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  • Goalie Indoor Travel Program (with Uniform)
    Fee: $290.00
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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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    Player Information:
    Emergency Contact Information:
    Payment Information:


    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. All payments are to be paid on time (see yearly pricing sheet for program specific payment details).
    2. Late payments are subject to a $15 late fee.

    Element Athletic Player / Team Tournament Registration Cancelation Policy
    1. Full payment must be received a minimum of 2 weeks prior to the event. Without full payment a player/team is not considered registered.
    2. Full refund with 2 week’s (14 days) or more notice of cancelation prior to event. If client cancels with less than 2 weeks (14 days) notice the client is still responsible for payment.
    3. No refund with less than 2 weeks notice of cancelation prior to event.
    4. No refunds for no shows, forfeits, lack of players or any other reason with the exception of possibly weather (see below). If client no shows, forfeits, lack of players or any other reason, the client is still responsible for payment.

    Tournament Rules will be the same as USFHA Rules
    1. Duration of games will be 25 minutes each.
    2. A match is official when both teams have a minimum of six (6) players including a goalkeeper, in proper uniform, on the field, no later than five minutes after the official start time.
    3. The score of a forfeited game shall be 3-0 against the offending team.
    4. If neither team meets the required six-player minimum at the five-minute point, the score shall be 0-0.
    5. All games begin and end at the sound of the central horn. Penalty corners or penalty strokes awarded before the end of the game will be completed.
    6. At the conclusion of the game, umpires will record the score and each team coach/captain will sign the scorecard verifying the accuracy for the official record.
    7. Once the scorecard has been signed the score of that game becomes official.
    8. Signed scorecards will not be changed.
    9. Umpires will deposit the scorecard at the nearest scorecard collection box immediately following the game.

    1. Every attempt will be made the update cancelations on the website. However, weather conditions can change rapidly and all teams should be prepared to play as soon as weather and fields are playable.
    2. Weather cancelation determined prior to an event may result in a partial refund.
    3. Weather cancelation determined the day of an event will not result in a refund.
    4. In the event of adverse weather or unplayable field conditions, the tournament director reserves the right to:
