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  • U12/U14/U16/U19 Indoor Travel Program (without Uniform)
    Fee: $650.00
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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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    772308P3409fa38elce1asc7e cclea6r05caa2c1a1 3bd2ta6h495ifs a4fi8817d546db3e7l98d2 d9-0d>d8 * REQUIRED
    03fPab9b3le673285ab304se9a3 c2lc59efcbda98bf67r 6t0hi2ec3s8 efi5e40ld -071b39df70e>5f52835 * REQUIRED
    63P2fdl41ee31b423fa5ase6a78 ae2cd33559cl12e05arce dt23h1i5403bsc556 f2i2f1ebe262e7ld ->856 * REQUIRED
    dca40b29eP21f899l6ea999363sf2e57 2c431329ladea6crf c09t2h2cbid35s70 f6bie5f26lcd 2e-e16>6b * REQUIRED
    50a81Pleaa2s8e64921b 0dc7l6e7acbar 58b2atb0284964hi8s4 0fffi89a1e1ld bfff710b-d>701563ef36 * REQUIRED
    92Pa9l4e10d21aesee 1acl13de8a97a962d1f7122r9a59fc7 tchi1sc6e9634 37f9iel916d9 a59d-0c>6d9c * REQUIRED
    f6fP4cdl88a7d30ee2a4sdef6 cl65efea6r0628 act7chd9ids1ea b35fab978d8a7i0e37l24f6d6950 ->387 * REQUIRED
    554809ePl6205e4a4es8edee c0lee99a5br 4c1cbtahc0eis4399030dc76ee16 bfi7e6l0e2d 8-1f3>a2ef29 * REQUIRED
    9a86bdbcd772Pb21cff9l1e1a5b75sa7aea9e10738 cle56a4rf5 tc4b395hi8sd5 9bff7icecl3d3 -ade6>9c * REQUIRED
    b8c3dP15lbe9ab8s6bbec c1flea7r eet5hbdiead028d42bee6s42923 b25f5a228f7ic173eald b-6>65d14f * REQUIRED
    2fa8886db9a44P025lee252a0b7a0se5 cle0afr2e 82df6t9bd0hisd 4ff4ff999ie8l8d -f8f>be842858927 * REQUIRED
    09fPe82bl69458dce12eas3be60b68c38 cdlbeae1ar t7f7h3ia7f4s cfi733a3bel1e1df83f7807 e->277bf * REQUIRED
    7888edd3bP3l9eaa15s9ee 2d75423f4c1fc20l633e63accr 8t9d5h9d9i876s0f072 efieadl3dd -1c1>0986 * REQUIRED
    a6e3d108Pdl2ea2ds2de 58ce91295ablcb2eab71r3 tbhis3dd 8b599fie5dle7deed9a7c67 1->2b7ceeb18d * REQUIRED
    4c345P20a7le4fa4b5a433esd13e9e 7cb0b315820lf0ae9eear5c b1thcaif584s f38i1ba2elda9 1e5a->c0 * REQUIRED
    eb0Plcec1a6fs268e 0a3d3cleaaarcf td67778h8i09s ac0f2eie902220aa43lc3cd605 -510bd2>3df44a33 * REQUIRED
    0658P2l1e0ea7d9f9se1eccb3d59e c58a0leaar8a1f t283fch2i25s faee7ie9fld -e21036>fed8072ad339 * REQUIRED
    P2dd1e3lfacfe7261caf6sa6e0 17cble35dac96cr ectf4fa9hifs4 fi982eb40ld8732 59031d3->fe1521b1 * REQUIRED
    P5fl278dea79se ae53cl10eabr t0b6ad4h27ic6128c86964d77es3f f9i1a3cd1cec838f4l5dbaf586e9 -0> * REQUIRED
