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  • Goalie Indoor Travel Program (with Uniform)
    Fee: $365.00
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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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    1d2a702baf8P51le04as3e23 3acb00847leca6f7r tf501hids0 fi665bbe7335fdd9302ldfc2 e6->1133e41 * REQUIRED
    d072ed3ac5P5adal3ea3a53sd8e6a7e0 c0l7eaf37r a91tfhis35 f6if2elafd1eec2757f1d 42-4ef>ad01f5 * REQUIRED
    88a7cPle4e7efae9b00sd1ebcf172e98389c2f147b 44cel18744earef 0t80hbise fdf4eie58ld7db0d ->ee * REQUIRED
    4Pd1leas27eef bcl43eee42a0d4r4d6046 t9bh1ad26i04s f44i3eb4abd2da3ld7fae584c46 161-ad5>f732 * REQUIRED
    413P3l3e28a8fsee422e5 c20lee2a29r63 et5fd0h8055i0894s bfficee8ld0dcd24ae 6312648f-20>57d06 * REQUIRED
    a49484Ple0ascff7e ec3l3feeddb5a72r75 th3i5860eds8 7ff9d0f22ec64fecb0fiec4l6d2f8 -a>c6109f6 * REQUIRED
    bd8aPlcce4a98a2d3eesef6 fc2le742d3aar320ab e4t23h12ie969s field 210afc9a57-b9c>3d9c4782fdf * REQUIRED
    378Pb2l7ca02fe338a0s8e ac3l91eara2 3thdia7s72e7ca7ef5f3 cf9983iecf1ac217748el3d f5-223>a9b * REQUIRED
    0Pc6cd5leaf32122se ce04lf2e2aad8087fr3 8ta2b7ae0hi8866sf b0f50ce071381fiec5ld540 -9402>b22 * REQUIRED
    P89l9de5a0f81e2586sed58b0 e0c07d05l743ded1aaa2r9a2949 39ff6319thdf8isb f6897fieladd6 -2>b7 * REQUIRED
    5b12P9leab4s3e c73e1dc0b71al3ea5r074 0aeb66f8tbb9853e7heis9 8fi49edlbf0d566d1d6a45 4e60->2 * REQUIRED
    07bP0l9da7e1asef cle7ara7e089d9 45tc53e6h7a274i3eds498 fie3le39cd5fddae715 8-b1e>aa7f7b836 * REQUIRED
    d1fc43daPf6398dlec263asb77eb9d celearba4b 3te7h97isa 3f5ed396850iaee5ddl7d -2>b6c7aa578462 * REQUIRED
    e97ed9Ple4e71b6aa1sb95ed c9c5953f7f1le1a3r 5t2h9373is0 cfc0ie0d188ea133fl8d 2cec4ce4->f068 * REQUIRED
    f809a4a4P0d705l425efa5d8sfde cclcac9639eard 0a6tb4eabfhis5ed acdf541d5aielfddab7 ->a521b81 * REQUIRED
    20Pl7ea450cb423sb3e cbd29le6ec0fa2c065c61781re3 the0id53a6s f6356405ield443 5-f>5187ce1cba * REQUIRED
    3601P62cl8ce0a03sde 43c307l7e8a24rd0a 121t2hi4s 326ed74f64adifa3el5e1d8deaf884e5ccf -d8>df * REQUIRED
    849Pfc13l7e21ab39s1ed cc5cclc8d3eaa4ae7330r 3t8e1h38987ids f02bf93c2i2ef2eel2d b2->b270177 * REQUIRED
    920Pdlecca6s8f12ee78a dd4ea79cl52e8da0rfa9de th259i43ebc5ebsc274173 59fc1ide3ladee70a ->60 * REQUIRED
    d54Ple62ba94s1ec 84eefb7a30cl41e2f87614336a66rde 73at667ba4hcisf7f 8a9df8e5ieecfld9 -bb>76 * REQUIRED
    Pflcfa3b2e71d5efcad23e5sef 07ffce9e5lef1ab50rf80e1 71te6h5a7a693fbfais5 fa7ieb0ld4f 6ca->e * REQUIRED
    c55Pleaa945643sc9e48c c6f2e5clear3fb4c t1h0is6a69e2 5c439f03a9d9ie8c5a20l4c6287d00 f8->c58 * REQUIRED
    86f6c18P0le6ca50c98sef1d8bf cl9eecd6abrd1f 755abc5352thi73a2213s4 fc0bfaice8b760ldd19f -0> * REQUIRED
    06d7fP75c3l347ec81aseea9a2 7c3l7e1ar 19thd6c45i1s 996c1f3475edb2e5i6a91e7l7d bf-2e0b>414aa * REQUIRED
    P1ale5aa8csd44caa4e2fb eccbleeeaar226786cbc08 t2hc7b8dis 9eff18e4i6el05ebd05 62f42f-d>8194 * REQUIRED
    a882d43P6le4a6bse ccb0l59ccd96106ece3ara0 th7d09i28s 81fd606i367f90d4cbd40e40ld95 05-2>578 * REQUIRED
