Registration and Payment

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  • Goalie Indoor Travel Program (without Uniform)
    Fee: $325.00
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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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    RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT

    THIS DOCUMENT AFFECTS YOUR LEGAL RIGHTS; PLEASE READ THE ENTIRE DOCUMENT BEFORE SIGNING

    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.

    I HAVE READ THIS AGREEMENT AND FULLY UNDERSTAND ITS TERMS. I UNDERSTAND THAT BY SIGNING THIS AGREEMENT I HAVE GIVEN UP CERTAIN LEGAL RIGHT AND HAVE DONE SO FREELY WITHOUT COERCION AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE FULLEST EXTENT PERMITTED BY LAW. I AGREE THAT SHOULD ANY PART OF THIS AGREEMENT BE HELD TO BE INVALID, THE REMAINING PORTIONS SHALL REMAIN IN FULL EFFECT

    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.

    Weather
    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.

    Medical
    * 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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    da2ad2P7clffe6a8a2se3e8ac404202955 cl2a105e6arf2655 59th80is1 fcdi84el495dd2 -3c>f48dee903 * REQUIRED
    1Plccea7fs0f5e99fb 0c71le591daea9r0 5c528ethif8dsefb72 d9fcbic37801a4a9eldc53 -37>415a376c * REQUIRED
    P7le1b4da27se 1c60l6aa0dc320e4a9rc8 06t34hi3sce1 2d7f1e95iele2c45fe8d5aa3359 5-6df>8ef1b4d * REQUIRED
    9dP2ab1blce228ase c9c4c3746104lebc04e9ac1e2eb3r0 1tehi73s f4e8ie419cld71d24 -59d1>a35e0833 * REQUIRED
    a08d582Plea7se4bbe 3c82d71dcle9bf1a25d37r4f5 5eet084he4fba5i7s f1ie8ald63f9d 992-e6d>7608b * REQUIRED
    cabfP87lae5a79b3a708sde c7l5cea7953444radd44b284435 ta76c9ebhi18s dfi5ealdd d-b>48a5099253 * REQUIRED
    58P7892lbe691da4fae81fa2f009se8 cd2l7ce4a0rf 1at2hi9e48s 5f7f8aai4fc67el644dd292d0a2 52-b> * REQUIRED
    83P82857l20eeas8e cl572441ef6b8aad0bab59dr 78th7isbcb332cc 60d16fi5e51e43eedl34d98a 02->79 * REQUIRED
    e6P8le67ba0ded8a9sb6e0538 7c1365leea02237r778 464tc1hi5s afid0aec000lcc8ad5b94ba 0e20-c>30 * REQUIRED
    bcPlbe7455582efase11f744a c4c0l978ea8dcbr tfb2h6dbi4cs2c 8b71fbie2fbldb2fd8a0b -e6ea>c50d3 * REQUIRED
    7fP0l33ea46a2c87e8a1se 6cle94aad4rc 89218dtfchis f5d5559bi891eldc1 16-a>38bbe64c2f6c479e70 * REQUIRED
    dfP88c50b66al46f6eas99e9 c5c34le0daf7686ae6e9efr t60dhis7f 9df1fcdi41e28l8add 2->8b3865990 * REQUIRED
