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  • Indoor Goalie Training Program
    Fee: $100.00
  • middleclass~spray
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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:
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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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    65028b9cde53f4dbe4Pl381ease0f4d0918 84b88ecl05e5adr257ccf6 d47tc088dhisb92e b6f14i4eld ->b * REQUIRED
    c89456e58Pd32lee5d3asc9c4e5 373cdd018lear2eb at64dd79h2is f68fc493idc9e3c88le6c58d 6-04c>3 * REQUIRED
    642Ple2c226as1ed 6cl03e4a344d67a13beacr 6c38dthdbis 502df66i094edd7e886ld449586 61ca->57a1 * REQUIRED
    d412Ple19bead0s7e5 8c8463094b86a8alea6da17d8ra 69e1be0thei0f35a0s 77fiel659d5a304d156 -3>a * REQUIRED
    d71dPl1ce79a9seac3 53c0ealceef5abrfa2a117c t4hbisa9e5fd6 d1d203fai0eelef02fd 2->85868d6002 * REQUIRED
    82ea8Pbe698le3as87e1 2ca39le53aeaaf5brdfc 62f27t2cehisf5a3 8fe99f4fi7e4ee2ldd 6->4324604c2 * REQUIRED
    89P36f66el6aea5dfb7f8s108e909 clea46rf 3940eth0i3sbbeb c2fie9c23871bl4c639ed5 -6>f34a0b168 * REQUIRED
    8bc8dd7ePl5be5a5sc142ed 569c3ld99103eaaffce1d0r bthis3 ff7ba27f0ib0e1cb2dfeldaeb 5a53->f7d * REQUIRED
    7b6Plfeas68e01826e71 9eeecaefbc770l144a93453314ae28bar thed51ibcs0 fbdcice8c925eld -940>87 * REQUIRED
    de2Pfdle046ceafefsf2d0fef8c 94clf5eefa344b10b8f6r t48f3e9hi62s a3796f8ield f->79d1ca9428d3 * REQUIRED
    Pecl505aec8be2aas2ef c1alae692a22r2a6f t1f0h6dai3sa282 84fie4la37fbd98f9 -e0074>48687df61f * REQUIRED
    b09P6l3eea2se0243 cleca745fae4e471r6 6c911t2d34h035ecd1is26 b8682fi6elf1d2049a f->5d9e3208 * REQUIRED
    ebfe7a6dPl9f1e9a7s49e39 cled9acr2d231846 a36e251deth0is27ea9f 99c2efca54ciebld4 5d10-6>87b * REQUIRED
    071Pc69l35a7ea573saef7438 cel9065e7185d118af7r4e4 c2thic85s f2bieeldfd72cdde224 25e-88>1b0 * REQUIRED
    e9bffd2Pdfd2lb8edacd7abesa60e ea4d5c6f8lbec2ar3 b36dt48e7hib3522s ffcfcie399ldd ->a78aff00 * REQUIRED
    Pfle01aff79sb24ce 99d75c61afc5b13fc9lear4 4e77c54et01heis1 bfica551ae5l7d70b883 f9-0b>8d17 * REQUIRED
    dfa17a37P7a5lb2b5aea5139f3af6se ecle0fa8r1b4 792the085id27s8 605fb64ec8ie4l391924d9 -2e2>2 * REQUIRED
    2P861775lae3579aase2d7ab a280cl63e21eedad58f8r t6hi9s 526f3da1f8c0di8e3ld90b98e1 4-ec>3ac3 * REQUIRED
    P2def8ela1e330dfase77bf f0c73471b693l06faefabrc c161t6597h4is6 1ff1ebie9bf9lfdfc2 b->d1f2b * REQUIRED
    2Pa8ldb9666382ea47sec4e68d7e70ea 41224ca0444l8e89c65a65r ta82hi4a27d589a99s efi0el5ebd -f> * REQUIRED
    8606dPfdlea9eces1b82286e6 cdlbe600ea29dba48r1 7th737cei3sbcf 3df4baci6e8la43adcb 29-10>d3b * REQUIRED
    aed1P60l5efd5970a21ad05s0ae fc433cle2a283rc6c8 1t0174h69fbaeiasf 64efi5fe7lfd -c>102b3bf17 * REQUIRED
    4b360360017adP4l229e9a1e015s2001ee cle1a3r d49be36t2dh9is09fe7d8 53abfie5dldabc6 0865->67e * REQUIRED