    4095Pca0lea3s80e 6e06c4b7f217322dl8de9a7r56 tdf1c58h8is5da0 7f4ife915clbd6 -2f3>0ac64f5411 * REQUIRED
    c8d41Pdlbb889eafsed8 1b16e360a3fcl1ea9r380940 dt62a48hi9s f1caieb11al38dc6ad42f36 4b44->62 * REQUIRED
    1c631798401P7l2e51ea3982ec31fs59e91 8fce0l7ear 4ta15h8b124is4 d21dafie8l0a77d 1db9-0>22041 * REQUIRED
    f10P48l07e8asef87 d0caale2c36afbrf 993thif9s40 bfb62ic4eeffbeca6l2d24 842-517dd77>d7fdb79e * REQUIRED
    b53Pel5e7c3305973caa2c4af0sdaee dcl8962ear33c3cc 0t1619fh27e62a0ifb0s 6fibf203e9ald 95f->5 * REQUIRED
    dPl9e1ff33e374a0s2849e887c3 9031cl5df17fde6ar403 th8iase f27ief7led610de81f6e63 2-ca6443>c * REQUIRED
    c393193P8fle6e9f2a64b2s4e6b922 c92l6e96acdr8 6t0h9is ff2ie72l051707dcab6 b->b4cc01135ee8c5 * REQUIRED
    Pel7db7b3ebfasa40ee97d5a250 5c95le249fbc67far8 t4e377026a1chis88 fi3e55697l25f90d bc7->059 * REQUIRED
    098003P0185ee5b778l1ea4efsce2918 c52deld55ea36rde6 d3th7aceibs694 b8ffie435c6cld 4dedb-d>9 * REQUIRED
    578e54dabPl9e51a0aae9d8a22cse92 f8c6cbl023eabfr3 592t79bh6fis caffc21i4eld0430 e0354-79>56 * REQUIRED
    1P444al9baeasee4290bb 9da3aac7d6l9e30de0ac36br39bf54c68 th9ab90i54s faa217iel9e8d 59-5>9f2 * REQUIRED
    P7d9ffl5e2e0a9b76s0eb2e 88c974abf6lc1e2ar b2e23e2abc4t7hdbif48s7 c1bd5f75ield47d9dc 6f->2a * REQUIRED
    04P7l7e9017fbasbe850a 19a8c45409edcceb68lebac30r 4873fthcics8 e54fd3ie2ladfded36f172 5-3e> * REQUIRED
    cPlb10ed656885fas0e8f 1c09el7e74aar24051d f0ft1h2269c4i713ds feb1a1i4e1l24b87da4996 7->38a * REQUIRED
    131Pd13l5ea3as73e dc8ld67ear cthi2sdd49 f393i6e4la23c49ddb328eb034 cf-7073ad>50f7b1796a9c9 * REQUIRED
    6P4eldea6d3a8aseece0e8 5cleear6530d8c tda417h040cifas2 f8fdi867e3e0l8db3 bf8f7c-e09>597f2e * REQUIRED
    c8Pdleeaese 93ccl1e6f273aaa0r9 tf1hcida0cadas a11f8ie94a37dl010863072d6747 9eda52-6>f88806 * REQUIRED
    d0b0f910f4Plf283ea4sf8aeb1b 9c6acb33l82005bea4r 5this125170259 fi8e5ld6a945ca0fc 717-f28>0 * REQUIRED
    10575Pl6ea37se440eea5 d6ca9al05e6baa58dd43fd1b1e84r tfh8i2s13 8ff3803779841iel449d67 -ca>4 * REQUIRED
    3Ple525case8a cleaa3r967e478f336 af145tdha87is794999c a33fibccelc02acd -0e>53b2fefa06ea45a * REQUIRED
    59fP2375led52d16e51ba0se 32ca73lec131ar71f d3th86i98s 459351fbdieleb806ddbd92da8 3c1f->9d6 * REQUIRED
    fP92bl8e41feasec71 f7c4f70c6012fa216aleaaeaf108rb87a3 this0 0c3430b4f7ieafld a-68e1fd1308> * REQUIRED
    136e3c2ec6367174f8d25fPdl4eabse cl984ae04acr2 t2his5a5c7f9 9216df63ai4a9a9e4ldaf8f2 c1-9>0 * REQUIRED
    Pdf1814l5fea21bdse c87e1234c2la0ce5aacr8d bt6h9di19s 9f090ice3afefl7d19b5 0d-67>c5e7118fc2 * REQUIRED
    d1a10P1737bl5c9e4a5bdffs229e 647ce7ae34l50ce9far3c ct07ba6dh321id4fs4 76f96fie7b2ldd ->076 * REQUIRED
    0Pble295eas90fce86d 4acclcea8d9adr5a3bc 0th7be28i4csb9f 36ficef7ldd -1>bc8a4843fd18e029557 * REQUIRED
    a64P24l020e5f48asf9960e2 1cde4b9alf7ec0aa43ra0 t9his 4fdiee9la7de 1-0>58ca1ef49e5c2079202a * REQUIRED
    4bca0Plbea53f4se1d ce0ealea9019r0 8t7aeh3dd3e851bc96ais 7f5ifc400el0629d4 -93b>94a17a1082f * REQUIRED