    b6dPl2ce51fde9b0cas6e7c2eafdf b6cle40d4880ea8ra5 4t6hcd7isf4 126f4i15b1740e80afld9 -62d>40 * REQUIRED
    51Pblea25794as171e bcblec50d1be159787adcar9 tedhbi993s0995 786c5e758f4fdcife6d9256l5d5 -d> * REQUIRED
    2bcPcb13leacd0sce c606cld68265eaa7r2f4 a2t21h6cc1i463369fffs8b90 48ff0f90ieabl72de8 27->3b * REQUIRED
    686dPb0lc5ceade5s1bca1e3ed3b0 cf5l2b48eabfe7c0rf 214th8ia052s56 0f1i2fe55lde -eb6ef058bd0> * REQUIRED
    Pla0655e9asef11 c0l695fe8da2339f0d3frb ct6heais6a1 06673f8ieb0d567l2dc2 49ad-0c395b5>afa68 * REQUIRED
    e8Pb32cl3ea87se0eb9dc76c 9cl72a1ear20 a99ethfa2d8ai13ca68e5c5bsf38 9a50ffe7i8eel22d -06f>2 * REQUIRED
    b3f3bP8leea371s7e9de4dae0d8c94 bc81dl8e45472aerbfc5 cta0h5is9b 34f7ie9c2a0leefd -aea>d720f * REQUIRED
    0Pl252e33ase 6c5d71e056a4la8e5678a1877937951r9c938e8 te1c1hicsc7 fid88ecld ec-d>925649ddde * REQUIRED
    0ePb1l0edfe2ase27 8cl402ea27a881a3967ea3rea et01a6b1dh6is96 fi8eea84l3d88f 9e-382b>178a0a6 * REQUIRED
    476Pl6eaeabs4ebfc 4a582clf3ea9d3r6 65bbt94fa32e0ah1ic5sf d5fec1c5242ie80f1411ld26 638->ef9 * REQUIRED
    1426Pld9edc571d81faa36se8 fc0ble9a9f2r51e e0th53bi110s4fbc4 db133fi5el3defabd3 a8788ef->4e * REQUIRED
    f8P727fl3c5092c1ae6e7271a2a5s777e0 claafbb989ed1abrb bt3heifs6 afi6e4a45el4c91d0 7f->1112b * REQUIRED
    fb9fPled2fae27se 8c827le63ac4ad5re 6tbeeeh1898i3s3ae 1faide2e8dce5laa7a415d724e5ce ->245de * REQUIRED
    ae6ccPa3lea8aac4se08fe48 d3cb8lb5e6eac160r0f022 btb33c29h7is 08f4af1fic47efld24 9->404a869 * REQUIRED
    1f80Pl58df3a9e2f91ad3se5 1053d83c80le279c0d1befar6 th00bibs0 ad7fi554e2407el9d fe5-d87>be6 * REQUIRED
    48b3e44Pdlbeeased cfcf42d50alde35da06eerd dthie48b60s3c 6c137f8694ibe6eelad42 5a0e66-776>4 * REQUIRED
    P5fl13d3eeabsdf57e9 a1cc95l6ae4c7a1b5r7 442559tchiscba7 c9fc6ci5el464fbdff09bd44 ->ca954b2 * REQUIRED
    4b5aPb4l9ease5 a0591c629alee2eafcr1 0e966ct78821ed1519h388i6s45992015f fdic1f5cecld d-2f>3 * REQUIRED
    2ff1978404P537leaas15e5 c1l214ea082a54677r2275c 5td2h8a8is1998 fieb41l0a5e058bd fe4-ea1>ff * REQUIRED
    2b1ee7Plbeae1dcab5ca07cs4e3 cl5e7a8r3f883 aa7th2i828cscad 859501fi3eld b89d7f83d43c-3>2073 * REQUIRED
    340P1ef5e7lea4ab2a6see b8c5abffe0ec1a081a5cf73e425blee9fa4rc1 th87b3e2is 8cffieaffld ->e6d * REQUIRED
    5cf708fd3c967Pl5eacda5se7e c993dl457f8eaer2d5 t62chids0 f3i381be27f1ce47l5d e939b1c-30>a3f * REQUIRED
    08cePlca9ef5ea4sb5ece7161 43c5l2ebbb69aa86e25dr0 a9t8fhi1be996e4dsd47 fcd7i99bfec9lcd8 9-> * REQUIRED
