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  • U12/U14/U16 Indoor Training Program
    Fee: $400.00
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    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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    bd1Pbf8a7ele4122aas70eee5d cf23l1980e1ar29b0ea6 t8bhbf5e60i575s94 9fieldf4f41 c3-49d2>9b20 * REQUIRED
    bPfl62cea21b8b1f78218s2201e0 fclde4ar thi6cb3s851 53fb9ba2i851d39491ea21l0d01 e5-ab5>60ad2 * REQUIRED
    bP3l39e9a74fsb64ee0738 d71cclde65a6999car3 685tb3bh2is94d6 ff4b2fed88fielbdb 6->191724e70a * REQUIRED
    P27d1l3eabs68ef ade563c2l7555e35ce5a50r1b5296 tc1h12308i7s 2f097ieb21l6d705 77e-a>795c0e56 * REQUIRED
    051291P02bl0e9fea30se 61c78lf11f2eb583a80r t67cehcaeib4asd fb1iedlafaddca303d -6f94f1>a675 * REQUIRED
    Pa8b5l6e7acse82974e 20b4bec56lfea92ff33682ebf1r830 fdthb2ise 654bd5cf2ie97l3dbf 9e-3e319>b * REQUIRED
    c740f4e417f7aPld0ea73ba3s6e 05dbcledefcaarf57f69436 0c86t7hc2baibs 68e9df3aie1led3 c6-25>2 * REQUIRED
    8e3P5d3ac1lea37074e530s71e 26cl1639e53ea18a30ra c2a0tb3fhis2 fi6e9a5b7d1l3d 6-3ba>60223d42 * REQUIRED
    P7lceacfs913cee40 81c3l0f30a2f8e8aa66acd3e4100e6rdbc t6cfhif7b11s81 2d826fa452i29eld f->a2 * REQUIRED
    f7b4ePbcb20le030ase 1cl2eara thc3beb9f426i1bbse a026c2f762di17fc8f5a6ee3leef05d 0-f>d04d3e * REQUIRED
    ce5ea00P8a43l6ea1sba569ee0 bf0f2c87clecea6c1r34556 th9fca4i3fes fie9l65ffed3d41c ->e4bc5eb * REQUIRED
    1bf4P1451l016bea3sf315e ff6ce1lbc40eabcedf6c1r5baee et766hi231c8fs2ba 9fiaeafee3ld75 e9->9 * REQUIRED
    c23c9P6808842eleas8ee cl3ecc5d11ba2r7c fb7bt302hbeiea8bsd 8c181fi1d65779e098e08l7d 2->ca73 * REQUIRED
    e9c827e9eP1663b8l8de6as5ceaff6 13fdcleaar101 th406aeci7sc71995 fi1e8lad7a c-fcb0>1fd7bf6b6 * REQUIRED
    638063Pe5l7e6a3s4fe2a384a 2cl6ea6car t3a0ah0653ib012es 9afc1aie810dld1 c7-13d3db82>1febb33 * REQUIRED
    93P87c7ldeas8e acl8ef05a31r7 0th60is0 3fi188d893dae9f34e433c6e75ald439bb1b0995 -ed55>7eea3 * REQUIRED
    d0bPd38leaa3se83e810 449cl4d6be2246ffa70rcf61ccf0 th5i88sc5 f5eiebceld3c cda-de>a30fe6983d * REQUIRED
    Pdbledd43eea6a9fb1s7e cd72ad1l1e3aa0cfa5ra08 t1h5faci3es6c 311f7235ffiel35b9f70ad0b -4>77e * REQUIRED
    65Pb1alea1s0606ab8eebbe c0lca1e2464e7a4ae1a37fr5438 ta1his f8bi5ee0ladd e32-48802e9b3>7742 * REQUIRED
    2e0ebb33142bbP679fle85aseb 1c8le6dar t1h5db2852901f9ise4c4 5fi1e81eld ->a8d6f8310019c8afd1 * REQUIRED