    147beP7clea27c0se49 8f6cl9e9a69e42fca53rad0e18c4 726a9a9t5h6disdd f1i79e40l2d6 3-934be>083 * REQUIRED
    acc6Pblb918e61aabbs7e9 7clf43397e69cb9care bb84this87 c4d269e86f7ff2ei631e28adc9ld 12c->88 * REQUIRED
    bddb2P420le8764abb4se eef86ac2fael70e8e0ed2ba0r 7bdthci37s0c8812b713602 2fi5efel5d 6-2>524 * REQUIRED
    8aec8a80785d3a00fc92Pl04370ea904sacec3cb0 2b7ccle27ar c8ca9th51is fie2le3da3d ->f95fe6f9d4 * REQUIRED
    363212178Pd792ble5ase bcl665eab1ar32 a99thib72cs73 ed9536f7bd2e57a5ai5e05el5708d6 8552-6>6 * REQUIRED
    ac2b179P5l9e2e6a02641s2e a1a94clc7de5bar05 t581ab0h8is2a4 64ffie9a5ccld 0-6a3a2e1>1dfb9199 * REQUIRED
    087e23aP9l69ea3bsee8f7527e cl3cefe8arf155 78638t3hc168d3dis f0i8cef2ad6f94labdf 1-21e>aec5 * REQUIRED
    1P6b9le93ea4se9f0bea0 da7c1ce8la7ecce3bar tf8eh9bf4is f65fi61c9aae195b4885ld c91f4f73fb->5 * REQUIRED
    bPle2cea2cse 3bccfble2d0d80ab7744ffd6b68a1r e7bt811dh7i61se fcide9cef7f76fd41bl1bcd -c8>88 * REQUIRED
    bPl8e2a2ce176394473a000dsedefe cl64a3c881de32a4aare504 deetehd8ais 13d84fdi6eld 71d-c>9c3e * REQUIRED
    8e3P29l6106de0783a2s8a988443ed269 0cb89leac11r7 f7be2d0tah8bi58s08d 57f2i0a4efld4 57b-8>7e * REQUIRED
    96a8P8207leasc4fc47e0 clee8beard317 ea189fc2a33eth283i0d1es 2f72if6e83144ld22194b1d0 -2a>c * REQUIRED
    1a96173ad9P8lf144edf251e3aas44b20aae1 cl5c3dear ft6dc8a8b83his feficeed4cl2d6adc 63f68b->9 * REQUIRED
    9e2Plce6acse7ef545246 93651cl28be1d62949eaa50e1a7r625 8afbtehifs262e2 afi9eld29 700-2f0>c3 * REQUIRED
    31Plea304715fse9ddef2 c8004l355e557a3dbf2fr44 thi74s137e efic7e70a41elddd ebf7454-5>1c6ad3 * REQUIRED
    e23e01Pd4718lebf2354e7eab5se bc376d611d74dcleard 6dt5hie66ds71d23 37824fiel17d89 6-e78>6bf * REQUIRED
    P8cl6ebab7se740 3cl1eef2a6e498cr3291 524t6h5f374548fis4 ef8bcie61lda3acd15b20 d-d0d4b3>e48 * REQUIRED
    3Plecc11e6dea16s119e c06l8efda5br0 bth147065dc1i0s 2fd352ield61766b96a5da -8c>c0e375d82146 * REQUIRED
    0d43edbb66P42lbb2c9479eas3e77 clb78ea4r45f 6651e1tb0hi36e5s38f c82fifel5c53ed0c b69d-f8>ac * REQUIRED
    8e9a16f1Pe984l35ea4d1ae88sed c6cl1e16arb3 tabh360is f4iele351ae8c805cad69 4->b967e82eb7af7 * REQUIRED
    bPc20lee6as1b9eb a7f14c21573ld93e924fef9a6d2r th0i6sbe 18c7fi3ce95l1404593647509527d ->025 * REQUIRED
