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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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    1d484e7ee35Pl3e44f7afbf1494see7 cc6l6cfeaere40823 thia6a984a5f5sc4 fb1ied6cl536d 43->11727 * REQUIRED
    8b70Pf0lefe3a80f6cf0621fse4 5c30e23le6a99r9 4fbthis 79f336b8b15a7cie5e5b1ld8 00c80-585>ca6 * REQUIRED
    58bPel2ea95s63e18 71bce8aldeaa90f69b3r1834 th97eiacc076s 98df74fi42ceae6ldf6 96->4abfd83ab * REQUIRED
    1Pcd01lea8affee34fb8a3se6b c3942fdleebe7b358c192f5ar fthis3b 3afei42ed8lfd62b64 1f677-b35> * REQUIRED
    c48944Pdlbee4becaase9e58da c45el8aefad5rd f1c17e9a2dbeth2ai2s8cbe8e6a3 1f31bie9eldf2 -73>3 * REQUIRED
    d4eP0b9el4dae28e30a81s09e f2e91clde6ca559ab9r 5aet516hi9bs926fd 6216fie43ceal7dc 6abe6-b>0 * REQUIRED
    Pac287lec4aa6s690fc118f7e ce02ec914b5476blcea8ard 0t4f7de92h3i8d344s 9fi9ea2f8ld20d8 ->057 * REQUIRED
    67P9fle809473daasd1c2e dcbcl960e3adr 25187d9b8t645hd5ic7s26e4d 57ddb33field147 b2-5>025d2c * REQUIRED
    c5c446ae155a8P8ld3eac21csace0d 8c5e2l9ae54e07aa1rcb3b t1ehi3s ae53fi34e19ldf 0-4c265b4>159 * REQUIRED
    b014P785cle9a7debas50de3d708 0c9c1al980ear5 aa4thf71isc a79353df3e4c3di77c90el39d -6c4>50e * REQUIRED
    10f4ea3Pldea3sa55de84de fb9clefa635f93r4a thi8cae13f2692cd4720s75 bfi0ae1cld67 6-4>3f40f71 * REQUIRED
    16P6l1easedb 41223cec1e471lb8ea9r7 thc7b67iaaa9203856e866a2s7ff56ff afa3i25e56c885fld 4->d * REQUIRED
    ffc0P3f70ad882l51ee2a56d3s23e02eb53d 32c6905ledard 79tf9h84c1963is21e 6f9fi6efld e-8>c1cf0 * REQUIRED
    b589dP7fl3eeaade3753c73sbe 358a477f2e0b4clearadb t4a5ch60ais3 4fc61349if0el8d 38e-69ac>9d7 * REQUIRED
    5178P10lae3b274ec9aee4ased c9ledd723a3edr5cbccf t7h66is 71f43d3ca6i86ed8l69b065a20ed df->9 * REQUIRED
    f693901P40ffdelcea4a4s68e97a 420c508elefcadaar0 t9c0a7hdbf29b5i50s 04f99fie9lcd29 5-f0>2be * REQUIRED
    4P095bal6e36171as48e cb675la6ead405rc4 1t78h4bis714ae98 fd6ffbia0el7d3e 574028-10f>5654e62 * REQUIRED
    578Pa2lf2ed9asef cb70965l857ebe3a72aaar2 04th7is1fc f4i2e9cf48cb5f5455ld8bf 166-7>b2f22d39 * REQUIRED
    1b870ccPb163l7ceaaas748638e c6dleabeabara9 te8hi0s7 216187648fie71e6lb5df5d 60->f5591617a6 * REQUIRED
    5P6403laeec1f47as1bf3e5b5 3c75l839e3aar257a8 fdtc2fh482ids8e1 92d09afielda3394f121 686d8-> * REQUIRED
    8971e5P9d9l25c2ee21a1sbe9 83acc4710ale05a0b8r 0a26t6h0cib8se 46af99f2iel4d333 e9f-f534>f1e * REQUIRED
    5527002Pleaese 0b0c0c07a144le853aedaca8a741rf td6chdcc0a2i78s 81fiee26l2d be9-7411e3bac>23 * REQUIRED
    1P39leefa1se9b 7c7clcedar6 aeb7tf0bhdic594asdf e1364cfi88cec38l9a1d 5f882a24fb-23>459758ab * REQUIRED
    P23l710e2eae93s6edefe0 facl1ee34ear5d5d62 11ebc5thid22sb af23fi5el9d8c09fffd 44-e>bc5e3c2f * REQUIRED
    4d3Pb64calea6f13b901sbe74e2239d 1bcl8eae9r9 tf311fh91aiaafs 8a15fi6e61ccl707d2 77f-c>dcaac * REQUIRED
