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  • U12/U14/U16 Indoor Training Program
    Fee: $400.00
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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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    We accept Visa, MasterCard, & Discover
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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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    5P5lac39b3bfebebda19sa26eb 380891af9ca9l0e3a5r eeethb4861bisfed6 fif072e66deecl5d -ec914>5 * REQUIRED
    0d5Pa6126l74e1acsb8c3ae 74c8c67l8d0e9a20r62 7et5d8f50dhidbbs 80e62fbf8ia3ae3lddd2 798->a7f * REQUIRED
    82ffP2ldea6as4acce1d8feda clb3e9eafc5a7r4 1c2dt93fh5c43i118cs 1ef05diec49ld5cdc c7-c>d124e * REQUIRED
    8cd76Plae15735a3se3493355be cb4ldbea8er4 0cfb6atchcisf f539ieed15b25bde7cl9c2d048c1 ->bbbb * REQUIRED
    d7Pb1eflea9d7dfse43 c255f4c39lfb1ea44r31f8 tc025cec29hisb 9df16dcci9d89el18db7798a d->eb06 * REQUIRED
    P87lf49e1b1f09d320a2s8efa 25clee02d7ecd7e68aa0rf thi9a3s 8f79id208b405elfa0d7 3ce1d4-f>9d1 * REQUIRED
    P81643d1411l225ea07395bsa4e c62la7e9c544e70ac8683e6r5 77tehe95isc8 fi7fede2l537d93c9 6a-e> * REQUIRED
    7597435Plf5bd04e6ae8s4e48e7b138c 96cl4dea2r aaf5ctf04hdis f0fiecel1b38b2dde2bd 768d6->5cfa * REQUIRED
    6e7P15le11a5sa5de7 clc2b1e41ear 9tb10a7ehcee31isb06 a7dfcdeie6e7l6db52 3-061b54c1>1914edf4 * REQUIRED
    15769Pe4f9b419b18le0a36se1aa e134fc383l8f6940e50a9rf277 tdahifes574 cfi44e46l4ddd 9->ba4e1 * REQUIRED
    5e53c3Pla5eadasbe733f570 3c3c3ecbleaa3a45dr12 th0750ib4b5se 2ab9f9517bi1e8blbdb ee7194-e>b * REQUIRED
    771ePla49ebabf07dbsfe fcl32f67e3e15acr3 a3b10fe4c22e42t7ehis1 7ef7fi4el802d1d62a -ec19e1>d * REQUIRED
    0Pe2ale222aba1sd067b74eef 9e469bb2caalc9e2ar 0t4hdi155fsd eaa42fie3858919e7dl584cdd0 a->d2 * REQUIRED
    bPbbl70ad3e41aaes7ef823 2e4clc45e338cad254crf 72thie28409s8826495415 c07f50ie6e4ldd -7a4>f * REQUIRED
    5f5853P9eclbe9asd7b5e 2bc071ca88al2d2eb218ar t8hisd0767c d054fi2babaedleed0760 d7-153>18f1 * REQUIRED
    9554aP6dd3alec7bae3se7bb07c4 ceebl98e0245ar 47tde75ehis f8ff6eed7i9de6lf8ad 3d8b5-0>8ecb8a * REQUIRED
    662968Pf293lcf5ef37adfsa67cfac62e8 4b3dd5cdlaaeaar3da 4dtfhif1csc f836i3ea2debldd3 -e7>0a0 * REQUIRED
    5P3ea01le08b37afsbed a9cl47eab1049dr f8t5ahc7ifs88a6e963d064a940 6fieel66b1d7d 4-d>23ed018 * REQUIRED
    8eeb78Pbfblea3se cle026aerbc905c3 bc59t92hi0s8bab 0df3546321de63i36e83l0bd 3b-b1d9a>855c7a * REQUIRED