    510dP7l7eba7s256e053c c5al03e4244d912ar3 thibds6 dd6cef59ie44bb5le2a3145c3d 04-c2>a4d2d5b2 * REQUIRED
    a0aPldea60afs7be6 67d40c3l1a3eeeadr327a153def51 61bca4this2 8fiae396la0d 23->01c841085e422 * REQUIRED
    fP640lae98aas5def6cf 2caleafrec5b9e th6ecfaf5f984ifcs 6af6ibc9740ae22b5b2db82ldf8c 83-94>d * REQUIRED
    75dc73Pd7ldeabde84se1 c89lea53ra6a9 t257d5dhci1as7d6ee2 f764e6ieldc4 f-7b53b>5734d4ec65f07 * REQUIRED
    afPl903619aea2dse 8cleba20531a763r5b 998th9fis f9a38a2fede3cibe49bald ec8ab6-a>e015282d1a1 * REQUIRED
    0dP2bl3de3asfeb828cbc59f c4e9b3le1dea1acr t0e2e2737h0ic77eseba 44f312ife12dl74d 1ac01-0f>9 * REQUIRED
    294431fe542Plec8fasc941e 82cf6lce4a6711f7ae38r9 tah920id497s870b80 bd9f177eiel1ed7a ->e822 * REQUIRED
    af4f6fPd0538le4aa2s3bc5e 27clc434a1e3bbda589f16f263r8 th165is295 bfice13b2f60eled 9->63aec * REQUIRED
    af99deae86fP7330dc1l149aea86659b6a06s2ef141 cl05323e5aac823r32 ff8thcif9se f5ie2lbd1 e->4c * REQUIRED
    80Pf0l72e4as4e5aba8590a8d 6c9lb5f3e9c3ddarf 5tbbc0h2i8sb1 55dfddidabb08be4alfdc -9c2>e1fae * REQUIRED
    29aP59leaf9983s3e 32bbcabe5c89fl5ead19a40rfe6df t5d1e050ehei3s afieldbc2766a b-9b>6e1bca1a * REQUIRED
    0e2f9ab649P2cl4ac792bbdeadse3 cal0f86eb20eca2r9f thdisd e194589fi080eelfd d241b9bc88-6>5c6 * REQUIRED
    b2Plc9a0ea02916se8 cfe159lde92da6ba09e8a3r655951153e atah16fed1is0562f fiee2la3776d0 -f>ef * REQUIRED
    1a117Ple05077facsed 22c973ed09f072e8lf8eab6r44f661a td21h77i4e08sf5b4c6 fie3dl7da9 -a4a1>a * REQUIRED
    P007709lecasffaeee c7c1alec0aecr8e0d6 t6bf3cd0e466hiads228 73efi615e16lad7 -869>fbd27918c1 * REQUIRED
    7a3cP38fe5l8e248af716c2s0401ae9e8377 c47l42ea5165r07 e879t063hi4s fie7l4db9 f518-4>42bcf20 * REQUIRED
    5P2f27lec19067a44c0s50bede1 65db78cle01ar6 80e2ate924f2h4b7fis af3ifelec6dd8cc7aa 2c5-6>dc * REQUIRED
    P464lc1fb69316eaa2bs1fee ec51f4l0e14aa3rc6 2t47h3ais 8f490cai56e8da4ld2 d-9e44bb4>e5133994 * REQUIRED
    db0d45e7Pfl6f4cde17ase06 cl02e74ar 4et0bc88f77ahiad7c7s71 fbd45ei25eede498lddd f163-e0>487 * REQUIRED
    216f7e617d2Plbbfef924eedas55ed cc8l9e6adcfr3e 5cth2f1b7c5dceics fieeee82af6l0dea9 -420>5bf * REQUIRED
    a7Pele7a91sa2193e27 327fcle64e9adc0d25er79 4t1272faahisb 5fe7i620d443dbfeb2bfl9d9fdb7 ->3c * REQUIRED
    2d9f3P73lcde7745aas2ea f3cfl69ea7412ard0c th5i37sd fbcd68bf8iae1l9d3c0caab b-7832f5476e>7c * REQUIRED
