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  • Goalie Indoor Travel Program (without Uniform)
    Fee: $250.00
  • middleclass~spraymiddleclass~spray
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    Registration and Payment
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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. 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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    Pl0ea9b7e8090382s7e c98456el20ear t1faeh7baa2bi0131fsf 0fie42e8db693l2ed6 cdb-2f3>cf3f804d * REQUIRED
    4bc31562Pc1lcbea7f72f9s348e 236clf5e10ee8ar ea638th2is f87fbibe6dc828ld0 517d0-87>1ed39bfc * REQUIRED
    e05b76ec8Pl9eas9e7bc 5cb0l3ea5828r9 0thi24e1cs 94c61a02f1ed412ie8le8cd093 da-7>1fd5433d1d9 * REQUIRED
    fdPleas55ee 2bbc75e6eblb7febb4a7ae2r81 e46t07fcheci356s6e3 dd628cdfeeie40lbe9d ->a826fd378 * REQUIRED
    197bf0Pflee0e4a3see7731d9b cfel6eea88698br bbth0if7sde28 93f3edie98led9 bcbb5e-402c2b>be0d * REQUIRED
    bPcl29eacs9ecb4 c446l1bff8e7ar 5be7851t6ba4176c6hifas5 f6i1ef6e3b11dld2be0 -843>ce20e8bc73 * REQUIRED
    78fP6leb5a1055sd1e ccc8c6fl3e9f5a6r1d5cbf96 dt7451bhaab1ei1s68e d177f0ieb75lada4 8d-eb>cce * REQUIRED
    08Plbedas3e10 a78cle84de95e32db4a1r0 t5h8is876 082ffielc8d15a08ce fff-40c8c04>6785ef8bd9ef * REQUIRED
    5916Pc0lecd68ae0a3eec8sbe6 baca6beleb09dc952a4r21 t7hi6s 140cfa9aieeladb0ef1b3 -eabe>9ef55 * REQUIRED
    0489d3P1df635lecea3a95s8b3e f2c9b8led63acrf3 fdtc7hfbi62s ffc8314f5c3ic1eflda14b ad-c8e89> * REQUIRED
    dP12le95a6d6fa66bse87a8db0 72c2ffcle639af51069a9r23d24da t1hi0s24 f97i34eble3d04cdfe 3b7-> * REQUIRED
    1cP6ld3aead20s345e 46cl3be18a3e589rc 229a9c3t7bch3ia0ce827e4f9149s ffce0ibe02l75d17 09-a5> * REQUIRED
    c39c88Pbdl96b84af6eeaaca2b7s58f2e598 bf6cl5ace6173a00933r b507this 85fifd7eldb068 f->0ae82 * REQUIRED
    4a74Plf1e0aa3se dbc747ale3ard851e8 7th5f807i8fs88a 6c31b1ffdi4298d4el7a3e73add44b 50b6->b4 * REQUIRED
    e2b75aP6aclb1061e25dfa4s2ee7 97c8c6304dlb6e2a63r tach82i5s 1f69d75i3a9003eld2d ->5dcc1fea7 * REQUIRED
    P97flea96b29s9e cb60laee1aerb 3t5dh063093eisef43 b8ef3296i6f7cee8del3052d 70f7b->eb556139f * REQUIRED
    Pl6bce21a3132ead7137sce33a 5bc178le7ca78aar666 c58d4e5116ddth3ec3ei4b67sa 3fef6ie95ld3 ->0 * REQUIRED
    76Pbl5ede18aseff dc4e5cle6ec3ba3b6r39 e27ct0h5ba1isb1034e814 9f5iec3d96la9b33ded3 60-387>7 * REQUIRED
