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  • U12/U14/U16/U19 Indoor Travel Program (with Uniform)
    Fee: $735.00
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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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    5Pl02cea22csee clea2680afr 3e383ea7647cf57t3f9826bhia2807s6 fid9fe2l47adeb95632b017 ->ec72 * REQUIRED
    P37lee59ae0sbfe ae97c7f53d327aclae4999a4r8d3 ctbh7edi2sd12 6f6i3e4l5ad 5a6385b9-ee>bd2eac1 * REQUIRED
    9e6a515P07l7e6as6cdd2de3eef3 cle047ar04f 539t38a854h6i2a1s9 91fideld 742->7705a1b66ce8e176 * REQUIRED
    6c74Pl8a2ea44dec5ebfsbce cl8eb4a181b8r 1t709fhbffies244 67accfi6e67bbfca3l49ed92f -be8d>cd * REQUIRED
    0e95c0f8b41Ple482a8s2e c728l8862ed7620095abrd thf7is642 fief9d04d99ld3 ->b5fe7c3957b70e1a9 * REQUIRED
    dPl8eas21fd9e6 9cfac680lear475 t26e5dfhisbe2 cb9ec312f67i4e8e492c31189l53d5 57196-f8a41>17 * REQUIRED
    dP1le7a8s231afebbfdf a6acle41aara3e55bd 00tahficebs9 fi63305el4d c-387>de122ebfb55b63208fd * REQUIRED
    38P6lae4ec9e01a5d982481s695eabd 4c7cle3f6edar 4b6616cth5i38a6s 2fice9fbbed8ld 8-d>efd8b9df * REQUIRED
    0890114d53Pa75leea9de1accb2b0s37350e b70da1cl21ear 5904th41eia7sd5ae f36cie3l9d3 a3f->4b26 * REQUIRED
    2e27P3c90l9ed4ef0b40590a2se 1c367l934eacr3 9f55t9eh2ifefs 0a5597fiadf09el25d3ec4 ->7f8a911 * REQUIRED
    5d1a94Pl916eads2961ee 6c39fb4elbf01c5bee52bearc4f 62t18h8i4f9s 4b0d9bf8824ieldd 2e2-b2>9c8 * REQUIRED
    dafdPa05lde7bas2d74e5263ee8 c0lef91e0f4ar 775abthi01s4c86fa7643f5d2 7fi3c7e04eld32 -8284a> * REQUIRED
    47c120Paaleda3saee8d90 cdd60l7e2ar7 79tb6haf178a0dfdci1s97 ff653i2ffbe7e069638l0d ead31->e * REQUIRED
    52P3c3lf1ee36cc84f13dcf2aa13se51 c5leabr 9bdfd8fth7cise 3af3bie5de3l3dd260287d8 e10d6b1d-> * REQUIRED
    09b4085ePcblea3d84d2e91cafsbee0 cl81e9a4r 9t22h4a22i08e8b3s 7afi25c665e8l4d ed4-0cf>8a4d60 * REQUIRED
    5afP55e332lecab09s5e1 f7c8a587clad77ceb4cdf59arbf 8t63h2i989sd 2f5i7el70d2df a839a-d91173> * REQUIRED
    c7beP8e5c3lea128200bsfb4e7a8 2678cdl20ecca7drc c7t03dchi1se5810047 f38iefl7f63d e9-534077> * REQUIRED
    0299Plbceac5ac269s7e48 bc1a09618b0cbbclear2599 thb55is f9c903ie8l2a94dd8 b-759f>e5bb72fca5 * REQUIRED
    d422c3ad0d00e611Plcee0acs75b07aec 5cl997ee13ar 5f25ddt1his 5f6ielda68425b -f1cd99>2e85c5cc * REQUIRED
    5cP791ccl5ed94a49sef 5c6lbaee54ar6 5e222058c395bt6h57i3568b2s 34f2d49i1b69cfel882d -d57>c7 * REQUIRED