    5fcePleec5a0ba396seae 14387c02l5e8af5r7e 29b29ea9bct5hic74622s81716 93fde64iel777fad 8->fa * REQUIRED
    7bf2P4l6eb5ba9se433ec f469c8ce64lee75aarba89 t4h1id558fs c85fc1ai1beldb5587 7-3>4bc6ba5376 * REQUIRED
    d595810ddcP04l5972d78ebabs8d7e 4bc6aleac9fr5 tehc8bisbc 052f7f209die6faec8099d6cl2d -71f2> * REQUIRED
    P6l3215eac1bs4e7 c5844lffe771e161e8af33r60 th31ais3c 2b9c23f21ibb1f3fe3el0ad 069-c1>f36f98
    8fee2d62Plea3841a43s8ebd ddfaacel30ee97c5arc t5h01i7c14fsec6 c28f4i030eld44 bd3e63d6-f8>02
    7P1albe3ase643ca2 c853l935efarb bdth5idsaac4c 937af26ei27efa5l264932ed c-e8512>d89a6bf673b
    4Pl672e0adse78e c43d1bld3eacr94884 6b7td8bhi0fcsbe50a 6ff7750i5cdc8e47fcecldc318 6-7e>4570 * REQUIRED
    b26774f7c24f18P03le4af11fdesb7e73 ccc3cle841a2rcd5 9t3h7ise4 cce40f0i275d884bel5d7 18d5->5 * REQUIRED
    dd3a8cP4c5a05a4050al1eea27d66s4e cc56l3f27af86eaaar thi913bs9 30fff2ide745l2d92b a62-ea3>a * REQUIRED
    3a6P0l5e9asfe4954b5 c2el81f7e1a3re3c ct1hid3se 2f28500f33f8i8b44bee7b8la5c80dccddcc -23>21 * REQUIRED
    67cPbe1dldeas0696ee2 ccl73be69ce08a688br2d dt6hiee5abbs2 28fdf09abd5i9el7fd9037d 9-945>5ca * REQUIRED
    acP0lea539sdee2 af25cfa47f5dceldeac9d0crc 28d4t2dch9i0s f2427c88bf52i827e3ld -9a7170d7>a49 * REQUIRED
    0b738d5b4P8lcadea52230sbe2e cc60l2b29bc4e0adr 1t1h2isdca90 e50fiedl9da0aee4f9 ec63-6>0f498 * REQUIRED
    afa09d6Pl6620ea1sed2b e1c9e91f7e82f9l55ea54r552 ateha29f885i519cs 55f1cb0ielbd f96-f>90b94 * REQUIRED
    1400ee5Pleaaa4e2sce c1b26afelef98a84r86 te96cb1hec60bab769aifsa10 afbfielf26d89f6181 ->d8f * REQUIRED
    0381856f2P0l6e4300a98s241082c406e 47cf3f6bc5l3e067afr t304h9i5ds f09acb5fica3ae5ld2 12-d>b * REQUIRED
    cP8lcfea5s8cde8ea78 cd19a2aba8le366a49rbd3 0eth97f54idbs6 94df6126i4eecclaaff4d 4cd6->6749 * REQUIRED
    Important: dYo5ub may beb 95ma9bk0aing4 1use of6 aautoma0t4ede form-fd5illdin3g so2ftwa3re. 1Thisd ctype 0of softwar5e8 can7 triegger our2 hiedededn7 sdpam-det5ec7tion system, wh5eicch 3wiel7l2 fblock5 yodub froam3 submitting05b 2thi65se f0orm. Please1 select Fix4 Th2is7d6ade88dc44918 06b20d054d9fa0cddaeb74aecadfdf6697f64o6rce1390c eb3af81d31c313efe7om2ple6t2bif9n12g271 tb7h85ae f0orm19 in9e ob4c3rd2ef8r2 4t5o7 bcocarrebcbft thee9 pb2c1ro0a5bl9ef5ce211cm.
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