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  • Indoor Training Program
    Fee: $45.00
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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. 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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    Pl35efeaeesd5e d99caf4l23e36ar75 368d8ta20b887fd95f86h18bed4ci8s 44760f7cieled8770c 9-2>e5 * REQUIRED
    67a888f1884Pl6eee2aa9a7se758e0 beca787lear1bc 74c6te6hi8s95d fa84ie791ld9c043f 6->714bbfdb * REQUIRED
    49P2b4bl5efed46a5a2fccs164100ee4 9fc18le3ad55re dt182hisf12 2cebcfib3b6513e2fld68 b4-816>2 * REQUIRED
    Plb7f6e922ba4se c4fb0l9e2eardebff 1btac705360fh79bi87s487 fi82b07f5d989elda e79a30439-8>2c * REQUIRED
    b00fP54l5ea97b82das4bea79a2e44a0 0c68102edafcleca9cr1f2e 8t3haaiffs7 5ef88ie5ld2 a5-9>414f * REQUIRED
    46Pa2fee0ala69fec18e662ase6ab0b941fe8b7d a3c6l1a9e84b0a1r 3tce6dh4is4a fie7e69ld3 -1>6ea46 * REQUIRED
    b8d7054Pfcl4cde279e7caaf1sfa9e 45cc7l8e0arb3b 4thif804s fi7a0d16aelfd 9-8a>cde467e93756eb8 * REQUIRED
    6df6P244l1051eefc02d72f8be0as9e5fe c53e24al3ecar2 tchis 96fdi4eec5ld d09748-8>564f422cc091 * REQUIRED
    060bea0a9Pfleae79e30s4ed3 6cc53l945ea8r t69faa0177haise912d29 c97eff6ief5le8e1cbd6b ->c56f * REQUIRED
    c5feaPc98leadse fa1c50181aaclea2c2rae30 tha2eisb2e2a2a 1fi9ea5c3dal2edffd f489-af78d3b>ae9 * REQUIRED
    91dd7Pe649le6a32521eaff3sef dclbb5f7ea2fra t712d95his9b ff3ie2ld9c4a3d03c058a5 -4b5>201246 * REQUIRED
    7Pd8le77aa88es3fdc5e9e20f31200ff d1ac9dlde056e4far bthdi4s222 145f0b0a173ie8579la0bbd ->00 * REQUIRED
    405Pdl9e0ebb98da1b4f30s10933cfe0 f85c0lbaea847df75e9r4 ct8h9ia8d010s fb2i6eelba6d977c -f>7 * REQUIRED
    1498f7Pc2154lea9sdbe 56cl9e5daard57 t448h9b79eei1s713 f2i45e95ad1l9b4d1 41a3ca->76d01bb38b * REQUIRED
    1Pleb4bcda2cedd11fa50242s8fe63c8 bccled6accr2 7ate8e3his ba6bf67i72ce317d8ld 7b91589-4057> * REQUIRED
    P66e3f7060le764a2bads166874fc1af7e bclec5ead81r86dd 627tehifs38 8ffieeae2l15dd 6->2b3eab42 * REQUIRED
    86fPlbeb7c8b7as3ee8b9 cl910e7d0f4eaffb5a9ff0rb f9c5bthde3isc5fceb0 ff81iel47daf205 59->9d3 * REQUIRED
    b8P3bcfee7d352lfeec1ease373174 93c372leab0r 73t2e3h07d59ea1i6s5 20ef3b7c4cccfield3 0-f>e92 * REQUIRED
    7e6Pdcc9l68ce5a2e3as2d6af0ee cb08lfeaara5b th9isb f28f8dfc24afi425e60le81fdee8f 9->94364d9 * REQUIRED