    9Plb6f8f25eased19cc c7fl7e1514da449ef27fr12 9thbfis fe74b7803bf25ai6eafddel1ed a2->f670711 * REQUIRED
    79029102f76cP45l7e55a805834as0eb0f2 5b7c894123c8b7647l6ear24b this 752ffiela611d63 -88>e90 * REQUIRED
    dd02064ab8Ple7as97427e9d6 dcc8l2fea9a08f0413rba2 f6tfd1hise4 d3486fidele3d 917-8>a517132e3 * REQUIRED
    4c6aP8lf821ecc7ffcase c268lefabr etabf5hdeaisa5ca20844 90fi0ef12alafb9dad0a4b81 ->9ae643ec * REQUIRED
    c1d4a9b15Pbla979eab5se180 c0aalea8cbc1cr670 cc2th9823ic88cc4s8052 f87i4fe4fld9304cdb5 e-d> * REQUIRED
    760Plea0039a87042s3e78e56 55clf2e7bae8ra th95a1f73isa fia92acel6deebfc6c1bdc06 f-8>0792aff * REQUIRED
    185P3c187l5e97ase1f1ec 0ecle6a6e1bea5a0e0r9 t1h0ee9is 3fbf9i5el1ed -a877c05a73318c5>46ef50 * REQUIRED
    4aP6f9l8724deabe1se1 dccc92dal74e1f38ea1dfer 22b5b4t0dh5d6e4i68sd fi2e44cb2leb4d d577-f6>e * REQUIRED
    8ee10840e56P315a1leaef85aeba6ad045s82ce37d cl7e9ar2c bbt6he8ies58 106fdi7e3l28d8d9 29-2>65 * REQUIRED
    63fP1a9le10as8ce0a e43b706f8f783cdl914e4adr8b6a72 fathcc7i06bsbfe 1bfie12l0da1 468->c5a5f1 * REQUIRED
    Plea9esd7443a0c9ee bc5le06aa3r7e4f2fb 52t6f6eh24728iesc98 fb806f41i12el1a296cd 58959->6651 * REQUIRED
    85680P45l6ea03s761e7 30cc09c668alf7eac50ba39r74 tee9ad83a7a2660h9i9s f9ib14el2d 4df0-85>c5 * REQUIRED
    dd17Pl174f9e30aas6755e6be37ff abcale56a1dar 0t68hi8s affiec3d3el4594ad80f 32-ba785a8f>e55a * REQUIRED
    8aPalc91ead03aese667 cl0ea01ed7ee12r5 ate2f61ch8isc fi317ee194blb84d772 0-7966051a>8d66b67 * REQUIRED
    P369l5e8a0s5f1b7ddfe1 cbbl1231a28e27a3c89e5dr22f254d 70th8eis88 3fiel22754d632 ->c7782d0bc * REQUIRED
    dPleb5eec9ad9s628998fe b6cl78640e3ecd6d8car1 6td1hfe948ies8f77 1fa48i5e5ld7 2702bc1ec0b5-> * REQUIRED
    9e397148Pfeled0eca7fe74s9ecc d3806c427lde5af4r t6h316faaisa2 4bfi96e3l90244dcb1 -1>fb7364a * REQUIRED
    7ad0P6leaf383c3sea 6clea7b1846r0d 4c86tha133f80ebf76i86b114s bfi2e9589eldbae 8e0ccba-a5>11 * REQUIRED
    cPl2ee7e4ae6csed c7cc5lear t2c31hcfc5413eics8ce8a 5df5f3b6ee87i3e5ld 3bf596fb17e-7c7a84>1a * REQUIRED
    0a483ebac23381P3l1495eaa2s6eb 2cl5779aa7087eeaer7 dtf029h7bbis36c96c fec1ield -47c564>d05f * REQUIRED
    d8b23fPa508le73303as6744ee383 7dclecea0br dbed9t9h51i63s38d8 53ede4fi872el85cdc4 7-c3f5>c1 * REQUIRED
    42dPlea9f0d6aba160sbe37 4cebl8e52a4e4r0 05dt98592dhie8s66b4 282df7i38ee90l4d -f>ed2af11162 * REQUIRED
    P6fl0de7as8c1e 0c18cb7lbeabd4r2cf d1669a9tah04is3 c11a3d53f1c6ie1b806dldfe 5-1f>38136c4812 * REQUIRED
    fd43e412d252Pe4l4ddea6bseb c56l1eeb6a3734c278r th28c986e8is26c3c3 555f1i9de1l8ed 8-c5>16a8 * REQUIRED
    f6470f0P21leefa39fa37c563se44 d5abeclea9r b77e9858t5hi55sf5 af746ca9eiel5fdeb95e be1-2>477 * REQUIRED
    11ffcPle700a68se e59c8d60bl44b3213f2e4aarff6c 3th7cisb2cd3e f02bf6i49e4ld 8-9>a005de044a92 * REQUIRED
    dPe7cfdaalea4s25ae 3fcl9b4166efar0 87dth95ic619fs7a35b a8516fc5acfd3iee5c31l0265c2d7 0->17 * REQUIRED