    - Reduce game times in order to catch up with the schedule.
    - Finish games before inclement weather arrives, or to preserve field conditions.
    - Reschedule games, if possible.

    * Games stopped on the account of an injury will not be replayed. Scores will stand from the point of the game stopped.
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    b668c66ePleas304f8bf6f5527fe8 7c4e0l468be24650a2b3r0e bt3h574dis7 ad6ffb1ia1eld b5c-781>3d * REQUIRED
    b2eP23546b2elea7abccafsa1e20d12 9dc893l14deba01e1r5 thi376b1ac5s7 f16ied7cel9ded6be 03e-a> * REQUIRED
    0bbPale5a66s6fe56667b92d 96cl48daea8r tbe1dd31h77i0sa fb12i4f2el4b6e9d 6c1-441f40>7d59776e * REQUIRED
    b05b09Pl4631e1fdba882s80eed 97febaclf163e66dar3b3d7 9cth94is e894f9i53ee7fe2l11d369 af-a>d * REQUIRED
    a0Pleed451fase9 5calce3f63e0e535ar8 9a2t8b6h8ed3aie6se5c5b ef2iee4flecd106bd05 41328858-a> * REQUIRED
    P68dc6leafs257cb3e fc8e5le7c50fc3b3a5r9ba t4hfe14bi10es68e3 ffea4i6e7ld1b79d 50-7d>13a1270 * REQUIRED
    4Pcldebeae33fse38 789c4650f4l73ef50a1ra tah8i98s5241 f1686i3a5ae66l8d -a>21623b9eae7395124 * REQUIRED
    3ePl86087eea3edcs0e c8l5ae9a2260re8 d2theisecc40b053c1e fc6fdafcff04fdidel6a6d2 -f38d482>0 * REQUIRED
    4e5bf1771cd32Pdbe1lf22eas3e2 c8cc41lcd304c83ba1e847ad6r dth9is157630 b4b00fiaeal7d -8>6aa9 * REQUIRED
    258Pl4e8eas5fbee c2bl7a088ea2e0a15fr5 781t275h34i848a526ces16c a56fiel07e39dd53 -9>cfd7e4b * REQUIRED
    32fP2l65a5cfe9as25e022d0d 0e909cleabr6bab6390e1f52 th9is1acc 1f635i23e307dld478 2-0>c3b2f7 * REQUIRED
    d3cP38leaa8sd2ee3a1cb bdcleb201a1r aeaat0h3e25831ad5idd3sd 3ef9i3013a13e4l0d ab8e-1>3807d9 * REQUIRED
    c48cbPlbfeas5a9e0879deed9 48c2ldebab060cr dt4hd98e5is0851 cc7fi2fa0e9fb3e9acl7d33 ef3->e37 * REQUIRED
    8acffbc37160Pl46e36ab488s0c5e5b 21c0l26eaca648r 3t942a3ahis1 f9fe078i0ee5el301d9 ->ff7605d * REQUIRED
    68cPlea4sed38cbe d5ce2le18c3ar41 27b9793c6ecc4ec78d273thcif77s79 ff4ielfa88c1db -9ae0>67ff * REQUIRED
    P10c4lea7sa8e4 clcebbcc9a1a3r31 t51hbc2bd70f5c4i9df3fbeb832eb3s1 1f4i07eaff7l8d8b1 -c6d>a6 * REQUIRED
    P64le94eeacba48sfc80b3e 5661cc6l073earf3faf61b25 5tbh6ib30s3 cfaid296e7b99ldaae c5c54->cff * REQUIRED
    e3cb455d34a4P700l0e91da7sefec 7b86dcf1l0ce0928ar t5a7hi4s2 fb4d7f7ci4ae4a28led 2858b-4>98b * REQUIRED
    a6fP1ab7led3a1saebd201 c743lf564bde9da6rb1 0f49this84653 fc53i80f2e49790ld 8b2066->39e8038 * REQUIRED
    ae5dcPdl8aeccaf20s26e cl0adfdea7ff0rab thc4fb5998edcis 1f16i39a40e6bl2dc60 a4-2f3164ce>35a * REQUIRED
    e7Plff52e0eaca380sfee 3d99d0539c1ledfafa02r4 fb6th41is ff207e685d1b6ie5d0ld3d 8-78>6a8f7b5 * REQUIRED
    b28Ple89ad5be4aec645ef397ese4e 0clearb 9t6h86is4 e8f0d2i158eab73ble6067d90 f-658e64e0>aebc * REQUIRED
    P2b51alf8ce4afs916fde 4154c0l06caeara64a0b6a0 df2099tha5i3ea197s40 e60fdiel8dd50 a-b4053>9 * REQUIRED
    Pl786969133d76feas52c4efa52 c2lea217rad 1cd0cd194t29hi09a5s6 6f9c82f2ie2acl8f5d ->1728cc54 * REQUIRED
