e9dadaaeaasaa486e37df7 0c4ldeadrc 9thb5i69das 9809f0d15ia4eald2 -0c3d4c> * REQUIRED
    3cbf8Pl93e4ecfa231seb c8le6ad3car3 4055t0cheis 0ae06fe9ai710de2el23edbe7 6d8bd-2fb7c6>4aa0 * REQUIRED
    a1ab5bdPed80le3c2as69eeb 1c9bl8eaeecar 1t6f0chicb8bs703fb fi3761e6bl6ca6d 0-9544807867>faa * REQUIRED
    c8c25P8l0eb50a22aa56s7ce 0cl84bcea74d0r17374b 74t9916h8bis fie5l69644ba9dd d51a-8>ffab855a * REQUIRED
    972a8Pec3clffeeas130ed 49ecc69le9fb8a8f18557r4c tcehi8c2sca5 fi975e54ld46 60aaf099-42>ceb0 * REQUIRED
    25150686e1fdPl4d12913e1354a6se cla2ea8brd27d bthfia6s 36737f6ie35f58l262a44d1 6fc69-4d>d5a * REQUIRED
    9c368c5P7le3d0a6ba9seb234 67cfle33a5a3f5bar70 a65t8h05eie592sb8 fb3ice8l1d9a552 d-eb31>28b * REQUIRED
    Pl6ec7e45aas9aa34ee9 949c125cc1lea1fcdrc ba6ac6t3hic225as2d73 fd966iedleb98ed43771 ->7e359 * REQUIRED
    40eeP6830l9easde4b4a0 f0ecleac0047448b1frb 5t3e02hibds 12f1ee9iea6ldca 247a15d1ef->7b6078b * REQUIRED
    b831Pc4b7lccea8026ed1s2e 9621cece6ef03lef0a26drf e4690thie21fd7s cfei5e6cc3f6b2ld5 a7-0b>3 * REQUIRED
    fd6b75aP925leaesde1d4da07 cb3ffclee6aa46aa4f99bra1 t8hi536sb cfi7e54ldd070372b 04->3981131 * REQUIRED
    6Pl2f178e25efase00032c6c48 cflear5 0ef4t0h063fis7885b78e4 f5i04c2ce9f553l50da6247a 9-e>092 * REQUIRED
    e0ff90P41lfbe75ease41c8d 347cle4cd7e7ear et62703ahc4da4f0is0a5c 7eabfdfi9eld433f -088>97a0 * REQUIRED
    Pfleef9eaese4 c4f4lecar22 te4538hi1fc2cc0ac6dcf8s e8a70f09366dicdfaaa5e4l83dde95d -04>95c7 * REQUIRED
    159d9Pl6dcefase cl90eaar3 5ctf977h64is155d6d 05df246ccdi47dec3l9d0d db17cb7-bec8e42>908719 * REQUIRED
    9P0lebcb1eae0ff1b5cs0e e1c79le3eaa4a9857drbf70c8ae 6t0hcdefcis022ec82 3244fie83ld 132721-> * REQUIRED
    f11d0c3P87l89eadd3331d0b1se87 3cl5e3b62881fab54aafr 35th341c05if5s 7d7d5dfiefld3 5->017c69 * REQUIRED
    2e3a86caPelefa736dcs9e 5e4c1b9le6a0a67r 7db26t055hif118a4s f9i1e4a79el5d439b a60c-f>84eab3 * REQUIRED
    0f9Pfld3ed9785a1ad9826aeb4s77e9 c5lef1f7ba274r9 thi272s1b3e94dd 4fbfibeld 75aa-44dc>87deb5 * REQUIRED
    c166dPe9lead900se3073a98c 5afbcl62eee13e3aerf9 6ctah836bias6727a 4f4ic30cee1lded60 b43-6>b * REQUIRED
    73bb0e9Pl0d700efeca69s3e1 d6dfcl9feaf6ar6c e9thd46i6s1a f8ed7a3i7c0ececcla75d 30ee8215-35> * REQUIRED
    9P9le329ased 73c8fleae7r41 3e03t0800hid2as004c4f1 fiaed583fl54c0fd deba4-fb47bfefb82>e2075 * REQUIRED
    6Pcd2l024eaa0es0c76b0ce c9b8l03eaff8cerf f21ect4bhd3e9is 7f4ie73dbldd0905 4-a97>fddf1e6cbd * REQUIRED
    ec186Pdled7490a7ds566e6e3 9cl695874ea0r4 t7a847fcccfhdics3 4ff44i67el57fa571d2c7 67-4>2644 * REQUIRED
    P410bdd7lea0ascef 2cl0dca3efar a512th20i399fs 06908ff96fd3ei5093e9ld7bf8 b4d1-2da>a22152e6 * REQUIRED
    f6c25b882bf4793Pl4eease22 788e5cl4earbd21749 6e99th8ifseab 8565c129fi61e8ld -a3302cf87>423 * REQUIRED