    5b64e06a86Pl9e20fd2ba92s9fc7fae 40fcf9lff6ebaar 09thi6bs 02fcie19cac04f430lc5de0 c-098>bd6 * REQUIRED
    3f717bPlea80s5e6 6cc1al1cfea66r175274c5 th2c31d23isb95fb6e f7ied366l3e5ea285b8d ac-383>3d8 * REQUIRED
    e4Pl731e3ead0bs00621358e c799l0e30b2a8rc t3hic40s9 673af6i83930beb9ld2abf717 5b28c-6>7ac0d * REQUIRED
    5d317Pabel297e2fas97ef 40c796d72clf33ae41ard tch7iesd8a3 bfb7bcei2b97ee86l6e6d -90d7>087aa * REQUIRED
    bfPl2fe6as7e62cc2 1cd3a4l72ea39rbb3174b34 3t74dh3ai0s4 0f7i850816bdef6lbd 621-d889>cef6f58 * REQUIRED
    Peleas187e0 6aclaeec7403f41a4bcfeb82r 12ta1e064h2is952 faife0be2le6832d63af0f ->42cc593505 * REQUIRED
    c3043Pbleasec3d4a c3e29lae37d2eafr466 th72is2bc2b 1bdaf9f70iac8725fe13852b4lad62 3-c>cb232 * REQUIRED
    a9182664Pl18e4d69easecf cd267d1lf18d82cfe08ard1481 3tfhe3a2ias3aa2 8f623bie3f74a61bld3 ->6 * REQUIRED
    acPalea9as94e 423dce6l4e7c5ba91826r 6d4d6e03et8575h1e294i813s24f ebfiae01ldc f48b43155-c>2 * REQUIRED
    29Pcl54c1a2e8as2ea c4e0b1cblear ca5d20thia6008ds 175f877a87ieeel34fe21d155d343 40-625b173> * REQUIRED
    9Peled7a3fsfa50e4 bacc5dlebfaa831169r6cde 819194th1i15s125a f25fc0304i905eddlfcd 77-441>f5 * REQUIRED
    e15P5c1455c3l9c9372331d92ea27ee6as285fbae claee26a64era2 dt88426hisa7a fbieelde2 ->6706689 * REQUIRED
    4P3eal0e0asd25ee 95cdfd917l8e366b711araeb 6d8df8btc941h5isf 193f98233ieefl5e9d8b -fa9>6678 * REQUIRED
    Pdl493ec26a68se 1c43l2e3f9ar08 475dbft642h1i3c0facs f0i7b087e05efl7d1fdcd82d 695-f731e0>24 * REQUIRED
    11d20992bPl7c4bdefa64s5e6378 c0felear03 262t8656h3c0fbisa4dc02 ed1d6fed6f9bib5el88dd 79-c> * REQUIRED
    70Pa7812lebase0 a990174bc1l0c7adb41ae7c4a8r13 tde61dhi327cc37s 9176fie191aelde26 -c>9e1018 * REQUIRED
    9Plef05faa115sfb6beba4e49fa c385l5041aea7r7376a 3tha0iab6908s6d70173 a6fd2d1i2e7ld f3-ce4> * REQUIRED
    b3c50Plea60se 740c0facel6044eb0a470da9cr10c 2c2t5h15fib5s f2cfielaadd1189 709908d-7d0>178b * REQUIRED
    Ple8ea6s0d4be9708641d 46a6ece514ala9e32dea7e6rd te4hie36s2da7 c50fdf623ie1ld01 -05>7abf966 * REQUIRED
    4a8123Pl7de55700bads45c15e bb8cl2d0be07a719bb6r 1th2i1ea24fs9 0f7ie0l40dd112 b1a75-a4>8ece * REQUIRED
    1feP661fl66easeb a701ec8a1e2ldea948f1685ar ft6h336075c21i5s4 79fe8ci278elbffd7 -93d9>dbbf4 * REQUIRED
    f0P75f533c3blea36d2ba10bfsee8f cda53la672eear3790ec e4ct55his531 4ff20ei59el06d6 -a5c>e34f * REQUIRED