    4Pda933936lea5s802c4e cledar 4th77isa3013851c907443e7 f3199fie4a1ld33e8 -71f>3807df53f2f6c * REQUIRED
    914Pel545ef00ab64bfdse7438 676c9l5e71b18ba77r 35f5t57009ehd7ies4f57 d7bf1ield5 4f81a-7f0>5 * REQUIRED
    a7682bPl4eas9ce 5ca7l76eear53 9dt547h40i1as0956b79217e3 dfdb94fie0l7c2ba8fcd0163 e782->ad6 * REQUIRED
    6142cfPd2149l041036easabaea96 cf8e88a4l7f02a4c096ea7r 3t09d5hisbdb 7f94e2ieald7e -76>e577c * REQUIRED
    d7dcb8bcccdb6Pfl4eadse558f2054bd6896 clbbe1dbar teeh4i8s f7b08388fied24ce5l6d6 c39-20>a53e * REQUIRED
    d2Pl3e277ase 918c69b8ffcc43c49f115lbe7a8a5r 1thcis0a36 29e0bfie6l5a89d2 a4d0-c64aacaf>8724 * REQUIRED
    a88aP2d9b98bedle4991436a6as52e808bbfb5 95a23cbl02e323ca0r5229 54taheisb35f fi581eld2 4-2>b * REQUIRED
    be89f77aa58c9bP8l8eas6fe clf574e9b547ab5dadc8rd3 8b9tb969hei8s7a5 37f181964i4e7l61d 7-7>87 * REQUIRED
    b877c080e02Paaal0eb117a50bs3e 0fc5bf20clea039622r te0hd88is a5d25f2ebc1c7a699ibc4eld a-d>e * REQUIRED
    7299cacffa9Pl7e28aeas3ee3232 479clf29e82284dabrb bth38i6d0s6 eb39916bd3fdaficeb34lcd8 -39> * REQUIRED
    0777Pe22alec78f3abbas7cfee 6561cc8b3led94ar44 5tfd6bh72i4c007sa fbd0bfi6e2beld3 3-7d06e>2f * REQUIRED
    4P10b9l713a8ea3ds151e c272clecaca10240cd9abr t5hi0b1s fa2ce7486i1ee5lda -e>5f8e21ca85252de * REQUIRED
    b78Ple5aa36sec6 73435cfda2059d7f1dl8d79ead9br6 2ta31hi9e614360e6sc1 f0d4ie7cl0d7da20 -9>25 * REQUIRED
    427eP0b0a7fl2c06eacas7e547 30c1l34daea2627r 21ed7tb2h5eis affi02be5a913l6d b->cc58e5b1e1e1 * REQUIRED
    2f59Pa8lc59ce5a8e569cs4d019e c301959e3le80a2r2 t3hci08fs4e 31d6fiecl09d5 -403ae6>9abec696d * REQUIRED
    a66fP00laefec635ase00 cl7e8ab8r7 t592fb5h76ids f13f55iel8d5a8d2a14 e476a3ff3bfc200ab36->db * REQUIRED
    fP12al5c92ea89s9c5e0 9c7l5fed2a01r4 8d312b37278cteea918h5is fie3740124dld 2280aa0cbc->f229 * REQUIRED
    09d9a51P5le202250f162a14s7e3f8beb8 c2cl934e036b89are3 6fethi6as85 075c8afief361l4d3 -f8>ea * REQUIRED
    P619dlee22a8cs02e bbc8d3aleab4r0f 7tahise5a ffd2398eifd59eled73641437fe bc-4>ea9f00682277d * REQUIRED
    b95P78a35bfe6lea7se5 cecflf3f5a4eafr1 88a678fct1e64a28hibs816 8adb9fie9034ld a7711-884>930 * REQUIRED
    52P272le38aa6fse4288e3 8c5ace18465c7leab37rb de75ft907390hie2sd98c6 66f2iedbfld -3e0b4>115 * REQUIRED
    8Plf67a2eadds86467ebd 8fc12e8631leaaf1drae145fa04a t2hi53d8s48 f5a9i9feld6 bee1bf1f56d6->c * REQUIRED
    457f42fPleas4e8af303 485a8clb8a28b8ea4cr0d59 t8fehee43i18s01626a8e2 4fi81672el51d 4-9>2205 * REQUIRED
    bc9ff572eb2ePd9leab0bbb290esee32 fc7cleaa12r 22t0c89da452h5ie4s ffbi821ael0c699d2 -f>5e051 * REQUIRED
    d0c1dP56f7100bb01lc8eased86 4clabc14d2eear b7ethbis64d 6a9fb523f9fbi36a3el6d2f -bbf2b>373d * REQUIRED
    6e5e85a70e0Plbe5bbaac2s9605e81 ccle8a7rf 2c29e8f19tbhis78 0ff55ieeld1d04a61 9->82d7a2d9b9e * REQUIRED
    0aPa030b77fael2f8ea1b3abc134aasbeec bc2l6eaarbfdac4 4tdaehic35d5s feieldd f3e->290232da193 * REQUIRED