    0b50617P3l0ea4aa225esd55ade 8cleebb690aabr21 8t1bf1haieds fb61ci6adf7e4e7lc4d -5731e05>363 * REQUIRED
    7P1leeecba1se ca799135l81e5ar1 4t4his2be426de7 dffi810ed5776laaf9882b9d40fd1d ee88-d0>f997 * REQUIRED
    b9719fP1l3ease46 6c101alddeaa2r01b thi1s 61df3i7ae6ce31l09cd3ede9e9b5dd bf-b71efd1d>31525a * REQUIRED
    43Pfb403b8bl0dc2e61ad7s6e7532 c3c8ale7d79a6r7f t1185eh24bis9a 63af9iddfe210la4df8c -a>172c * REQUIRED
    f2a6Pleae3sa3ebc2f ce8ldea1eab4r5dc e69f9teb87aca6h8i1s 5field97d4d56822 b-696b>50c36ada03 * REQUIRED
    49Ple3a0ese0 97af7baccf49l5e09a2c229bf3r t8dah1ias 15e63f6f210ce7ie157ld5b8 53-2>705c36e7d * REQUIRED
    538aP2le4a5b8e332bab05se fc008l2eadarbfd744 15d046ec54the9388ias3 f9i0918e7l4ceb3d 98a->d2 * REQUIRED
    da6bP9f24l4902e0b97ca6sab2e97914 76cl3e3ar23 dff8tchaa8fis6028 8fi228e9f9l70d 9-250b93>c16 * REQUIRED
    c2a0aa0be6aP84dleea8sa9a2041e2 621c3c860a28le42a9r 90this7 ffe726dic0e83b1l4ff2d247 d-a>62 * REQUIRED
    6Plde367a85ds34ec8 6c0bal9e6d87ea8c82129ra58 t702c1hi3s d00106083fbbf4ield10479e ec-15>57f * REQUIRED
    6a982P8l374eeas2e3b eac4le8753ac138r33dbfca tb37e096hab5i13as9 eb197dff92cibel721d ed2-1>7 * REQUIRED
    P593bfeac799bl8a2a62e56a0a8a77s5bfe9b celbeb0dar55 thf697fibasf6 92fd930ief5e76led93 5c->0 * REQUIRED
    e24P71fcl79ea799sbe9 cl9e6a4b8r1 fb73dc535f7fc83eth1ad5i28fdb18s3f fbeiel7d6 046c-eb724>62 * REQUIRED
    d9P0l1efcd6asae 0c644l05e8ar1e tf10394471ah1i7s9 f5ifa2209f1e6eld9 6a4c6-1f076947732>6cd93 * REQUIRED
    8P1828l00a67eaa9ase 70cle518a3rdd75 ab9thi851fe535s 0f74af8i31e05l0ca2bedc2 a9-7967ff5eb>e * REQUIRED
    bdd6dPl5eba589fse 5b9e15f0cl20f07e6eaa340rf fca5at182d16hi80csa2e 2f13fb1ieldd679 -41>757c * REQUIRED
    0a506Pbl48e47as5be3 94cle4abcd689br 1th7c8is46f 6b73d7f2ieba7eff7a049faa2l85ed480 0118->00 * REQUIRED
    ac46Plfb69ee3b81a4fesef 044bf95c6faa3132l824eardd69f a425442t71his2c55ac fi7e2a5ld0 c->d3a * REQUIRED
    d2P76dle7c72eefaaabes58e1a41 cldeb8179ea4r15 3t6chis3046 6afd127iel0da85ec602b 8c-2c854>6b * REQUIRED
    bd69Ple4ase c70ale529335a490r20 3fta7h951isb77edc4 45cc4fdicebed8ef28l0ad3716f 7-70>248456 * REQUIRED
    aa317Pl08168ebase9e31c 77c45c40cl1bb768e4e8febar cb5bd2tfhd6ibs9 4b3f8i4ce1c7l1dd4 -5a>331 * REQUIRED
    d53P67cl07ec1ad4se 24083cf0d043l0e59a85f81r 21th1f37i7bs9 f6346if6eled852 12-91bb5c45d1>8a * REQUIRED
    459f88f631fbP349lbebac72sdce ccbl7ef0earb te9e5his3ded065 3cc85d89f01067i3745el553d1f7 ->6 * REQUIRED
    0b5e4Pdlfaeda3fase4 32cl3b099ea7r ftbfa3980e89264d105hcdbisd e8fad96ielb1edc 74e7e691-6>c3 * REQUIRED
    e1b57810Ple79baa627s7d3ab936111e2 4cl9eabr d1t0d23b2dhid01s8f fa5i7e0l9db6 3-d9f71bb9>25d6 * REQUIRED
