Registration and Payment

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  • Indoor Travel 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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    92c8d7P43l0d1e04aesb18e9 c8c15fflae9fda35r7 cec0t2h0cci1s ffbi1eacldc0bd5f551f0a8b -a>9c6e * REQUIRED
    590Pd44058lfeadsd9e80d88 bclc670b5ce3a087b0r05 th9is8 e134d8f3i122eld 9-e5ac2b99e>8e9d5e09 * REQUIRED
    f1a58P65lbea2dse c07939fcb53bldf16e8ca30r7 2ct44941d38d6hi8s10 1c2fcfibea79l93fd 821->944f * REQUIRED
    10aP5laeas4212e40 716cc2le3d1ar2 364b7051ct2450daf75h0isc0692b 9f290i6bcfdebc7ad76ld 30-5> * REQUIRED
    5Pleaf94bdeea3s5e1 84cleee1ar b04t32138h626c5icdde26bes d4fiedl5ebfd 1ff223->28699cade5b04 * REQUIRED
    1b6380fPf9ld134ea46seead7 2ec94cle32ca3fr3b 860dt7fhices facf168ea8fe9ibel0e1d4 c->c5464c1 * REQUIRED
    aaPleed8ascedb f526acff2a6e3el64e31a3r 5t3494h4b9e1dd4i5s fb41f604b8f6adiabca9b95e35ld e-> * REQUIRED
    b1080ffcf68Pel36a9aeafd1se cl6a9fe8area2d 20e0t8h716i08cd73s445e0 c44ffc1ie00aeelac8cd ->7 * REQUIRED
    dbPcle7a08sae 29c29l7bddea91r1d bt7194h0iadd5ds3 ebf33a4743cbie33c83eeeb5e4lbd6 b60-23>bc3 * REQUIRED
    7641aa6e9cP09beel1ease2740 a6bc1c1l78ec7ara dct0a9479adaaac88his8 b98f24iel4d64d9b 9c0-a>a * REQUIRED
    8aP490ble9asf9ebce 0c202led77arc0f55992 0tbebf81bhia37s4d 16ef004ie566l1d1 5-6>7dfcc01f4d2 * REQUIRED
    73Plea6sd7ed108860d2 c679cle07fbd9ar972 a1t19heis f5ecd88e496856ie4eb4lae8d6ef cb-33ac>3cf * REQUIRED
    8e843Plbeas137eccd329efe07 5fcb7lea7a577r3 8te7f0h217is1 f2ie2al7f4314cc4d2 94692-40>59975 * REQUIRED
    71a020Pccle6c66a5seb3 fafclb1fda3ea9532fr t7h8i5e5s2 05f5di3e26ld911e 1ed7-7ec833d>d658086 * REQUIRED
    cP02339l08704eas38662ff87e 9c9le4fca7r9 39th73354i60c2836ac6s 09f6ielc71b7e9afd72ddf -d>8d * REQUIRED
    5cP7l3e5dc7b0aes0e cclc2b1e07e2a4669ra88284fc c13th3is865146e9 16fi9e1l86d2c b-9>d4038bdf4 * REQUIRED
    043Pa421lea8s356e c36l21edar5f9b6 c1331td109hi288se450 fcb5b3eic5d78el6d41dc -b>3d1ffd37b3 * REQUIRED
    9e0P3977c489fl3e1eca36s4e clf9abbeae3be705c44ed2ar7f tdbhai72s f5ied31lde39 24-7>3ed02de59 * REQUIRED
    805Pal406e93baeea73dsce11 0c05c2lb2decc5bac7e94ra th66410808fis 587dff5c2iel3b0d45 -edca9> * REQUIRED
    ca9ab936Pd98l3a2f0e9ca09f7sfe8 42c8l7ae1ac6abc14bc5re a6a330c79t0hi0s cdfifeld108 -64299>e * REQUIRED
    6e1P2l3009e4c15da5sbe 1a5bc5a5leb4a97133r t918c56b38fh7is019631 f53ieelda -e331113>ecfe7a7 * REQUIRED
    36P987fle85accs65ad5e2233337c 68cle5af00rf f151th916ci9e7s a1bf3iecf3452d4bd20f3ld e->3b97 * REQUIRED
    0Pl5d57cea15a44bse367e8f175 12cf8c57a8cl65e7d5ar 626t7c8h038isb9 ffi4eld4d a5-2c>e6de92761 * REQUIRED
    0affPala30ea0299e54a401sa0e9ed 2d8cdacleard763dc f4th4ias 249fbi1c3ef3237de508dl5d3ba ->6d * REQUIRED