    08Palf59e74as0e840 7e9444c4al8464d38e3ea926r2a 3thi4e02a078fas 7da2fi24ebldca -2>2fcf93fea * REQUIRED
    Pl26e2ebc6a8es2ee5a cf4l63834de82e2c6e1ab92a80dcaa78r d2tfa8bah3896if47s8f fie53eld b-9f>f * REQUIRED
    7cPlecdeaa4ecseee1f86ee01b c959lbearede76ce6ccb89 6t5hd2i786s f6bieb06l0d806de -48a6d>b8c3 * REQUIRED
    a8aPa5ee27d6dleafcasf041276ec36 c41ddadleabdr4a8 89b5t6hf5is fei81a6ee5ld50a230c40dd 87->d * REQUIRED
    6f2P2df7alecf405ea80aasee cl40e1a0063r1d9713 4tc34e544ah0is 91fcb8i4e009ld 5de74eb64-d>36d * REQUIRED
    aPe402fle1ase 81c13l2aeb6e9a39438a95da7fbr5 etd32his fiae1d59fela96816d4 a-7b87ca5e>2e7775 * REQUIRED
    Pdaa8le000f03de1e7ed83af6s830e 0329e5c6l14c2e3ar0d thi6s 7afif1e0l1583ec6826dcb a9905-89>9 * REQUIRED
    5ed6Pf8le2adbc5s877e4 0c8e5lfe9far dte9hb92c62559eibcfbs0875b 0b2711f524i9e0lcd 5c1->34dd0 * REQUIRED
    6a339Plf50eabs5ebce85 a54c8l0beab4f99aabrf3a 0tdfhd3f7i4e196d81f4s f61dbfebi2f77e5ldb ->bd * REQUIRED
    db6edPalefc56038aese4ef c3cclc8cead2rb ec64t5hids1 55df8aic4dfefcd571l5d 8b9d70e47af-b848> * REQUIRED
    f6Plae3a97490s3a71e caadd26fl0818deea1ad835ba3r t8ah4a8ias691d f77623690e3b25ield96 56-bb> * REQUIRED
    3f09Plef4cdas8e 353cl7530ea9e35ce4f2d45r t6hi2s1c7c9 232fdifb4el0df2d5db12 c687-3>a3b585cd * REQUIRED
    30edbbPle6ee9dd325c204a11eseb610 af33e8c1le7ard4b fa32tdhibcas f3iaeb43dlda054 -85e72>5030 * REQUIRED
    3ad82e78a9P8cal6f4e7d68as08ea c8lf2755d3ee19ac321r6a 2abth8880di6fa0sf97 f3ie79lc0d a-9>25 * REQUIRED
    94bP3aledf6asbed43e1914 19076cc3l0857ea175ar 1thd90d0i9s 7ac1bcf16ia4e180aldbe -721954>f6d * REQUIRED
    P61ld4deda998ad4s05def4 6clbea7ada57r7 9btb4e7hei8asdb05 f30858caiae9bl19c9ad5b5 cf666-8>e * REQUIRED
    7cPd4lbefcafsce 5cdle687b09e774a86re9a 77tb54d3788dhc3is66847b af13ieldbb76939ed435 0-d>e6 * REQUIRED
    e6Pdf29e8l12ebads1e8fe 84clca91b1eedbe38a2r30b1 ca2thbis84775c8a39 95af8687i251eld5 -cd>2b * REQUIRED
    a9P8aflea6fc10as4ffee60a clbea96e9527refe 8thia5s2528c fc12ief1l4992d89596166b8b7769 -ff>1 * REQUIRED
    a7b6c0cPl8a3d25163efa3df4se c22fa8cle56270a3b5bcr8eb etdhc42is19 cf0993d7ie1cl0cead9 -d>42 * REQUIRED
    e26afcP87le2abs4e9724b9ac6ed c244cleecar104e6b ta01he3is1 f2i4el6da111a 94-df>f56ff1c3bc1b * REQUIRED
    8056bPf52le1a96949fcca8e9s5aa604abe bd1c0le6b3a77aer t13h898eis16 b0feief91l98290d7d ->9c8 * REQUIRED
    2abc3c8bP29l76b7efe4b0edea2bs95d3ec 4c0f24leee9ar8fd9f t3fc33bh0i2s fc460183biecl4df c->d8 * REQUIRED
    8Pd503lee2as282e2f 6fcld0ea2ab29dc2a341r 5a20t3h6fis2 5fiabae51577965elb0dc3be -4db>948a21 * REQUIRED