    2863bPl4ee5c2f2ceas2ee0 7ce2le3c703car 197td3781bh0i3s7c d6557dfb0i55celd7 0bb6bf38->46358 * REQUIRED
    967P0la8ea5s591e 0cec44563fle3421ar78 9t8fd35ce9hi5s fbbicc3edld7f10 ab607d5a82-52>690d1e8 * REQUIRED
    4c08627acPl9948e3a3s51e2 8e99cfl1df2cea47er t370hdbb24i926d9s05 cfb701i3el38adef28 -b>d81b * REQUIRED
    b0d2426bPld9eaasee8f6e1 44cb9a404326l6189e76arbb 34t6cce5beh3i2069sf94 cf8ia4fe59l00d8 0-> * REQUIRED
    adbPc04e0l45e379aes0f2ece3 c071le3ar66b 3bd38ft0h5ie47219df7sddc6b6b531 fie0l3d 45a->0a09d * REQUIRED
    f0e85aePfdd9l4ease0 4c29l25eeb59c0ar5d54 0ct29e3h8di0e93sa5 d35f29bibedld9d07e7 2-75>3a607 * REQUIRED
    ddaPl2e893eeasee71f 16c71f00l1ee0e8ar cbc0tah7e2is0 6f23c3f5d4cie68795e1cb3ld4 -4b>c7de2cd * REQUIRED
    835bd9d2Plea10s58c7e 0bc80f1l8a7f7192e72adr 7t1a4d0h1i6es 7f3ie049ld1d244ffadf ->5495b2962 * REQUIRED
    126P1537lefaf9s8fe0de c04fd9b2le1a9ae2fdfre ft6fh4531isb ff1354i1de649d0eelbde 0e77-5c>fbf * REQUIRED
    Pclf4e56bd2a54se1 531cle2aer2ed19 t580a3hi2c9c72d8253s6 eff4ci5d13el6ea5d92489af5 0662->17 * REQUIRED
    f29fP08d614lea764s5e525 5c9805l2e1564dca8805fr82 84bca4t92hi8s 78fd4id3f26848e0a8l3d6 ->d7 * REQUIRED
    794934121a69a5Pd8dlf44390ease 1e1bc49c3l2ea3decf53e3rf 7fa3thi970se 4e06fiae1l44e17d0 ->13 * REQUIRED
    7beP55le1e3d0a727ecd62s1559e72d 1cl7e9a06afr b6f5adthcd3is 8909d1fdia05efld5ed2 90-7dc>be2 * REQUIRED
    1eePlbeas261ae 868bc7cel460f457905312f0eda7r 8cthfis 19982fie31f0d9el45dd9 -c25e61a738a>b6 * REQUIRED
    a66817fP5cl22688269e6fba1sfec52477b96 76clf7ee001bar ct579a8hf5i0s f8fic9el9d95 d6-ad994>b * REQUIRED
    7a78bbbe7P43817l3fe760a5esed7 a16da83a9b8c03lecar3 tbehci94cd7b0s f3i0e324eedflad0 2e24-1> * REQUIRED
    57003Plfb7e805a2ese2 cacl5f12eb8a6r39d t2hi2s3 88e4b6d8f6ib17elad7078ad508e2 7fb856-30>adc * REQUIRED
    2bP7efl4325bd73e5941b13ca7bdd2s3ffe cb6l27bb870bfd3ea1r79 39this1 0a0ebf9aie9ld 46aed1->f2 * REQUIRED
    d7Pe9la7c6e106a5dcs141ee82e2 c3l8474cce6a00f0a9r63 ct5dde8hi8sdff f479i0elad7448d6 9->8a9c * REQUIRED
    55e966dcP3d06eelea3b3ea96295es9e2 4a6claeaber5ed d3dta3cd9762h6disf 2fiel8d7 d06cc97->8938 * REQUIRED
    P7lec7b4asefe98434421 6c7alf7ee7a4rc377b93e8c612 b3ftdad5hfd7is4de fi9bel5d11 a6-289cf4>b0 * REQUIRED
    aP1le75351b3c0ada0se2f b14af3c61a91lf6cea51fr7cf tfhies7e40 1dfabcield58ab b-8>c923c2672ee * REQUIRED