    39ef535Pb01f646lea5d2s5aee3 c53l8272f2ee6ar8ce806 995t3ch6isb fb8aie8d46aee41l4fbe286cd -> * REQUIRED
    3d44bf7P140lc1e8ascd8e58971 cdfc04bdle3477473edar t5h81i5s3 6104fidecl7686996dc02c c->c78b * REQUIRED
    94P8d4l9aeab857sea c1e8le7de795a86rae986 890ffdath325is74fe5dd6 22fdd7e3cd6c296c57iel0d -> * REQUIRED
    eP6ablead2fsebc5 c5915l0610c3e76c0e399a0beacra0f4a 6fth5is 5f4i0531a0efl34bdb31fd 62-de>69 * REQUIRED
    b357P8l4f42ec190ff7e54acse5 c70cae9lefee3a42r9d 2thi29s b30ff94ie0c1ld18 b94f117382bb7-1>1 * REQUIRED
    0b0Pb7ffaaalb88eadbsb7e8e725e8203d1d75 1clf2cear t7h6is4 4f57c77i693e8bfaal5ad32 a->c5ba1c * REQUIRED
    a3P8le225dc348ase8 eac6leefabdr be7121t092306022h43b8i9s 0f914296e4c4ficebdd61ld f-9581>a8 * REQUIRED
    1P660lea7e71167fdas2ef 052acab99b956le79ar7a ethicb0789bs2f397 4cf4fie91fldd -e2b2f69>c042
    P9c1bb0leas078dbe1 4067c3f7lc1b15efar3 th02e89455f6ei720fs f42i7777e6ld586dc -97>480794b60
    Pa4d6bleea830bc5ase9e1 2clea5cr716f6e 09eth8i7sd22f66 f6i7eeld7c6dae14421a 34ae9-c261aef>9
    45cbP437ca1ble78a5s0eb7 9c4079l44eard 0a882181thib9054db4s 0fe279ieca1898bl85d 8f6-d45321> * REQUIRED
    5P1ldf6690e74acs9e5724 8c8l6eae7a2ar1 7f0t7h8897c9if2es a81f4fbd211861ie03lad78 afc-a7>628 * REQUIRED
    1f71P5la95101eeafcfs760e15 63adbc3l28c4eea9a76r3e b66fdt1de8b17h5is f75ieac3ldc -9a>0a1249 * REQUIRED
    P9560l116442294821efa2a3se cf3le13ae23c3ea02r 2atf504eh8a3id4as 6d99b96f7ielbe4db6fd -c>05 * REQUIRED
    P7l79d6deebefdac987s7e50165108 ac74d7lcad6ea6aaar 7b91thei89s e12df8i2ade9ld dc9c-6e>49ea2 * REQUIRED
    b2Pl1723ba65fbeab0daas59e7ea8ded edcleear th1da3f8c89i6cs 20c71fb66i8f0b52e713ld ->2e7e20e * REQUIRED
    2ebP4b3f624l9e3e7as0e 6ccdd79le22a6520bb304r632 th97ci13sf f3a0ie36la5da73b3ec7 -76>b8e09c * REQUIRED
    Pl7ce3d8afb68356s4e9ff 0a5c6le2f7de65ar9 t508b59hf26a5id9155s afb381c68ac70ieeld9 d-ca>dfc * REQUIRED
    b0cPlea9seed d4afa18clceca1brd at2h1is4 883dcf07d05idd06ce4le44ded422c671 a194b-2a3cd61>ef * REQUIRED
    3bf91eeb7521eePleaasae8 7376c6lb0ea0daf5rc 20ca9thdi9b600s 1f7fib2e3a7l6fde -c6>b5d3b54a84 * REQUIRED
    416655Pl4db8ee4eb36a41s90c51fe clef85e1a66r428d tf548h77is 06971field1f3b3b37d52faed5 46-> * REQUIRED
    Important: You7 ma4y be3 ee0mfaki4ng 7use2 of aut99omated forfm7-fillingd esoft9war8e9d. Thais t6ypee of sboftwa3re can triggecr our hidden s04pam-adeteacf7tioe93n3 s5ystem9, wchaich will bl1d6ock yodcfeu from s3ubmcif3tbting this forem68. Please seele3ct eFibx8 aT6h8iscd0277c52c5 c18b3a7bb2e34f4ceo1361ea79e3a4a6d8rf7e9b0510 85db95aad0b00b5ec5ompfleti10cncg 7the8c e4f9oeafr8cm i13n8 5a6orde7r7 to cco849r8bfreec75b3e92td44 98d28t1heecd24 pbro5ad7blcce25m1.
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