    93c8fPec8le8a908s5e b8c1el7a39c7568e53eabr4 t10dhis57 de8e1da1f3ai2ee4ld8a b87a-d>e6f88306 * REQUIRED
    8cdPl796e5f2eabad2se 0358clcce7ar 36ftc01h8c4di08sb8e 0af150690fiefl1a3dc6 -a6>fba43b03e69 * REQUIRED
    ad98P36l618ff28273ea8bsd821ebe c5644el5115d8ece4ar taahfibs7 fb88ie4lbda868 e2-0d806636>b3 * REQUIRED
    4862Pfb7l883e6a5s5211e0aa 29c4l715809b7de89a8r 26611t216hiea6s0 e18c5f6i1celbef7d ->fd8553 * REQUIRED
    af6P5eleas93e d7cecc8l6aaed5acrf30 ath7d93i1s8 1147fcibee4e73f8ee9al0227179dcf 788-a1e8>07 * REQUIRED
    bdPled6ase87d4 eacl6f1fbe94f83cd4f69501dee769far t2861a30ff8hicsd f6i62fe1bl1ded f91a0-46> * REQUIRED
    db39bfaPdla30510e0acfs45e2e9 cl14272ef6a7r 0bf2et18h9aifs f5fi8e0e38l23daa979db125a -f264> * REQUIRED
    a020P058lae37c8a2b93sed 9672f2986f5c42le2eaa309rd9 taah8iasad4 15bfi66fel1df7 -9>e417bb5a1 * REQUIRED
    P5861272ef0ld90eea39s29e6 cb0elb50ebeed26be8af7e6r2 ft9h3i8s13f 8fiee0c8bleafde ad6128d-4> * REQUIRED
    63Plf6f2ea8ase ca00flffe3cda97fae34r tchie2f9bbs 3945f4764di7ea58lb4bd7da2e 21-a56>b28af38 * REQUIRED
    02P4077l3ade22a5adsd5e 19cla92efa10r bthicsf ef5bd4iecae3ld7ba924dd5bd -7d>f0810dcbd16b3cf * REQUIRED
    4Pleaa9s6b7df5ecbf34 aabf8f41ccl5fear1 6t24feh37d7a2i00s9274966c 47965ef1fi4e1lade d->679e * REQUIRED
    dPl0deb21a39262s390ea2 6ec4a107le3dbaea658ra51 dt8335hc1e219i938s8722 fi5el3dbd2d4 e90-0>f * REQUIRED
    5c9fbP5f4leae1e1268s4fe 2acc15el20ceard6377b tcdh5eis efdiel6d9497daef40c 2be6->489321ed57 * REQUIRED
    4d8P00715leff75a21574see 10c8l82c30e1a2e616ar b42bthbei8d4f8s df4i8eaala6df0d 1cd-6b>3f6c6 * REQUIRED
    a327a67bfaP1e29l6easeb6e9fb94cf709e3ab 3efclbear2838 70taeh0is 7dfeafaiae21lc44a3d -aa8>68 * REQUIRED
    84Plcbefe6a9se29 fd24961c74336le3d4car1d1b 84thi052s e1ba25affieclf7be78f09090d0384c4 4-5> * REQUIRED
    3f9Pl52fe9f6ase 7e1c2le36fa6486ac1fba71ra6 d8cth60faeibe052146ddscc5 ef1b72i90e40eld 62->2 * REQUIRED
    5ePl3easf6e c3le8a4913a5r6f 721cdt806hi99a6972sd2 f046cf3f355f1f3ied9953l0d593e5eeed ->619 * REQUIRED
    Pl7e6ab11ef6b6a06a5d3cc366c065s3e9c452c dc5l1ear1 c7thids1f 8d0ddefi92e1c7554a034albd -af> * REQUIRED
    93e80e8181Pc57da7l0ea1s06e3e6 eacl2ea3cr15 t0a2h86cc27is55bef f55af91i188eld98d e5ea-2>68e * REQUIRED
    742dd9550acdePflease6b 0a72dcbabcl67deb3eba1fdr677ff f3a9d5bthdcic34s2de bfi1e0l8daf 9-d>f * REQUIRED
    a66Pleas278d7cee c0lcea8ra 1t35hc647da9i362bsb fci2b3e36d565bc334l46cd9a -d6c6>070d3331dfd * REQUIRED