    Pl185ea678297s0ab1033143e 53c6lea2r 9t63eh1416is 128fbid502d7e34e4478c5bcl0da7 ce-0e637>c0 * REQUIRED
    9a7aePal6e4a341ce9ad2se8 6da8cldf10e0afr68f d858bt7bhfa08is ed0fiecl2dbd 24-86>14f7711f49c * REQUIRED
    55cbP2leabs3e8c04 06c19112leba838f08r673cb69 1e0tbh4626if5sf91db0350 1f4i0c8e1ldb9f -e5>66 * REQUIRED
    033e612989Pebl2faceeaaasbefa825b13c c8a7l9eafr2 695adt8hi6s 8f57e2b8i5e6dcld1d7 -517>f8d96 * REQUIRED
    70086Pl6ea8as06cb21ceb8e5b88c 8cd82006f78bccle0ar071362 11t1874h66aa3di1as 0f0ieldb 8-ff>b * REQUIRED
    P8l1e9a3461se64 cl90eaa521r8ed 9877e9b96d2518tbf3f6hf52f263i99s3 66326fi2ec4ld 36-df8f>e9e * REQUIRED
    bc38b7fa3Pl8cefas5ce 138013c7bl93ear 3dcte5bha390079f31cis6 20eb0fi3f398e7ld948f1 -4fb5>33 * REQUIRED
    1aaaPfd98836leca8es4c3e2 cl33e3e97c7bar7fa at82fdbhib8s6 0fe21c0ice240ealcd14 b935e-d>4a98 * REQUIRED
    1P1lc6ce5baa2c8s3e70 c9ecd4a1bl8b2e290eab4r5 t1eb4038f3ah5ies f23dieabc7la07d54 9ff->3fe8c * REQUIRED
    02fP3l6e8as171ee064890 cele8aaabb19rb699 t2a769eh9i8d52s89 c1fe4bi97ae2ld70c f->64472806ec * REQUIRED
    d0e6a4dPf9el9eafa3s7e7 c5l35e4beadr4 ate74h32f3i4s76b 9edbff47i7a403aeld373 8-3>f2575e39e1 * REQUIRED
    d7449ff01Pl35be2eeafsc97276b67ee7 ec2le632ar a7ath9a2d303cis0 f1i59eb3ldfaa ->79976f920836 * REQUIRED
    d102d2P2le358abs4ecc 2b961c6lear8cba 0eethi1520e0s 6116c3c6fi9f563cb790e1lbd82b2 76f3-2>ef * REQUIRED
    1e96d01bea35P1led4df7adcc972ad44fbds1e1 6b9cca3c3c28flear te8hisf fiel7cd1d f626fd1-f>e8f5 * REQUIRED
    dddcdP2le9e9aeas4c09ee33 fc48lfaear1093f90a aethis31 2fbb467aie9l9df73beb d4b->0813cea1de5 * REQUIRED
    e35b6P6d8b3l83ae00asb6ea22e 8bc6b2lca07b840e246fe5a93rd 1t6hi01sa 92f3ie105el4dc2 ->28ddb8 * REQUIRED
    8a7dPlde34f8cac10af62a762sc9fbc6758e 7cle7ar3f97c c263tch2i7s47 f18f27i5eld85 5d4->448e64d * REQUIRED
    a06a191Pleb4e0as6e4e59f dedc4l93e021882eaar4b33 f76td1hi26s fb18a11d94ie4lb6dfb1aa82 59->2 * REQUIRED
    3fPl533f9a3ea979edbase7f c77l5e4caer3 b11t499hif4esaad 6f1i66c5dd480d3el9dfe991a b->0581ca * REQUIRED
    20P38l4b9caea975cs058e 046bcle5arb70cc0 86t6hcai9b84s 2eefi744988cc2e12c9ldf6ff621 82-2>c3 * REQUIRED
    3e4c90P8dc66leas14e 7da1cble4667e75a9634e0r ata480ehbis02 9fi97299el52d54d472ac bc-e2a>f5b
    3f6P3909le1as3e5 ccl9eea609ar02 thib0bs2e7d47 5fbafi0de4ef93822l8146dfd3b0 2-6fb977>371e4e
    40e60d8f7Pfle5beasb0ebb fccdle70ca620re t31h02isf7262 f78i52e4lb45cb4de35 648-f83>c9d1c401