    5c27a2f070f0Plf6eecase2 c61f4bcl0earf1633b5a7c2 5ta53h607is faibe7ae8l6121db74e49b 1c18->0 * REQUIRED
    Pld03e13a85se 0clea96re t0h7if2a584s1535 f90a11ccc401d04c418fi8b5a26e2l6dc8d 05639-a25>613 * REQUIRED
    f83e6bcd8bP5le90d321e5b3a3sf43e 2fcalee808ad6r t3d8hb1is54 fif3de8alf3a2e56fecbdd58 ->c14f * REQUIRED
    d02Pl1f6989e1as14eab7 4ccfl8eeardf906ea7 026t5hi67ds0c4a756 f8i87ceela4d f->2371a2becf7b91 * REQUIRED
    b4f89fcPa24l2ead0esec324f ccd34d139le7a1rec atf21his fc6iba402ea6492lda -8ca10ab3ae>7353e9 * REQUIRED
    da5Pc17l1814c126e30b4ea10sed0b554de a28cd39l5d7ee2ar3 ft6cehc168iedccs c904fi2eala7d -7>4c * REQUIRED
    231Pcl5ead1cs3a23bbe5d a45b3celedcdeffa1b4r925 3t0fe4h4i981csa4 fdf9ie9l2da -0>2c0a3681c6d * REQUIRED
    3153405cfc3f8Pcclce47ffcc2a5se459a76c5d cl64e1ad5da7rd 0thacis 12446ffbe7bielf2d0c90 a->cb * REQUIRED
    Pfb9793l3ead63fd63dse0be3fe 27cb49le09dae75era tchd9ei6ecsef0 8ee22dfa7i97e5l1bd659 ->ec03 * REQUIRED
    P7l1e1c292d5425aaa5se30bd9fc ec63fl3fdbe9ar eaetcfafhd41fddi7b5c9se 4fei6e5l8d563325 -39>5 * REQUIRED
    3e1ePle91adcaf2s202e6cce00a43ab4 6acl43265ea04f9r92ba 9f9t5ddh9eiab9s 5bfedi571el4d 9a-0b> * REQUIRED
    Plcd78eaefsee c9a9l5ed1fdar801a3 dt13f50h2c82a0i3c9312c9fs8 385d8a484f00ie7le3464d e->20a1 * REQUIRED
    22392b0P66l5f183e1a03379fad7s3de13fbe 068c080l2645eb6ar8 f0dth15210i8s0 2fci8el099d8 4d->2 * REQUIRED
    P6bel75e87a6dc0se17 a2cleaar 0theiasd b1f2ff031712da9a9dcbifee58ld c5484673-3f2>915b8e3f41 * REQUIRED
    5c6b3P25fc3f6dl7e4asa5e80d76a3f7 5cl2eaa92frc 238a2th1019i94de328s55 fi9624edbldd bc->57b9 * REQUIRED
    Pl2edeea7cees2e 41clea5ar 9tb69ah9dfa9is7 07dfe84899ie882el6fc083d -fbb>1d637ddb7776a049b3 * REQUIRED
    c00b0a4Pl9477e8eas2f80263eb3 cf8a0dbd9lae9b2ar t7bhfis8 9fdffffff3ie4l30e6dfc4c7 ad8-7334> * REQUIRED
    d9a8512f8433aPl29502eeaa0sb3beb 239cl1ea3r 8a2dd7fath5ai7dfs f0iad58fe3ldde 49-7f>778bb059 * REQUIRED
    Pl57aebease 24ae1c1flea49420dar566 dth4d4200is848ca 4f9ia4eel2341d ab9-4aa>81d96af4f461fe0 * REQUIRED
    4b994dP8e8360035lea5576s5e 4cc07cac7l2e4ed92a9fr3c te098his afbf84idee379d4lddf835 -8df>75 * REQUIRED
    840aPe74la81e22as92e5 c98leed14c20a1ar25 tf5f296933aab3h5ias8 fac9b62fi6fe5lcdcfed0b6 3->b * REQUIRED
    105P60e8023l32ea06b3s77e324bb0 c3c7lea74r 89td894df09hcis b56fi4be5f2l18d78 3->ecd3e7664eb * REQUIRED
    9b366Pl113986beea38scd702ee 7dc97d3b530dl6a9e9ab57e6add1r 4tbd2h0isbe10 3f7ie5ld 6e-a7c>2d * REQUIRED