    f0333a596abd153Pl90f1e3b1ease aclebf0a9f1bd15rddb 8e10deth7i7as faci42abel9d5028f5 -9ac61> * REQUIRED
    aP703b4d6l5ea27sfe42cca2 c7cleaar7dc 00d0tf17eaha53ic09s4 fd2c093ielc9d42db -b08c7450>6aac * REQUIRED
    bb318P2l8e5f323154asae 1c1bf2c2le7a83r 63t55hc6i3dfs f9ib1elb2ebdcbbd3556e1bd20e 6ed41-5>7 * REQUIRED
    75a1Pf78laa58e6a0s4e4eea 7f6d6beca749l5da0e5b8a8rd t64h9i7d6dsa 25fd3374i87eld 09-d290>dc5 * REQUIRED
    cPl5243fea8s2bf9e bbdb0dfc29dc13d67l4eaa08e678r65 5220thie75s052b5 fi84b5eb307deledd -ae>3 * REQUIRED
    9c3aPlc79e6a2s2d1e 830909fcle9ar6 cce41thcea3ec7fac1is8eedc6 3ee1fcfie05ldc c-6abb>1c3674a * REQUIRED
    6Plc2f86beaes5ae1 fc5cd935c9c7820le694afr4e 23cft3his055e2378 2f0cie1lfe5d4e4090feae1a 3-> * REQUIRED
    553P81ldeas5deee ba6cl1aaea688a0r ct61938heac3d2if0s22 7f36a1f4bd42iad723e5clfc6d7d8 b->5a * REQUIRED
    2Plf0b7dee2a52s2fe05 cb5c6lea9abr155 ae94t9hde17fa7d40isc2 1971f49iafelde2 4-32>0199a8b440 * REQUIRED
    dP34l6e301f93ec72489aa2as04ea 8340bcf0cdl9b97eea6879r5 467th2di671s 66fbfidefld 8-05f>5758 * REQUIRED
    711bP62lee7ab4a4se cdlea2b8b5bb22c4b764ea6rbca7adeed8b t9hi8s 9f5biedlad8 -897458f27>6251e * REQUIRED
    900cPaldeas8f47daeebd6af9388fa91 0cleead8r4d thdbei3d7bsf1ecaaef45 f4ie96led 3-d842699ce>2 * REQUIRED
    88Pled7ase35f76 5c12l83eaff13cr 5t2hd0c683ibcfs f47ib89eee4043a53e4alc7bddd0e9 d64b6c8-9>9 * REQUIRED
    41Pe3ald3ea020se ecleadrd36807a196 f1043ctacb0he5bdi7s05b3e b978dbfi5e02a2ld2 9001->2c0341 * REQUIRED
    98573245eff006dbP2lebbaas30e85609 e1efbc90leed252a77redf 9bth8i6sc 2feei33el7fd22a 152b-2> * REQUIRED
    f690f13P3lf849e60baf6seea cb597clear ad40te80h2eis 74fcif2ele2d50cd7abb 7-2a8ce4b2aca>50a1 * REQUIRED
    7089cPccl7e4ab6es6c0e 4afec94eflea22er5f t9h59is9d2 2f7524bi40e7ld74ad56e425d36 bc14d->ee1 * REQUIRED
    394Plce1a4ab6s6ecef393 29b8dcl7e9deb07abab7are44c7 t0ah7cia0s62c7 120fi4de2ld5eb ->b3aa167 * REQUIRED
    d2310P4l0fedaf364sea0 63d7cbdclea9re2 4fdd813135dthi7saa4 f6fi0b5e6afb6e383cled5dc96 3-8>3 * REQUIRED
    5Plbbe575cb6617d4a68e09a7se caff083f3104lce3a27r t39838fhi4sd86 f1id7823efldf f49a->40d9e3 * REQUIRED
    d911Plc4eba7115s22e ed3c07le2860a9ea06f39336r61 tbe0h6317i49ds 2ff7i46e07l75df9b96 ->f0323 * REQUIRED
    55769dPeel9eas0e1e468550b6 4c8leabrb e1934b9thf363df3216is3 d70afbfcd2e6ie32bl5d8 8ca4ba-> * REQUIRED
    201Ple72924ae36s0d9ded6c7 cc3lc99feaba160rf 37cd48b1tch82isadba6 f0faielfff0d 9-33>0ae70bc * REQUIRED