    30518P2l8175135512fe7bdea0asea7c214a0 9c65le99dearb t3hebdbc051d83idfs f8iael2d 4-e2>7334b * REQUIRED
    a3P4l8ceac27sbe94 ccec6754lea5f90041r7 th8i762c72a14fa1s7 f7f3ei3eal8c7d8a3b 77eb-a56f>566 * REQUIRED
    5ea7Pb8b6544a1a0l1beasdbeb 8c764fdlcec933810ar186f 48btah3icbsdad dfe6icde45eldc2 af->efa9 * REQUIRED
    f429P7lbc8eafse7dd ecdlea00e52afaer91a 6693t9h1dbac515ci0b121f14fsd5e49e8c998 3fie6l0d 6-> * REQUIRED
    3789P4fle0fe2a82s2e5de92b55 cbleea7b3r08f ed3th98iae4c7s6e 7754ac51fd8b1df2i1fb3eal2f6d -> * REQUIRED
    6P3147bfl357ee2aaas5ea04cbc8bd3 clec17bbe9ar922e0 4tc8h95i7s75586 ffa7361eidelda b5->22c97 * REQUIRED
    f7f9P5laease1e 254e6cc47650le9ddabf8rc5aa 805thfebifs3ec4e0fe7 00fbi6c3c32ce05l3d35 -c7a>f * REQUIRED
    38P020f8le01e441bfa22sf30c8c8e6f8fb8 fcc0le4f50daefdbcr7f 611t2bhis 6f64f89ieflf43d -499d> * REQUIRED
    f4Pe1aleas3ce16d a31dcacl316cf4ce9deaar2c294 981ethci43s32cb5 4fd8c06fc1ic36dec3l24bd ->4b * REQUIRED
    44b6P07023ff30d2l6403ede1b16ease997c bf5cl7e3c6d32ard4 785t92dbahisbb4 ef8ieldffb5fb ->16c * REQUIRED
    P267aa0b403cl1eba7a9s4ec7 c0c34bc1313fl9eaf7rf btbf2hisf8 74f977eid3d51e83aeel425d ->bb9c2 * REQUIRED
    f2ca7c08Pl25ec3ase f06f79c3lc43efa9rfc7f3 tcc39784c3168h5di654490fd7s affi1e4c2ld0 ->ec479 * REQUIRED
    4f42f4021e8Pfefld8d55edac2s4eea ce1bl5d0e0a5r th7i9c6s8 6f8i71eb8cld2e9da6da2 -2b6b>c5a0a7 * REQUIRED
    76P3f1l1ea3938c1s74e33bd1 ac3lad6e0a3a06e8bfr ff0d1tc0fhi52sb6882 31cfi2eel4dd882d f->6df1 * REQUIRED
    d18137Pfl05e8cas4ce3bb5678fe c8lf3e4ar btbh35ad8i8bs afiee0fc52dld585090 026c4->b8c4daf8ab * REQUIRED
    Pd4laea755b3c010dsacfb4efb6 cl16533e079ff81arb74 cf6e3bta2haifs cfa77cdi6eld09 6df5f-71f>2 * REQUIRED
    P224lee7ebc1177b4504bbabfsfe b94ecl65b1e73ar854e tc63c2b2ah9isbf f1iel39c67d1 -6>8d86bdb74 * REQUIRED
    70Pcd3e7l1beacs001661151587f4e8 f2dcble8a1r1 t6h095ai5sda33 2fib71824eflde659b4 ea6-b>fe57 * REQUIRED
    1c4ca2e50bPaleasd26ace8ea cclabbe7a25rc3514 72the49ee8ia0762es c9ffie46089l206711da -249>b * REQUIRED
    8dddbad8P5le37eas178aa6ee 3adcdl86a1e01a2f6r ctfh3ifsffd 50bfbeie1celdd9490971b6d ->0e4b85 * REQUIRED
    3f40P704l5ebea3c49csfe 5c1b9487l9ae48a0r0 1tfhf361i78eb5s0a0 b5f579770i4deelcd 60a24b75->b * REQUIRED
    83ad97P2le69a85ee9s6eab9426a ec6blear8 c45b4tchd715ifsc784da4 fi8eld ce9f37dfc1934-1>b1261 * REQUIRED
    beP3f1c83lbdceca07s94b1cec 92c1399lee4a5r 60th34i7505sf fif4c88f9e2l026ecfd30e e-c4>37fe45 * REQUIRED
    4bbc53P05ab9344le475baeesfe75a163 3clea63dr3 410th8i5sbd 9fi594e25001ld bed650b0-fceef>321 * REQUIRED
    6a4e4ePlef1e4a68s6c3e7 b03261dc9951642le3b8a57ccr0 52cbtfh8ifs58 f8e8c246i6de2aldd61f2 ->d * REQUIRED
    0d87241f40fPca81leas32428ae c5575lc5d2e7a7a0r6 822ddthif1sf f4e3ie4l6b60dd6301895b ->f24bb * REQUIRED
    aPle9ab5f10se7 17ccel820e248a951r 0c1ath9i60e15141as04 6fa9iebfbl1738d3f 53b3fc7ddf-70>22e * REQUIRED