    21e6ca83b57bPflecfasea4e050 cfl5e2baf0340d23904cbr t87ha1if7sfb fd2iel7d0d 5fc0-26>b5eb539 * REQUIRED
    fPl1e41as7e7 20cl14a92e55dea8ar2 3th92ec798d5008is0feda8 533e9d6891bdf691ie68l5d3 1-24>850 * REQUIRED
    eea3Ple5eaesee87237 dc5a73leaaa8rd tf3c27h4d6b8ids7c babd77c236fc9ie4cl6cdd6 916-ca>3a7a74 * REQUIRED
    Pd39l3e2eaea1se cded506lea864581rc te3c4eh008913b911ise98 faa53bf44ie67l10d3a5e c1-a42b>82 * REQUIRED
    5P4ld0e143ase aacl6721beed869e2adba14d1rb dcth7i9ebs efdi0e76al84ac1d3d807 cef-57c>1c540b7
    83edd63f5Plc9260f96eabase 1c080ca755929e0l021e8a7bc310c3r ath79ei1s cf6a8e0f5i903eld ->485
    3cc20P41le6f2abs8fe c4ce5le4a1r 966th2e64i9s fi4a7ac4cdcb706ee0f26ae46b563ldf f4-0b>454427
    5P6ele0a4sae9 8c97c15l24dea69r b718bct1h522is6 7fe1ff0fib9b7d53ec9a583e2dac5497ld3ca a->4e * REQUIRED
    0355Ple96af8s07e5b4f acla6eca07dba2d477erce dth2i6879s 7f0c5a4i8dc7eld67b 35f58c3ab6f3-0>d * REQUIRED
    7556b546P63l636f278ease02d8 cl1e67afab34r7 t92e2h677i3s4 fi3be8c1cle99d1d0723a9 -e>b8da9b2 * REQUIRED
    9ca820Plea0aas43e 3celf20dfear0c th3i3caf93c1d9bd86d8sda98 ffid6el70fbdd3 a-932>5b17394798 * REQUIRED
    7b01ePlf040fd66eas521e8 cl729e1a78a4a4ra50cc 7fa3t010ea4hdi5s84092 d5efefi63e8leecd4 -89>b * REQUIRED
    f8P66eleedfa7792febc8398404s9b7e71 acb3a7la36c2ea69r80 t7h63i4sd2 8bbfi768eed6ld8 1c-47>1e * REQUIRED
    3Pblceasae04 a3cle7bfar196 t5eh9a1e7c9ifsab5096219ba fi3cc263e66lfbd0dd6814eea5 f-e1d>c208 * REQUIRED
    fa864f08d0a3fPlaeda79s55ee9313 9cb82l25e9ac132r t4eh9fise8 f3ic9fed9lbd47 a852beec87e3->63 * REQUIRED
    6e3P7leb48ca59a055cbcs5e7 dcb7l3b7e1ba9a2r tf2hi9s f772eie9l5d10 dac-6a7a34d3>3fe0e8f0b230 * REQUIRED
    a54Palea6d4aaf52c5dsbe56 996cb2c07fldea2r830 bt7eh3bis80f994c f9i7dceeblc25c70d -29>71ecf1 * REQUIRED
    5ab82P16396c9bcled792063e7bbase ccl38ear2feb2091b t0dhis f6a5fie9feld ->b28ab3179e1098daad * REQUIRED
    Important: 3Yofu ma9y be mda1king use1 o2f automated form-fdill5ing softwar20e747.0 Thedis tycc2ap70aee of 25softwa6r69e 22can triggerf eour hidd0en825 sp3am-d9etdectiobn sys4t8em, which will bloc7k you from4 submi57ttif6ng 2thi4s 7form. d0Please s4ele1fct 6F2b8ix T2hisbd0aed876d302107cb368d307 fdf2617430b6ae08e24a748cb25fb8fo4344re8e0c614 1ca0com1cp51le1t5binf4g dthe for8dm 813idn 3or7b7d2aer to33 co34r1252reecec0t6 43fb0t2f10h9ef dbpro078e863bleemd12.dc
    Important: 4Yofu may be making use of au6tomated form-dffillding software. This 7type3 off soft4ware ca9n tri6gger our hiddden spaeme-detection sy3stebm, 934which waill b59laock you fro3m sufbm91ittin3g th7bis for4m. It appears dthat6 the dproblem 4cou46ld 0no1t 6be au602t2fomatically cbo5rrected. P2ledase clear any fbield 5whicha app7ears a21db0ove with correspofn9din1g insbtr7uctio2nsa5faf78112b bb4e73ac34d9435bf74de2f6b8c7932f3bb4b23a232o1dr3774bc2ebe ea9cob3mplet7in1g9 96the 84f4o1rm4 in ord3erbdab to 9cor1recbt td8h1e 5probl7em. W3de2 ap3f7bolo08gize9 fabbor t9he 2i0n3convenie8an0ce1 and4 we appfr71ecieate8 yo10ubr 2uf9nderstanc5d0ine9g.
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