    01Pa2leafb77fefs8e d517b93c2le7ba4e0b7bb9r 87tf09hf38eie8s68ae 6f46icedfld7ef8dc9 5-c>23b1 * REQUIRED
    143d8e7a2ec08feP351d7fla46a0ed7a61se9 f7cdlbe22a8r0 136a8tabb0h7ba0is75c fie1la4d -7>9ea8c * REQUIRED
    06Peclea26ase00f a1d0bac89clbed216a5r509f 5the4i1a9s38 bfie88l07f6ca007121d002a ->79fbe2b5 * REQUIRED
    Ple5a717s3e935 clc7f719e1473497aae3r80 0thi99734edse02 fd32iel5eb570d6cc 58bf-59932>509742 * REQUIRED
    Pleefae18ds57e 6bc2cl2ea47aaer7c 0eeb5c68t3e7he0eis60d7 2c061abfie8c5efbfl1eddb82eed9 -e4>
    * REQUIRED
    8P568leas56c45bceb9f 8cc5l1dc2eba7r td2262h6aibdse 471262ff3fb6cie65750bla54a2d 07380-82>3
    * REQUIRED
    98Pld7be7a6054dd6e435160bs6ee5 6c3649clbbebad98r8e3 thcis98d24 fiae7941l0ddb -e87>904ab40c
    * REQUIRED
    7ee33160b849a2a60a83Pal25bb1ecasbfe 7ec1cbldea2cd0r4 t3435h362ci8bbsd bf4428cd0aiaeld bd-> * REQUIRED
    dad6Please6de75 046c2c4el5edaac932c49a2r082 616t3hb00d56a5ic6se2a f2fi2el4d 9-a878298>5605 * REQUIRED
    0P9lefed05542a810fs4ae8abc 6aclee2cca4bre37 9cat7heibsa fb356ie380dce3ldc9 140513-f>e83fd6 * REQUIRED
    16f8b023557ab548Pl59ef29af9a65s0ed cb7dl077ce1ca0far th1a710324d5i3s91ec fifef7ldb08 2f->0 * REQUIRED
    8189P4186b004l0e23e147e8bbas5cee5d6 cl97e4a52e7cf21r6b the78is 8bf5ei7e17el03d b28-f>0845c * REQUIRED
    e5ae99Ple4ca972s91fce f468cl19e9aa19re2d33 tfh6ics14f6c6f9ad fc62cci5ebld05 6cb-057>39846e * REQUIRED
    588Plf0ea9b32abas165e 72c2l4429a6ce20d4db5dafe16cr228 ceb6tha4e9is31 fie6ld37602 -1bf>963d * REQUIRED
    0b5ePf647la69bceac15a499sde5e f8c80ld0c9a7dear 77th7eisd f56iedal1faca16df 741->992dd2e5f0 * REQUIRED
    bPle58894a8se6891f131 798cflbaead95a160r04 a8th85i0fbd53bs ffb4iedfc99e72ec7103l21da1 -9>0 * REQUIRED
    128Pl04bede1asfee 572707c7l82db5ef6e5ar35786a9 9teah3i45csa230 8becf9i5fed3aled -c95d>6bf4 * REQUIRED
    f196bd4Pbf91b54880l7eas5e 398c63al7eb7ef5a6r0d a43bthi2sd a7f6eiaealaed8b951c88b81fc294 -> * REQUIRED
    Important: bYou emaa6y39 abe mabking use of automateed faorm-filling6 s59oft1ware.1 Thi5s atyape ofb 6softwa8re can tri0gge41er our hid30den spam-d4e8ftecti9o1n csyst7e1m8, which wil9l3 bloc0k you froamc 6easuebmi6ttinfga this fo7frem. e3Pblease sele5cbt7 9Fie4x ae47Thiseff17a4babae 84f9e8bee16fe8ofc52rf3e835fdb7d2a9319f4c3338d8 6be62cbd5c72cdeompl9cetfingf 3bt0he8 form6 18ab7i1n1 o0rd12d9ce5ra7e95 to b9c7o07bfrre4cb5t8a0 t60he 645dfp9c58ro9bb49lema.a57c1
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