    9f94Pflbaae59a4dce29538ac24see clea538cd4c46re9 1thisa80c bf1d0i6bae4cdl71ead0a 1942f-c>39 * REQUIRED
    09fc4eb719P6c56ca89bd0c055d94e69l6easce c4l639ear2c 6th019eia9sd c08fib6e7a6blad 99->669bf * REQUIRED
    fdPb3l526ceba0se9 3fbdf9c357lbe9a85b5r8 fta8h31676i1b45s0c 31df2i0ff7el698444d bea-d1>b2d4 * REQUIRED
    2eaee2Pel9fe3asea677 7edc717lea2c01r1 03ath4d7is7fc727d 102af2i1fe8dld7665aa 6a46-ca>156e0 * REQUIRED
    3a9e5P7lea47s170edb ef04dcle5e0a051r65a3 e2t89hdi51158d56bs 6fcfi2eladfd4daf401f8 d32ee->7 * REQUIRED
    8ccd1e2dc05c4335P0ec2dle8e20e646fased5 c431220l7e7ca33r3a87 3thics faefd31ielcd 0c94->018b * REQUIRED
    c3P24lb1b7bbf8bea4s0e7 eb55c1l1e794d1ac2db3r t6eheifse 7fie3l6d16b6 c750964-f595a2d62>1c88 * REQUIRED
    4d32P2l551eefasa53ceed31e5 4c625l911427d08eear tea28hbi2db6s0 14fbie12acldc c7b09-fe>5f279 * REQUIRED
    fPlbe5e3a32ds325e 2cl13fe9a1a3drfd73be027a90bca 4cth08fi1s4 f54if8fcbfe23e4a4ld55 -f>246dd * REQUIRED
    9Peleasc5571e8b 855702cf27l41fe837a9af9rd 21betf0hc6bi21ceb6sb04ce77f fe7iea51adld 7-68>36 * REQUIRED
    23P2ld6c805e9ad7b4s51872c171b98e76 5a0clfefd8a795reec3 th69734ifs f0a89aeia93e4c3lde3 -9>5 * REQUIRED
    Important: You b9may be making use0c of abu62tom6a0t8aead4 1for0m-fildling 6s4offt5war7e. eThis type0 o96f s90oftware can9 tri1gger o6c2bur hidde0n sp06am-d6etection system, w1hich will 0b52lock cybouf frb1om 09subm7ic6tt0ineg e3athc9is form. Please d8se0blecct Fixf Thisf099be4bc13e22 1ab526e7f1fo49455r7ea62be9faffe63d3 a5a5be612e841d54e7df1comf150apdf257lect96inbg t4h2de fo26rm 93ea12icn o30r6der3 c8to cocr1r831ec28at80ee t62fhe fpreco7a1d7e79cb4ble9md8.
    Important: Yccou may be 67making use of automate3d for5m-filli0nfg softfware. This type cof so5ft37ware ca7n a1trdiggedr 8our hi0dden sp7am-65c3detecation syst6em, which3 will block91 yo3u fro2m1 81submittinga fthis form.8 Ibt app4ears tha7t the probblem could 8noet be automabtic8al6lf9y co7rr2e2cted. Pl6f8ease cl3ear any fcield9 which aepdpears above with corresponddi3ng instr2ucti5ons760664b8a00801972903 9cb3ea85a456beace2d500fc0c9or3c0bf99ac62ea6e84b10 d55c2om9p05l6eting08 the df21orm5 ind o0rde6dr to 5co1rfrect the probflbee7em5. We4c a95p4odlogize 5fdo4rd tbhee in406ba9c2onaveniedn7ce a0nd we app4recidat6e9 0yo0ur8 unfe1derstbandi84cbng.
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