    b0P7lb53eaas94f3ee4f9 cdlef60ca5fr4 26abt1d7665hb1277if10dca33sb64e9d0 6a53559f2fi6eld ->a * REQUIRED
    4Pl56ea14s68e 1f4c2clfd2ea5a9efrb7488 e219tb6h97dbaa701ie8s3 5fi7e0lbd77e d->8809eae62be4b * REQUIRED
    9638ebcfPlea83ff116base e1c62l48ear 9dbe46teh10i0s622f fi9ee3cl02dfdbecad6b 5d3-9>60e676a5 * REQUIRED
    1915ebePfleadddd2fc67ds8ee af8bcl0f9fa5ea6r 70fat8hic4936sc24 f3ief6d9dlcdf009db9 7-199>af * REQUIRED
    P5flfe6as7c8997e0730b76 2c0lea5bb4a0e20ra 0th8d0884ibbes09e f6dfc71ef9ci9cel1d 8b195->c748 * REQUIRED
    7P626b58c591b65lea8se cec14l7e9d3b9e8ar549 tde2e2h1778912isf1 8b3a2f59idelb79dbd1c89 -17>a * REQUIRED
    7dbPclec8f25caf073ecse82 86c9dl8ea88r8 3tcah8iscb e4fcei483e583el8df54 33e-6a>20c95a0a2a5e * REQUIRED
    8a5P2lea4bse 61dcclf12958e350a94de44r396668a23 th7a98a4b5bab80i89s 140ffi78e2dld e821->100 * REQUIRED
    145Pa9lffe0a3ds0fe 254c8lb6e2366acr0e8cd762 8t3370hi4se288fb1279 f7ib69eld caff63f208a->43 * REQUIRED
    d07b0b7bPl8eafs3d497f5ce 111cl1e5cfabrc9a31d45 te2hc611cfe2aib9fs f2519fie53ld24c2a -c23>2 * REQUIRED
    92c346de0Pl6ea1se c0l69eb97ccc5dffaa5eeb7r3 1tafh6892ais288 fifa820a110e6dl2da48a99d -6f>5 * REQUIRED
    f41150Plb31e3bc737daa62s8396ee6 74cdledea96r 95th3i6s23 afi32efa64l9f55d 981-1dd0c7>c7d2e0 * REQUIRED
    c6Plaeea3f3daa5se8850beb ed7439694d79fcl95edda9ea3r5 50at02he7ei79s f9ac70e0ifeld7d98e6 -> * REQUIRED
    83339d6Pelae4cbb7e4afc0cbsec 1fb3ca25l2efba4f80ar 25th811is4 a30f6i5e12lc2df9da6 5a67->079 * REQUIRED
    0709640884dPdlceaaa5se80 30c4leedaf6c39a5cea6r th14i5797e6bde5f9se bfiel72df7c2b 072ba1->e * REQUIRED
    d6a6d8eP9f5l2e985ase5 cb64l8e5e588a6ber 6caeat806771chi7e9sef9648 506b1f90aib2e4d5d1ld ->a * REQUIRED
    20b4cP2l4ae08a6se 7cleaa17ff8r6 f5d1t1b4h8isc050 181e1f3ie704l3784db7743f46ec072eb76a c->2 * REQUIRED
    5481fa1eb3Ple2d07afd72see2 ce5lear 5t9ha5is04ef2aaf0 fc2fe9c3c4dd90eae8811ie7ld2 ac-547c3> * REQUIRED
    73Pl8defads15025ce 2e61ec9le8e29171c32bb10f3a8a1d4r042 t1h783is33c fie6b4bld 4-84e>22d9d6b * REQUIRED
    2849Pl3eaaa2s68d4e3f917f1986c cae9089cl27aeaac7r9f3 26tdbh23is5 837f0i6edb0fal3cd5 cf->d1b * REQUIRED
    3f8d9452aP7652la0eas4f0d07cfe0cf4f celf2e4b25a6r 1dbt11his19 bedff9i7de5d044412l1fd8 -3>ac * REQUIRED
    8ccP14le3f081ase450 6cea081fl6deara76 t1ehisd f5ia3ce6a8ee3l9a382ddc5c4d9f5a 8a->5be4ff63e
    36231Pl7e97eeba6914ase b05c8felfedaf5a5r t2hisbb33ce 2a00f6c7ie36lde45b a7b03e19ee7-8>cbf8