    d2310a280Pl01a05c7e2aeaas7e326e 8cccl6b24e5a5r95a7 7b436th98i858s698d ffie0cc1ldf 9a1->0b1 * REQUIRED
    6a0c2P0leeas95fd14d057de 4c0l6cd46c994531ce9e0eb41824faa6d299r thai627s 2fiael20bd -19d>6e * REQUIRED
    Pl2ea35sb6bc2869ec c6blfe7acr2555e1 a7aa4cd10t574hba3bias 7afiel3cae5866aadd 9f6978->62df5 * REQUIRED
    Pl7417e8a167asc4ea1dec 4ac8lea7ar1c t2h937ccibcbfs69 7b26fa2d0ec0ef9ie2d91ld5c1 231-d88e>0 * REQUIRED
    adeb4P8d5876f8leab7caese 40c40l3e6a9975cr7e tahc95idbads8ad90a a8ff5cc7ieeaela8d -8>6b45cd * REQUIRED
    ecd9bebPel877e499817a957s69eacb2 5147ccd0belea46rb4092 thi781s8 fi7e5l0fd7 8c7b92b-7607>9c * REQUIRED
    bc69P55ad8cd8l36ee5a1e0aab03ads7e 47cl2e9ffa92areb5 t65h81ibs400a1e a735f6iel20d2c 82e->d2 * REQUIRED
    c0fPlea2a1eb776a989a059fa6se358771 054abdcl8fffeadr 5tbd4h92i4s66 bc6f9fei6aeld850 ->31e8e * REQUIRED
    Pl7c6ea80a85sbe2bd70038d ebfc2le9ba96r69 tc4haa4fbf9i1f8bs5fe74 f1ie6flcd2de3e3 50e8-d3>e8
    Pdl4de3base9b74 87c7ld5e0ac5r20f8 9eth6i01bs59 8a25dc3afie74a4693b7187eld36cfad -a9>b65d9f
    2P3leadca014a029se054 94c19dc3clecf5ar12749 f24141ath148idbb1s f0i4ebfl34d5a04 df6e->faec2
    c73Pe3l9a3175a933e8eab05897e7a64s9f4c4e66a253 cl3cecaer0 t7his77 efecie99ld4 5-bcbb7>2223c * REQUIRED
    ceeb8Pfle74ease4e4dff03 cc2dleare b6eft66ch8i2fd6fes6 83fdi70e117el1bc681db bcc->ccc8a7cf0 * REQUIRED
    00Pl79f2446fa331feada2asa2fe c184l9ear4413ad59 3et81152he6ies0ce fia5eefd4eldd 7-6>d75578d * REQUIRED
    096Pl997easa92e9 86c47le09caa64re3 f27t35a1340ba8hcie9s6ca58 7fi90ebe63e5ld -720d5>023cf55 * REQUIRED
    abPfde8elea719faec1c1c0a8se97 clfe9c01aear dth8iee876a4ef9se fbi5felda20 6d3070-67a594>917 * REQUIRED
    3e41aP6lfd3e1as7b2ed 4cba04l4e6a48brd5f7 t7079a15hi9se2d0 f8i9d2el2da43 7-22c5>5dbfbdb9bf6 * REQUIRED
    edb23d33f6Pefc9l75ebb7e4a0fs0ec 1cded7d6lde4ca1r1c6 d0thd8id07s7 6d6afi1el0910d 1->48c330b * REQUIRED
    df16aP3924l7f12fc265e29a88s920e0 c2123lcear c6ftehe82ies fc25i4216ef0563l75d -a2>dc99331b8 * REQUIRED
    09c6ef9cdc8965882P3leadfd6bcsefe 0dcla6dbbear9 8cd00th4is 87898f3i8aafec3e74ldb d9b36-af2> * REQUIRED
    7da60P7a3fleef5efbca69cas0a5e 6c6cc2efla72dd35bae1ar9cf t9h9is60 f8icafeld3222074799 -e17> * REQUIRED
    P3l06ea6bs7e 37ccfle1a452br 3bat7hifab1a8118sdd dfe3ieb4c4bl2e92d 673529-77>ea30a75097efd4 * REQUIRED
    Important: Ybo4315u amay be mak40in8g 43use of a61utoam1ated f6ordm8-d3fillinegd sodb8ftware. Th4048is t4yp6e fofe softw84aer2e 82c0an tdrigger8 oeur hidden 0spam-de9te4ct2ion system0,5 which will b63l1o9ck 1you fr1om sub1mittinf9g this formd. Please select Fixd 7T8his4dcfef307 b7ce6b5ff0d2b9o0711311rb78566ec41722 866d473ac7005716b6a9feb22838fd2comple78t26bingc the 1fcorm 5i62n or34d299eaecr60 94toda 9coer1084r36a8ec4tb8 th47ddeffe pf9froc78b7508l9em.71b4
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