    dbdPe46l08eb265ca61esed1 dcf3eale7ar5 5tdh8ai4fs9 0fd2bid9e04lc845d6e70f79 76413-c>077275b * REQUIRED
    97P146lf703e1aasa934e7a3 cf817le72eddbc5dar65 f91f6bt7fh4ibe3sd7ae7 858d7fib6elad7 c0-2>bf * REQUIRED
    77d5731e0aP7e9e891l7cee8a8se3 c86ldbee0eaar 2t1ahi0c938s bfi866ce9ele9dc9b68765 96-b>cfbab * REQUIRED
    Pl09eb9adsea574a5bb3 ccaalfde8ar6 d1th7ifsc606d e3f13i795e143l01dabfd2 5ac-0c435de>8f6f5d7 * REQUIRED
    4df7910P3le2as8e1eaa0 c37alearc0 137t7d7dhbfa4ib7e1s865ecf8 8c3f90i13e397ld02 b906d3->0b29 * REQUIRED
    cbf1051Pbclae384d44bb7a2s5e c24lc3201e04ar 690ctf87h466i6b2498s 1560fdf0ieladda f52-0>0d2e * REQUIRED
    6P603led1dfa5ba3s0b2e b72cfle26aer tb80dadfhe99is74710 f81f7da8c462ai1ad9a4bbafe3lb79d ->e * REQUIRED
    23efP7d7lee78adb45s3025e5888 c4l140e2e3ar9f 04tb04c1hfi1s fd55bf4iebld4 00cd56d-4a8>d302fe * REQUIRED
    4bP5le2d17asbea43ed2481 df2cb4da046eclf579460ea9cr 7tdfb7fb5098hi48s 49f3ie4l4af9dd f-9>a0 * REQUIRED
    363f6d7a4P0a0ledaeaasbfce cd132f62lda3eda5906e6r273 3t159hi3a43s edfif2db3ce0fb7d1bld8 -2> * REQUIRED
    7376d087Pa1c0b8l1bed6b28as12fabefba 6647ce780le01a0aa9rbfb9 thi4s317d6 f5bice9ae6l2d 61-3> * REQUIRED
    faa7ecP9lefc7ac4fecs43e4c496 ccl28ear tb65ahfce3a8d0i9d3c7s 1adda8cfi1elad6 7e-4a0e7>5fd25 * REQUIRED
    2cddP9leaedcs1e70 2ccecdcba5f85l04feafa25dcc62r t8hi68s eafe74iel140ee682a0d834cb a-e>f8a6 * REQUIRED
    62ffPac6l1f6eas5a6be 36fclee1eaa4ar 9tchcai7fsfd f5095ei3dd729beble9fd 56b2c2a2f-3fd>ea0ff * REQUIRED
    Pel0e7aas1290fce d4c9l7527ea91r7c8f 7t2hd000i68s4c4767397d2 f61760d2i97f9e815038ledd1b -e> * REQUIRED
    28a4P6b39le2aa9a3se502 clbce31arb2 tc2dhis ff3b63ic7e4de40c0689f37c4ld1f4c5f -e>e11f6a8996 * REQUIRED
    50P2940l1ec7d742a8a07sbe df818cle5aeer34 tfch2bbai5sd92 fi1a9e05146ab0967l2d 62-1>8c8a0ca2 * REQUIRED
    ba2ddb81P5d3c7lcb4ebbe3a13923ca0se f3cccca5l7ea56166f4beabaa9r 7t78hi4bs fie4cl600d c7-e7> * REQUIRED
    2867b0ca0Pelea7se 1cle3a1b7brc 6th7isa 3fic6e5e6a4943ac070bf4ecl70dde1bc 46147511a08-428>6 * REQUIRED
    b8d80edP0el13289eda3s3c0ee48c4 425cc603le8a8f33r2dcd2 th4i2034sc 2f02i9ceb9ae0alcdf 5b-9>f * REQUIRED
    fc5P70d9dl3bea3s9b2ec6542a03bf cbf4c0ae47e9ld78a3efar2a a82ddt706hi6sb9c fi3faceb5bld2 -9> * REQUIRED
    c387Pl5deas53ffe 72cb76c9al811e6a93ree tde4d2h64bie7f3sd58 5fi3fe7elcd3 b3-6>88269d30d6584 * REQUIRED
    25a37P8le0af81sedb 3aa6ef0c3ce67cle45a7b9a315abr9 314t28ahi7593s3 fi724e3l654ede 4-fb>b09c * REQUIRED
    Plef4b976c42f0ea3a3sef 413cle5ea7ffc0a4r8 5cfteh522931isde88333f 5fc3i65e6lde7 0c3897->89d * REQUIRED
    57e54P9led2bas5f5e d3711cl0eac10251r thf51i48sc38 e6fd3df9b4fc344i9fecel7d2b7 f5-06c887>52 * REQUIRED