    ePle5af68386fcse1bf622d2e6 cb1b7le77dar 9t711eb6hfbics30093c26ad2a5 afe6ie284lb2d3157 -c>6
    0Pa30l608b8e7ae9c7se 1c1fl6e302a1rdb 442369t54fh2is5cd0 51f209i8el65cd 256dff8eb94-2c5d4>3 * REQUIRED
    f4deaPleas9ee 14c821c88leaea4ac9695e43328524ee27r 2eebbf9bc339thc8ids56 fiel6d4 3fdeb->153 * REQUIRED
    f9Pl0ce3fa3754sca8e34 fb9a4c21l8430d37ee3aafr 2ft7fb008hibscb03e f15i4248e6cld8ff ->0d67fe * REQUIRED
    c43Pdl62de03604acs6e 0a9ccal7e1019eaea4bb4r ef8tf94607hd6fie5s feb3idaecld24 8->881484997a * REQUIRED
    0aP9leas68e20e4ff06c6671 ad4d51cflbba2ea47rba3 02dtchc6is e73f654e8fd51ield 0a-87a354b>b3c * REQUIRED
    P3l67feeaese593d1 e78197c8ala4ceae2r7d19392a1587 dc1thb2ac21i3a9s17 f1i8b943el3d -fc27>df1 * REQUIRED
    86P87l6abe2c0adsbced060 ec245088722c6513l1eb2d0ar b61th8ei41s5 9c0fiel3e8db49d2 -cef>66a1a * REQUIRED
    c55e33Pfl4ee8as9e b6c24c8c437el96e2a0fr t9hi89bd1467ase73725a6d1 faidba2beld5 ->6481f5ed50 * REQUIRED
    50325P224lee13bc8fafa44ccscb35e 57clecar84 t0eb1hc4i2sf4 7fe7f5685ie96487eld23 3->8374c750 * REQUIRED
    2e6fPl88be1b7c33cab5se72 c0ec39cdl5ea0r305a1 5ct247d982hcis0 fi35elecaa3dd 56->bfb10720593 * REQUIRED
    7Pd0lae2ead1es0e9 c9891fa0fblef75a5552r2 tee06cch2is 54f07dciffb8facel8bebd9d df5-3a95>687 * REQUIRED
    Important: c54Ybou 6ma2y be makin37g u4se of automatc9ed3 f4ormd-feillin5g softwafre. fT2his t4dy5pe of sofc2dtware can tr225igg8er o06ur hidden spam2-detecction fsyst4em, wh1i8ch will bl3ock 0cy7o4fuf bfraomdb s6ubemitting th1i9s8 8df2orccm.e Pflease select Fbix3 This26e04f3921f 20d5db86dbb97de899efcaf63f33c6ocd684e27006r39e9ec7 d75dca50f11dddd21cocm8pl6e0dting t94hee f4f700o6bdrem3b119 0in0a order549 to cfofrr63ec0tc6 ta85he d2p99r014aoe269bbd4leeam.ba3
    Important: Y8ou m6ay 6be makin43g use co5f0 aut68omeatedf form-fiall57icng sdobft2w2are. 8This3 type 1of software caan trigger our hi6ddfedn spam-detect3ion system,1 which will b7lock you6 fr7om8 subdmit2tee8in7g this for4m. I8t appears 9thaet the problem could9 cnot be autom4atically corrected.f P3dle4asecb clear a6n6y field9 which appeara48s above 6with cor2r1fesponding inst4ructi1onsc424c03e72570fe944 71f60405589bb66499be4a7c9e4f46b37or6e40f521 539786513c7ompleting the form i5nc o5rae9d53e73rf to cdorr1f0ect thee52 4dproblem. 64e2Wde4 8a54pol46ogize f9ora t0bhe idneco6nve3niencfe5d and we aapcprec2ic4a7636te1 y3our u5dn4derst5a84a3nd6ing.6
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