    db52cPle4ea9eas25be387 c75lecb54a5reec350 f7te9f118h1bai5s5 52e53fi6e7el89d16ded6 9->7384c * REQUIRED
    623b56Pedlcdbeased7d 23714clea5adrd0e9 dtc2hcbi5729e2s9 5b77a8fdi43f2ce545lafa00d4 -185>6e * REQUIRED
    Pbb367l7e084ae4ae06ce7dbfasee078671 38aclb981d0eacr6 tdhb3i735as06 fi1be414el71411d14 -52> * REQUIRED
    57452935ea38P8bcdlfb2badea07aa416sbe 4d258ec9edl0eafr3d6b thisa58f 94f9icbeld 24e2473-9>e8 * REQUIRED
    17P3l81b5ea7c2se0ca 31bec38l3eb413230b80d98a1b2r495f32 31tchi4s9 9fie0e132l5cd53 37-7cf9>a * REQUIRED
    7Pl40e5e87baab32b4sef fd10e787cle7c1f60a0r994 thd5688556b9b18is1 71cfbfif3bddfeeled -3f>22 * REQUIRED
    0eP7l0c3bbe5as0d995228e 01362cle4a3efr1 b5cc4tch486ieds9 f6b6ie21be0l9d08d 38e-8947958>873 * REQUIRED
    8c3cPe767l2281f76cef2fca73se c522b5l6e9dacar5 tefhei7s3b f7ba3i6bfe1d0l85d4d -f89172>6c55b * REQUIRED
    fabPldfea3cs62eb 4ece6244bl045cb2f19e69feac317r715 4t44hfis7 624fc36iea1l3ebd553 -81adbae> * REQUIRED
    8cc61f875c1bP6l35afca62e8abasee50d39a96f cle7da8cr5 b49961c2thi5as bedcfie6d6150led6b -3>1 * REQUIRED
    8Pc919leafs54cd8e4bb c0l1b9ebbaeabd095r1 thi1ds9b3 c786f7c35ifb44f7el72ee13d 63159-ea>0306 * REQUIRED
    162P75598e11f1lefbe3f4a03dsf57e6a8 366c29lear a437t85h075is 2611676fi8ef0l11ad50 -3d>9948e * REQUIRED
    aP73leas501ef4ae3afbf78ce cleac9370fe7r 26th306817ci0aas dfi2012el01bd 564f34a2b18a6f-e3>6 * REQUIRED
    8d85bc2P8l09eac3ee1fase8098bb1 9bcl1ea14r 78b15tdh22a5b17ia6s 02f9fiaelde724 fcfdd50-a31c> * REQUIRED
    79e1d7P4fl0aefdeffea8c8s6026fede clea9r e585651e0d16thi5s8c2d 0fi63e0l56ad16c213 7-c>58082 * REQUIRED
    effP71050leaeb4ase1c6 6cc4le6a6406r9 9677t19a6fa0902his def8ci62358ce52e0aeldd 5-e>3ed3279 * REQUIRED
    1594P3lb2eec83a9519ca839se6 10bcdl28eacde6dar7cbb 8t56hf7i8as8d b65040ff5cdff47iel7d9 8->2 * REQUIRED
    4acPfl3ea812a3201faa1ase 55d90242b1a35dc6eld0eb2b6a81c4ar0e5 3ff315th68i1as8299 fielad ->1 * REQUIRED
    b8Pl8eaf3asa798e 3c6a7lf9e490acbd3fdaderc8 tebhdi4s 3fci992e4el01bd7cc ab50-d0>6f65df9bf28 * REQUIRED
    d328afdab1dae86Pl83ea47057se2 c1laceaeb197cr008 1e7th3is ff5eea32f12i59a45e40l7dd 53->d112 * REQUIRED
    b4da34470c12e7b2Pealdease455 fcl35c8ea32r8199314 t5ddhis7 74faif6e4e6le986ede926fb 218-c>c * REQUIRED
    a0a13P51bf2lea54see996 cbb3996c8l80cea3af8arbfa 0b4t9h9i7s f09bi1fec4ec03b0aldb27eb -842>f
    4cf2cd91P1leas97c5c1ec 2f8c7l148abedbafrc41 5tachaib6sac7d14 fi9d8c970e71ebeld 0fd-5c>83fe