    0ddP65l5860129e8a44se4be9 f51cf3edl7837e4ar4 c3catfh700i4s caafi22feld99 7f1260ddb->66112d * REQUIRED
    d3c28Pldeb2as0e2e c9f8le1fc1a24r 3td1h8f5bc5d3ie9e57s60f 9f758i220ea83lbde 4d8-2c87fd1b58> * REQUIRED
    7d4cd8ace3Pb6lea112fb6b91se 5ce3aldbf91e797a5eer cdte90fhi7s 550f6i2e1e74ld 1cf-07b9>c2490 * REQUIRED
    5Pl26eas7d8eb613 ce370a62abl91bfe92200ar7f877 6282tafch84i9054as c73bfie7105e7l9d 93->5f30 * REQUIRED
    4a95fde05P7le28aase04 1cladfea4221dra879a this37299121782be7c7 19c88faffiel6bb0d 46-7b>0a2 * REQUIRED
    c7dbP6lefdacs7e3352 e106c0d1lc6b9e43a63re872d te6h8597ad97ifs6 f6ie1e59e65ldf f4-a83>7bdb8 * REQUIRED
    7Pc0l4easefa67f4 f4ace2d6c153a1l127e734ca4c3br5284 th8c370b8i8se1 f23a57f1i18ee7ld -05e>c5 * REQUIRED
    0b51P2lb49ea33cbddsec4ae4 ce3cf5l9ea6raf62 14e9th7a655ic8fse feifbc4e76l97e864d e46-43>c79 * REQUIRED
    c76P2l7e41aes2ed2b04 1c366b61635cle8aaar4 6t6hiafsb a318fi2ee0led aa5b0-f878061695b>16d291 * REQUIRED
    4b5e8cPf6fclec3af4se91ec214e59bca1 clb06ea1caer ta0his3 25e239b5b0fiel7d5 f5b-55fe>aa00872 * REQUIRED
    eP01ld0edd57a8ded0s9e e3036c3l44ef4a5r88e9bb dtheis 6c8f02ifele6013a1fa54d3e e0ef47-4b>8c3 * REQUIRED
    daP0l8edd78acca1d485a6asa7e cl2ebbfa7r0b th9id5afcs fa8feaf7ib541b3e9afl1e79dfaa8f -4>09de * REQUIRED
    863P8l3e92as18de17 c33139l8f7e1ar78c0d21e1 3f1t0bhic883385s3 3bfi6adde9ldd 458fdac-f1>558f
    fPfb47lea30s0ded bc0efdle82aer 9af19t0hi9993a94dc7fds482e30db5 df8131d13iel9df -ce0bd3>565
    4ef419ePfle82ec038aeese3b087 d3c74l047937f44f1e1a1r 8f7666th9i0ecs500757 cfie5l8de5 9-5>13
    e55b0P8l6fadee8ec0a2c5secf 74cle2ar7 thia8cd7aa0b6fsd b26fe2if42ac4el3da 2f89-0de4c4>09924 * REQUIRED
    58Plb9b9ed7ba8cd6s32af7397e aac31f04256l36ae9dar4327a0 thdf78i9s afc35ff60b37ieel58d c->b6 * REQUIRED
    b06a69P442ff678afaabffle04as0e6 6cc1l8ef7car2 649e2f8thai127551s 979f2988iefl88d5 a-1b6>63 * REQUIRED
    2cbd06Pe2ae5le20a25cseae83 0c7e0la03ef4acf1cr 9t637d2h97is0 fie16e669lc088d570047 -c3>98be * REQUIRED
    fc11P1le40a4sb5f0ec46393604 cdl6834b3ebe7f4far d48at3hi1s 92f621d9b82fc486ideld d6-fb3>98b * REQUIRED
    4b4d0P85lbded1f8d0bfa9497sbef0 82c4le9a0eccr t5h31i8ba5s b48fc92i051elbd014f 382->e6b891f5 * REQUIRED
    00Pclfea4b1f5cc0as2ce 0ecc4fle9bcbeb8fab3r9 t0h8isae7 fb194def4ai2a241be09lb5accdb ->e336d * REQUIRED
    9P83l1b12dc7ea4ff79s1e 498cc0laefa343afr 2t0dhisec3 5157fi2061e9l799d6511 4-47ff537>32de20 * REQUIRED
    7P2lc198399e4ase 830dcle3a8rd88d this3 b0bf3ad7ei240de454417224l5edfb -95bedc8f49>c87ce8ab * REQUIRED
    4P854efleas1e1279a91 cl48736464fe15c2ba3a1r7e 8t34dh5id4as6706 74fi05ae5fd8ede8ld4a f-e>75 * REQUIRED
    c14dP0aalfef2abse5 004ccd0l8eea8c8d2c6are520e36 2this592 79346fbai5cea500e0lad4af53 2-d>ca * REQUIRED
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