    cPle2feeas894faec2 312cla9ear th4i280fades91df2eddfb5 4f0d8cbb1i6eac6ld 7-7913779e50708a>4 * REQUIRED
    89594Pl8eec28eca6s6018ed0 b50bd37782c820l5e8ed6car2f 6t8df6e8h3i44cs73 2f6f70ieldb 0b6->7e * REQUIRED
    6efa94Pab887l39eda9ea8b25b764s1ae cfele1360ara80e2090 34cbthfisb7b cbcfiefbflbfd31 -d0>d81 * REQUIRED
    98Ple9ac3s709a84f6727ee77d3 34f41062c8lea46r thid2971s79061 a86f121ic53elbd b-e>f8892b1fb8 * REQUIRED
    ee7b20cePledb9aes55f548af4e dcleff6833aff885d3r dthei3s7 f04c88ciebdlaaa09e31ed37c62 ->157 * REQUIRED
    ef0P867l71774ebe76a7fs09be 8ceclf99ebfb2fa2br4 bt7his d1b5887adfi854e6bcl5a5de10 7->29a780 * REQUIRED
    b1dd9dP507l8ea3se905 a8ecca356l7e4a1da9adr td2374afdhi0cs9 f1c6ac32iade130ld4 c-33bdf>84b0 * REQUIRED
    Pl3947ease220c1bca a7a7dcl29e2ar fte5h9i2fbs711a 3bf5ia37e2eale097deb1c2 8-00e>a214b5a208e * REQUIRED
    d24P6lb9c4efcafe9s85b4de f5c1aclf4589ee65ad63rffe 340t7h5ie876as fielf6e5a7d 7b-e0>914819d * REQUIRED
    2P8dd135l12e5bd1ca55se 8bf878c6f2le3a3r c87btd4h2cis fab2ffiec1f03aeld48def2c0 03d-c9>e54b * REQUIRED
    09Padbl99ea7s30ef2242 7d7bcl71ee24aa05e37d95fr 39b1et16hi6fs8 2b9d6fd6ie041lfdf97d 2-d>496 * REQUIRED
    a2P1fd5leb8a1fs8242ea0 0c3b69l89ea18d10dr8 dted271h875ie2ce92s fcf26i8e7a4913e32lcd7 -ca>a * REQUIRED
    ae2P5b99l5e0a534efs754e0eff34d c1083436alcea5r11 tdhisfe8 7f51895da8fiae007l1d59 -2b>63078 * REQUIRED
    16c4edPcleasd45eb4e c7l2ea30rc5 tfhi73dsa589 0df96fbfd38ba6i471e38081l43652db c8b0-fb>f1ae
    fb2P478lbcea5s51e5cdbe ccled7e28far4cd67793e a40167th13ffiase8cc97cbb f4ie16ld 34a-9f>f8ee
    86P6l884b8ea7620bea5se9ef2 f46cl8a7eacr 530f1d28bf9t72hi7282c56s7 7fciee7e1lada93 -0d>8dde
    0b8P7l0e5a6sae07 e7c28le597ea12649975r 8a8t0f6d96ea6h6ie411sda 08f59ci8e796ee7lf4d 5d-538> * REQUIRED
    P6le9aeae8d3s6afe890 9c5abdlea0f0r t64h795cic496s279 f476bi23el221ccdfd d32-ecce>04c130b14 * REQUIRED
    2c2218Pl1efbe0a60se 96fcc8098lc94f14e1ce09fa756r 3tcff26his6 1fd6i5e8a16e7lecdd 0e-8>11fda * REQUIRED
    9b2fadP9c6l8e5da7s1deb391f6850 c8blfeab3eac562r t5h4is94212 f0fi3e0l2d31 c-aca47>7ed34e1c0 * REQUIRED
    38Pf62cl9a8ef23as2e77997e3 3c0l889eacr 5tafc9fhia316esc7baa efi8eel485d e-a9ea03b>4b00429a * REQUIRED
    a57db0f9Paffl3e77855as96e2fe4c 21a11cle1a6r4c thi9960e0e8sbd72ff 5ffia9eeaa540lafdd ->7d5e * REQUIRED
    36e22Pc8012l0e357a3ase d0d9ed8fc3e187cdleaeabd93d099bfr3 eta9h79ifb865es f4i8eel3db651d -> * REQUIRED
    36Pld58ea5s8be9ffd4e4be 2clcd3f883a25e4054108ar ata51796hic2bsa85 0ef0ceadi7eld138 97a-7>c * REQUIRED
    1Pa536d095lcbde6ads4e 05cd248d9la299e9arf ta21be8dhi3e9s58fe f9eif3eclfdb5 ->8f915e676eb96 * REQUIRED
    4cc9P22lf9b5ee2aas7e 82ccl6ec743aaccr44 t07bh9bi1dc816sc4fb4e5 f0i0e7e96ld9 91-5>42dd3cd66 * REQUIRED
    af124Pl17de088ase7a4 b103da74e68c8lea2drc2c7cb c4dt1ehd5a58bifd26s7 fd8ai35e8feld 3e-b>3b8 * REQUIRED
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