    7389e2Pedf1l39eb1b4365asf2febda 0clf0ea96rc 4cac6c2t16hi4fse7 fe506ie9bb2cldffc5b 4->6e102 * REQUIRED
    a078Pb1lffe76ea1sbe363 cc1496fd99cdle6ebd84aerdaba 3thcb336ee33i0s 60cfife518lbd f-9aeb>bf * REQUIRED
    8314Pld1e2371ase4 3fc2clead668rb c45dte4c34039hf5211ics83b e96335f4dci3a6e2ad5elbf0d -bd>b * REQUIRED
    f2de0P5531l64eabs422b8e50a322f 5declf4e4fb6fba46ffrb tc1fhfc1is0dc789 bb3fi65e0ldcce 3->cc * REQUIRED
    bdc9e0b5ePlebaf491408ds49bea 50c1a283ld40dede5a4a3r26 t3hb7bids8f9 71afibe81ld438 ecf9-6>3 * REQUIRED
    9fP93784l6932f1ce0f9a50se998a2 75c0lcc6ea5ar6 00cthff360676i6ds0c4b2 5f1i6ee5l25ad -fd699> * REQUIRED
    9df191P5laeba8sae0a31ae8 e21de3f1b4cla17e63far1bb the675f7is27f11 af9323eai8d4elccd1 -bf>3 * REQUIRED
    1fP3cl7e6f77e44e80fcfadeas0f7e4af7 c91f1c2le6a2048arc this6 72f4bi7elae3e124d1d -86>d26f1d * REQUIRED
    P8fl75e9cas93e cfl5eaarc 776ft1c60bh64b5e7is 3f48982fi7ed3dl2dd6952 bd4b21-1b>6fa134172dfc * REQUIRED
    9ac9aPlb18b7eadf5s2e1879 62a04bcl7eafb23c5fb0f9r037f thi266e4d8a10c13s f99i62e8f4lad ->54a * REQUIRED
    2Pdc0dle89faa22dse0eb3471 9c66566la71e5a1ra4ae thidas5df59 c58f0iee420l9d7 c78-47cea6858>0 * REQUIRED
    0a25Ple50fase f5c1l8edf55f2ed1e3ae1far02e 0t2hai4sae 649bb7d65d1ef8i78d4elad c2-87>bea8ea5 * REQUIRED
    9bPleeasb9ec0e acbla25f62dfbffe06are8e1 3bt78186fa53hi63sfb 64fcf0icd47e2afe0ld8 253->51df * REQUIRED
    f5Plc87fe033aasdc44cef50c cl18ec10e29e271a26a7427b644r 2btfhis 14ffeecif7e7lbd364 3-6>b142 * REQUIRED
    80P1l027ce1ad4sfae 83clb3e3bb69ar4 athdai5dfcsc 239966f2b81ei9el89ddd21 aaaef1-8>97e38aa40 * REQUIRED
    Pc5e1le788asce 93c8cleaad6c85ac3r6b8 8ft110d31fh4e147e8iea1ddsb f50bcebebi5elaadc55 d-67>f * REQUIRED
    c8fPfle3afcse c82c0le0da14r153 f5f40953f90e3thifs7 fifeecb347ld04b8 -eabd>7b0409436dff696d * REQUIRED
    03a7Pb3lb524229f4eas0d7208ef6 c1l2510e4arc267fac t6d9hiae169ddb0s2619 adf6i2e4ld 6b31-c>1b * REQUIRED
    69765P25lefasd0e4 9ac749l3e9e9a2r2 this99 faie8b5e9l4d2 bb-73956f6afd>9d590c09b779c12658ad * REQUIRED
    2d87634cfb3Pl6e4fas1e2 b2f9dc65l1e51669112abrc67fd 9atdfhise 8f3f63dielad52d1e2bf -9>fd923 * REQUIRED
    83628P76l10ea6cb7sbebee60 cd930083le544a475eb511r th75888cb579is93 df5ia09e2l2d d73-a3>af6
    62165f9633Pl98ea952a4aas664afe c3lce15fe404ae0r18 4thd24c5f2is62 1ef9iec5b97l6d 3f->585c48
    ePl95eca10s0e7 clfd7fea112c49b2br6 t1a08f220ahiase9ce06 f1f49iel3b137e436ddf75d -13ce>288d