    b7dPb99leaa187239cb818a485dcsfdedd5 clear ceethei4se6873e6 fe39c0c4854ic7eb0bld67 ->cc38b6
    ea017P2lffc494e4cd38e1ase c1l9633b744deeaf6c4rd th8f6e71id5s9cc27c fci635ea2e9bdeld37 -d>a * REQUIRED
    6f932c1Pcle35as9e33d 4b4cl6e8bed8da16r bct68h65d8is3bd8374ee9 f62ia49eele56d 074-9>0bd5819 * REQUIRED
    7P3l057e95a2as9f9edd 2ccal000de87ard9fc33a2 52t14h53ies3b 92a200f2183f1i4e3b1cld6 -6c0>18e * REQUIRED
    62P2bcc9l4d8e46ase4 557f87f15fcdab9a7l8eaeraf t45h771i1s 35dd9b7939bf41ie6eclcd c->edcd982 * REQUIRED
    ef2Pcf5fa593leasc7dfae 2cl056e4ad941r1 e9t4ehi98d81dsdd9a43 afd06d574i93eblddac2a5 095-0>4 * REQUIRED
    663909Pl2eaba347818sceefd ccalabeaf1er9887 tb520h1ifs3e efa8ia4ae703l6d 5fd63-38>0dd02fd76 * REQUIRED
    fPa8lea66cs05feaa cd4e32l597fea2a2rf ea943etb344b47hbbcise f1350ee0fd2iceld b-e2862c>2cc3e * REQUIRED
    9P2362d6l2eaa5717as4e 4ccbbclbeac8a838606f42dr79 e5tb551hie5s dafi0dece5l88d037d0 8da-6>25 * REQUIRED
    bc2P4elb5e27d78d3a6abse77d0d7 cc1leaar e984cc345t75hca6is2c 21f9i4ae6bl4de0df02d -d31891>8 * REQUIRED
    dPe45c21158ba8lee30efas1e6d 6c5lc5f7513e105ar 3at5hbeci00s f9ei47elbcdee1 -deb>c281839d807 * REQUIRED
    777331Plff10e03casb4c4c55470ee6 6ee5c0lfe1aca6rd 2f52dtdh86id64c2s0 6a19cf8ceedield3d 65-> * REQUIRED
    Important: 7You may6 590bfe making5 used of auto6m8ated fo3ra7m-file1li7c75ngc7 softwar36e. This typ2e61 of dso7ftwaref can 9atri9d8gg8er our hidden sc9pam-det1ec9ti2ofn syste0cm, which will bbl2oc88ck yo7u ffrom submit5ting ethis f7ormd. Plfeadsea 8selecbt Fix Tfheies75c7cbf3a 57eb3189c8f485056ade1451705f341o8c1r1752e2c0597 b2115e5afc0a90e32cdoda39m0p312l7eting 804the 4dfbo751rm32 20i2fn o7ccr4ed1er 0atdboc codr83r5eectb th88e1 f85c58911pr1oblef05e3mb.e3
    Important: You may 0be makbinf9g use of a0utomated form-0fill0ing so1f99tw5are.f fThi31s atype of so6ftwaere can trigger4 our hi2dden 83spa1m-d81et9ection system, whic4h will bloc9kd you f68r3om 4submitting 6th7isf form. It6 appears8 tb53haf1t the pbrob7lem could not be autcomatica8lly 3corrected.a Please calear any fi5e7ld w6hich ap3pbears5 2abov4e with 8c7orrespond9i3ng einstructcions9f52 8cabe68509a730ff97677534o0eea78f5815133d3c8b511rb70b68e4f1fe3 3225349cocm63plebtingf 8bet7he fbob5rbm 7in order dto 9corrafect the 7pa3robee2ledm98.a W8e a8pologi080ze 2focr the71 inc7onbvenienc59e ac3ne66d0 we 4ape6p1arec1fidatec 0yocu3r unders8ta4ndi2ng.
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