    34Ple883131d10f35acc5se 8806c632a3cclear5 4thiac0ae0s9224e1 bff0fi2be6adb9aldf b1->682d37a * REQUIRED
    P64a28813l4358e6ccaef328672fdee97sfdb62e6bd clead2r 50et37bhb6e3fis 9fid9elde7 71-814>e040 * REQUIRED
    3Pclee455ab9cbbs7e5e8d0e0 6654c81l493666eca6rc 2tehib5s f10bcd1if47d74ae70fled472 2-0c>338 * REQUIRED
    497Pl5ae7ab03bd76eba7s1ee4 06cl3e53dda57ar 7t394hb92is cfiefecl5d7ce7a 4b9-5416c>4a5ba61fe * REQUIRED
    Pl7dfc472e8436as6611f75e9dd5 33ab7cle0d171a3fr 05315c1tfh93a9i0bs f69b89ab0i38eld -bfb77d> * REQUIRED
    89bbPdl17e36as9e7f c9al1beaa5699r19abf9 ct1h22i3sb4e757787 fi141ee7lfdad 11cfb724-aa>9a6a5 * REQUIRED
    97ddbP3l4b1c9d2ea44ase c44095c0bl2ebf1a53r 7tfhi00s 3d806f56532i2e97lda57ededeb33ee7 ->ee8 * REQUIRED
    d9P7865lea4c8bas25a6ed cl641eaa1aaar0b 47th50is94 a0fb2baie5e648lbdd80e90528862 10-4>62737 * REQUIRED
    82Plef26d8436adsea6d9 c6e7lab870dee5aa9r 9fbct1fh3ais31d5 2af8cib2202dcee31a4451ld12 -63b> * REQUIRED
    286722dP1l6ea9seb8 c2l17eca23r b0th0if59c19s7a8ad71c97 2e296f19c558b99ie8l5dd 2e->f0e37e0e * REQUIRED
    0523ffP8l43e3beac47c693e0023s2cae6 05cl7e5eard a7tahb3fe7dics3 2efc74fi3fe5lf4d8 -f49c47>1 * REQUIRED
    345aPle5a01see864b8 c00cda9cl0e3aa0dr51 29tfh02feisff4d 7af2f5dib2f2ec70bbdl07fdb0 4-da1>f * REQUIRED
    28e1P7l211a7eaasc07987e0 2dcdd2dlef0fd9aaa5r15 1c2t5h70i9s20 f2904fe99825ie3l48d -4bc>ab96
    6f4d5aaPcd1al0b6088ea49s00e clc150488a5ea71ad94r td54h06e5ie4c5s31 fi07aedc0ld9 b9d5->69ec
    e8006Pa1lea7c64bsce1bf 9d87f705cf0412lc1994110c8ea9r 206e9t831c2his3b7cd cdfif26elbdf ->82
    P2le5a3e1sbe 4be8dc746leeaar0f50a fddt600bb1f6149h7b8idsf1e b5b8b4f2i04e8bdfdcl06d4 8d9->8 * REQUIRED
    374d1bd1544e48P25403l4843ea43se cal786e3a7a2cr8 dtd914hfa06bb9i79a2s0 f18eib49eela85d18 -> * REQUIRED
    1067f19dPe0d0l0c5e301eeadese 1f10c1lebba359r e560t4452f9hd8is fde1i2ebeld5aeec 792715->9ef * REQUIRED
    f8a6482ePd7a614l9ceasa771eaf5fd 5406ce77le7c8de3e87ar tf657393hi0fsd9045 fi9celd6 -2>0e454 * REQUIRED
    2a4c0dPle2ae0se2 60ca15le4a68aer 6c3t96ha6c91cc44dc6e6i1sbec9 f4ice7f7l4abd8db 6-6e>4e0529 * REQUIRED
    6a7a8Ple0d72a9bs0146ee2b8 537c873ccd3lea856f93694a9r070 62tdhc6is bfi0e39fdf5ld37 15e->4ac * REQUIRED
    fa95Pdel263ea1base5 8dc84bc1elea4ed5r t3h4f51i2cbad454dsb46e 34c0efiee2l5281e8d4d ->d36b4e * REQUIRED
    9fPl2cbeae03esed cldea534f9r3a t291h1i8bsec85fc 826bacfi16f9el600b1d1 04-83>fad515e45fe194 * REQUIRED
    5Pd57al505de2186a5s0e90ed8 cl2ebe65a76r4c242d3 td240hisee fiaebe43el84dc2 167-baab23>10586 * REQUIRED
    cc72be6Plcc9e3ac8111base ce19adalcbee7d62a02r39f et24hbis 2447fddie9l038d1946f b-9a>7d0f9e * REQUIRED
    b2fPbf4la5ab9e2856aas7e85 ebcl13e2ca4r55 t9h91a8ise 81efee8ce84iee679fflb2d 625->b6fc03c5f * REQUIRED
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