    6b46150P7el4eebasce9a57 d9dcle36fe80011ar 7a4b5a1th01iacdsfd866 f5139efcic6e8e7ld -3c9>8d5 * REQUIRED
    6P0lae067fea3ddse6 cd483l6d578bea4car314b t58hba0i73e7sd518 cf4i15d7289el220d2d cb-43c>dda * REQUIRED
    e1d2dPe4b3l3bee5as2e9 d749ec2blbear8bd7 00thdcis ef62c4334ie9516l82de0 05ef4->fdfa13cd00ac * REQUIRED
    0b69eef74Pl0ef7dea1cs6e9567 6ca62l03eabab9rb50 tfh091d7237i472sf0 d455c7831f8f4ie73ld f->0 * REQUIRED
    776Pbalef10aa7csacebeb7df495c cfle5f51e2a8d9946ra01c2a d9tb8h83i492eas03f54 efi21ea3ld ->8 * REQUIRED
    41P8l7e5eb4f7ase0315fa5a 1d9ac62lec8d395a870r1fe4a t4fd0a361his d8fiee8lf86dd fc6d-d>8e2f0 * REQUIRED
    aPl238298ebaase c7ccc3dlf1cf9eacr 4t0bhis7c3d5d1 9f6i48e2229el038de0 -6e4>d3c478ff03182e94 * REQUIRED
    3aP4l3easce 29ccedlc17e6eb29ara28 7th30f62d90i2s f6ie2ecfe807l9dd0bd81402 3-7395c9b>a46c25 * REQUIRED
    a9Pabl8fbeecaaeeb1se8bf 5c3e2194la56e09a414r tbc9haeis7 fccb1f9a94ia3e21fled4c -d12ca3>6b2 * REQUIRED
    3P916l3b011ea1s0e63bd8 a2cd58l3e5ea42er dt7443ebh3idfs4a facd5eie0lfdb1898bc af-0d329>b1ef * REQUIRED
    1bc936dbff8431129Pl2d9dea03se 31b39bclb3eda7r8 fbd78d2thi92s f8ei7fa509de65le7318ed d-d41> * REQUIRED
    111cPecba0136lc76e3274a5352c1sd7dd6e8cc cb1ale0b4b8a856r t6h8is7d9 fi9eld0a1ab6 c5-b6567>1 * REQUIRED
    e8Plec2a6ase5e81590ed3f e12clea9ca774r13255e the2f4biesf1cd 0fc23f26d9f2iecdfld6c c5b0->d0 * REQUIRED
    P2l5e5496b44eaas5178e5e8356f8 9c375l262532d33eear57 th1i870fdsb 257060e5bfciea4ledd -6>3ce * REQUIRED
    Pla5eab691ff6sbe10 cle2276f6aa6r358 thcdi06s059 b87ef544042ib1eldd 085f5bd5b0640bb6-ca>3a9 * REQUIRED
    a3e7P74430lce4a79sfe9e fcal3e4afcr4 bt6e4bh7cai8ac5s3f990e76b0 1fibeae2ld3bb 54-2ff>e07a27 * REQUIRED
    3a37Pl5eacs2efb 3845ca9d5lea38cc0aafr4 e8150t13h384ic0s6504 c4fie6a1l7ec1a35d b-2bcb>e7428 * REQUIRED
    2P2a314de6l1ee92a7005af622eaa4s2ae640c b7fcl6188052e84a9r1c 76t40hifseb 9ef05ielebedc ->f9 * REQUIRED
    0Pl1186e9a83s8edc a288caa9964712bdledaa1r thisb951f4dae955b cdb50def71ieb01ld5 7-5a51>e8dd * REQUIRED
    cfP51lea192s0eb96 fc8c6lf08e5a1r ccteh6eib3s c71ca12c75f2f8f1c43ccie6del5bcbfd5 e68-ea>c7c * REQUIRED
    d78Pb279lead91se6391e 631c90559l423eabrf thcais fi68fee8b2balf9191d 5f69->e6aa7b858448deb5 * REQUIRED
    06e97c7e1d44b1Please 22eccedldecf5aac1f6382a33f8413c1r 7bcthids 1530fe8ifd4e0l820d427 -f>2
    198ea47a1Pl7bce0beaes4720e ccbabb100lde69bf2d3af13c330r7 5dbt159h98d887is622 6fa66ield5 ->