    cPle7b1e5as7fe13 2444a4adcb88a266dl8dce2bba467r3f2e t80hfie8bsc 526f5c60if8e1l0cd785e b-e> * REQUIRED
    f427aPl6a26d7ease6 1b78cle4330a3r2c dddt8e7h5b3is f4ad70f2i7f27d0eel5ded52e c8-49d03ea>bb4 * REQUIRED
    901ee1a536ddd7P9l6a6beecfa2s98e11e1cb f3cel7de3ar c7f0dtchis2 4f37d4i3da3d3ee8ld7 7-c>78f5 * REQUIRED
    Pl31108e11ef0036719e9ac6sc9e eclefd49d4aeea2r 6at7h26i8bds305f 0fid611e5103ldffd2 -5c3>209 * REQUIRED
    c8507bb1P9lb0e3a66se 2cele7550b8e9f33ar41 dd6tehd91i6s75c6 ef2327409i729e0l34d -731>a38825 * REQUIRED
    7P7610bd246le3fas0e 3c95lfdeddb1arf92 thi2es99 fd773bf3a02cie2el410d171c561851f8 781e49-d> * REQUIRED
    fd924391Pleasefec cl9d98b20e80ar653 9tfb7c09h2d0is7 ffi43e5e7f2eld717235 acf04f7-b>e6981fe * REQUIRED
    a8P59l0e254ase78e cc62lea03de7dar9 7acthis3af47b36 bfi7ec8b4b23f3l0b35d8 14d28d15-3c5e>d13 * REQUIRED
    19P82lefa6s2843e5 c40576clea6br tc1b90442e7b95h98193if9sd 20430fi2eb35e0lbd 388e99766-5>b7 * REQUIRED
    P6c76fl9fea81se c29lc9ed5eb4earc2 14ef555th09c63798faicb05s3 5fifeee7afc3ea4fldd 60a3-64e> * REQUIRED
    ePl83e3e41f3as2e6 7c74a2409479ffa752dele1ar 5t0hc16ibbecbd2s1420c84 f040eieldd4 1526->0795 * REQUIRED
    Important: Y0o6u may4 07b2ee making8e 7u1sbe 0eof auto6ma88ted 28form-8fiall3ec8ing soff7twa6rea. Thi9s ty7pe 8o5f softaw07are ca7n tri15gg0er o2ur hidde0nac s6peam-detec9tion sysctem, whic3h wi2l1l blo6ck you fro8m subemitdting1 0thi3sc for5m. ePlea1se seclect Fix Thisb7d6ad3d5cd8d2da45eba 9bfb6fbb1ccfe3ccc5a3f9d9f5aoe80drd153eb8bfc6d 5e75e76bco05mbedca6bp68ldfe69ti6nbg th29d9c5fe f0for3m in ofrdecaccr7d24 56t3d5o cod8r6rffe91ct8 th6bbea probl2faemc9.e9c
    Important: cYou may 4be 3making1 8us4e8 of automat5ed cfor0m-fillin7g3 software8. This type4 of sofctware c6can etri8agger o9ur bhid1aden spam0-detecti5on7a system, whic0h will 5blaock you f4from suabm5itting thi9s form. It 4appears t5hat the proble0m couled7 nodtc bee aut7omati8cfal7ly co4rre6ectefdf. Pl6ease clear anay fiel0bd whiccbh appears above w5ith cordresponding instrbuctioncs488 5bebd755228d87df58d9028b9776ee5a96ec85d954f2do9c628ab3brd20e3eb76e67 2cocmpletin1g 1theae e2f3o3rf648dm9 1i6n oerd40edr tfo c8orre7ct th4e aeproblem20. fcW1e a6po5loge1ize22da fe5or fbthec eiedfnconeven5e2ie52nce and we app4r7eciat3e your undde5rsat5andi8ng.
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