    e017a2c54681ePle4faf2se6 7cleecfa80r t1ee70ch6cdi5s f75e3b2e55083a8ib9cc8e9al2d b3-ffb>8f7
    b3Pla4ae90496883a9s5e c6lefa9r 95d5t6hi649b2e7s35223 220374f6i8e2801lda 4074e0-d>6699c8079 * REQUIRED
    9P1216a6lf954eea7684se 20c9cl0ear994 a5f4f39tcbffhi8b6ef6bs62 f0fdciel8f74d8 24aea-af9>75f * REQUIRED
    57P98b38le5cdca4s7e clc82bea34f6r07ad48 19tha47bisa33 f5d5i8704ef4al2a52d8dbd5 ->f355d2193 * REQUIRED
    4ed1P8f860le4a9e6esbae9f ecl562ddc5eard3707 3th656isa0a1b06 f7956i20aael90979d5 c-7dc>5c79 * REQUIRED
    c1P6e3lbefacd8ba1sf202de 0c3dl1f873b80eara c59b4eth6ab6is 427e54ce8fidelb5b89d c-1>c275e57 * REQUIRED
    f3dPcleaf10s2e5ee3 4ac0e4l4e5da4dd491145r t6had592i6f1fs fie11be1ld65bd1c0 19-6b823b04>fbc * REQUIRED
    9P033a8094ee2l0f5bfe28asf0ce5b0 94bccl6185ce8af1844e081frda fthi7asa 13f521f1iel8d6 d-3>34 * REQUIRED
    124106960Pl9e89e7base5 8clee0e3ea3fabdr10 49bde5t144hai2sf60 bfie5ledf69c90d3a8fd f70d-4>e * REQUIRED
    d0Pf2874dad66lc70dceaafa1sae3f c92l42ee5b8baf14fr9 t4chi8se6 f9f5b7i8f7elcd0 3d->d6d3ace2d * REQUIRED
    facf29aeP3l9ee2aaasae 9fcad88leecbe2a29r5 0edb1ethi3cc6s2a5 297f599i01417dfel88d422 b6->9f * REQUIRED
    d416aP5lacde68aeds2e653 c7l3ce110d8411ae5a4rfd t8c4b2d144hib71b074sf051 f96fie0ld ee-55>25 * REQUIRED
    Important: You meay be2 making use4 of au2t5omatefdaf foarmb-fib3llcing software2. eTdhis taype of sof1etw78a0re 0dcan trigger 7our7 hcid42den6 spam-5dete74ction 9s7yste3m, 7w7hi62c5h wi8l4l bloc9kf 1yo2u8 frob8am subbmi03ttingf t1his forame. Pl1ea6se s3ealedct 2Fix Thisf5b5e9f4992f43 475b44fc4c95bc2e2e7cf9beora375e42 1fc249c2eac5871f2b94e33b4cdo4243dmplbetif59861nge3 th0e foar6md8 i3b3cecfa7ebfn0 obrdebdre 0dtoc 64c8846ordr0ec9et fdt1he34 pr4oebbbc5lem.4
    Important: 7You6 am3a3y be 00maki12ng u25se f0of autfomated fdorm-filling cseof0tware. This type ofb2 sdoftwarea can 6trigger 1our hid2den spama-ddetedfctbio48n sfys7t1em, which w0il6l bloc4k you from submitteing2 this fform. It aappears dt1hat the 0pr5obelem c0ould6 not be automa18tical8ley ffcorre6cted. Please cleear an0y fie8ld wheich a1ppedars above with cobrres6ponding instructionsbc283944e8aa 2f89b30ab5dc6bc31b0bf5b247fecbf720oad57ar3ae1750 49ec76c8705compble85tingd86 tfhe form5 in 6orde6r t2o co6rrect the 01208p0fro26f1blem621c.f acWe a5cpeo2log5icze fodbr94 t17he3 incofncvenien6eace andb w7e apbprec4iataef you0r un01der2sta4ndbing.8cd
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