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  • U12 U14 Winter Turf Goalie Training Program
    Fee: $100.00
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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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    4P7beal066e08801945a9baes427c3be27 cl5d0a080f942ecard ecf8thfbi4s 78f5ie75fl685fd -1>dfb52 * REQUIRED
    0bc677Ple6b6ae05db8s9f6ecb85 7fc4l27a5edf8a228r75 3t4hbis df7i79e7ld26a585b6 c5f9->0452b74 * REQUIRED
    3Pa45fl9eea09se889f 7271c0acc9le334711a0ar0bd dt812d7f0hid3f9f3s4 040f8iaf18e4ld2 d4-5ca>c * REQUIRED
    7f6Pfl713e03abf7cs7eef c9cdflab3e199a7f8a91er057 tc104hifa4sc95f9942 faie02445ld 54a3-1fe> * REQUIRED
    bf24Pl012e2348a1sde9e bac4flea3157r ted9a1h5b03aibs db25f49b17i8el6d5f 2ede-2b692a33c0>bb2 * REQUIRED
    50P4fl350eeb64ase 6200clae2a9rd7 4b7thf0is7 af2eebf88ifelc2a70fd140941e7bef dfd4dcc->13216 * REQUIRED
    P0le2abs1de06fce6b 48efc6ala011ear99 7ctd23his9392 ff9c593ic5efd70591a608c5e72ld f->f7501b * REQUIRED
    4ee0Plea98fsfed 3dc50al15fee2arffe 26ftch8bi4sf5627a 9fi064f0feca255ld9 3f94-08ad9>09526ae * REQUIRED
    bfP110dl7e152e64de32a98f2se 25814cl0eaa9br e6c4ftf766hi49sf fc0ie1be98lcd 3b-460479e>ea5a4 * REQUIRED
    301264311Pafel24e7aseeb 508f9c4lc556dfe6da7r48b786a6020aef9e thisa 60b1f2d0eield5dc5 ->fea * REQUIRED
    cb5134P4le1easbfe8ce9a80 a7b79cdlae2a9r7 53ata434he3ff4is0 48ef3ci23e0l5d5 e5a7e-8e>357246 * REQUIRED
    ec9b8398Pecl0b2d41deascb6e83d3 4c08lb3ebe34ar2 76cfc4th0ifb59s8 6cfc5e5fi3e1bldd99d d->4b5 * REQUIRED
    368e067cPl3e2849as6ef 8748e4c86l1e85ar th8ecci4274fscb34 f2field162af60a5c1a12 b48a21d9-5> * REQUIRED
    P0211aeele48ad89a1seb1 7e66cede34lee3ar248 bt384fb4h8b53dis9 7d1fcdf31i3ecb1294a8ald8 -5>4 * REQUIRED
    cP512l07042b5e84as3e1a 24clear tha198af209if69a6e62sba8ccd0 f399a499fic8feld1 91081-9>50d9 * REQUIRED
    e317aPl9b88ada97ea553sc4fbe fcl4eaa177b0r c2164ethfi98sabb 2fd5ae3dei8cb6e5lbdadb ed563-5> * REQUIRED
    bb67076Pl2ac867bcc4dea1dcs337e895e ee57dcdblead33reec t9his431 f9i8f082ee70b90l16cdd8 -1>a * REQUIRED
    e30P1leaf52s1d3bc7de f4a9fa5e6clee3c3ba8a4ed8br11251 5t5e6hd2e30is cff9cie80ld ec65-4c95>8 * REQUIRED
    2177ab942cc11P56ac2l4f0507deaf58sf9ea4 fc5le34a2ar2f4 0at0c40hei6s45 5fi27eld5e34e0ca -f>6 * REQUIRED
    7ccd3bf65e1a1Pleas78e4da110abf 9cl1ea03c82d8r8ab270e7a 656t730hisa dfie3l4c0d7ae a->6d9323 * REQUIRED
    4bP5l9e698as3779be0e c7650l731efaard 8t54a4e4e083hei7s 6f3eielfd ff8-a172f57b251>1dd0a3d11 * REQUIRED
    06P069f61dl3191f9ef4as0c2e4 e8677ecl159ear415 bt1hi71s fc6die8l8ad21d90f -91>2aa183a79d090 * REQUIRED
    311Pcl0e7a986s219aeeeb 5229c6ad12337le3e2a0re thei64df81es5d f53fc3a8ie69d58alddd2 84->3dd * REQUIRED
    8140P9le2ede14as6e43e 6c3c1l22ead2fr30e58ead t528hb77if078ffs9 f648bbi3eld b45471e9d369->e * REQUIRED
    8dP38l0ea63eaeas78e f2c38lfear 3d59at4e5h1623idc0s2 bf5c50i388ed1l8d1ceec e0e1-ad77ae>9a19 * REQUIRED
    046P47404lf5cea7bs6e c2le9c06fbea5d3rb aft90h4is4237a3 1f79c6be3e0bdie01ld d-9>77e9bda5f3a * REQUIRED
    4a0778Pl60ea20asf1cb3e2e2825c83 c1calea8r 925this79362e3 f3i9d5eld12 b7770b3e8-055ce>50090 * REQUIRED
    54e4Ple2ea58a02dsbbe c77ec8l8b0eaarb6b bthai2f6f3fe683s49b9fa40 fe14f9bia8e20aedl8df97 7-> * REQUIRED
    8334P37fl23130432e106e276cacse3 clf67c9ae21a3r73e 2t906h2cd76di6s fielf00d650b bce-c7>a91b * REQUIRED
    1a79f943a37dP0993l7fce5821ased 4a22c7868leeaf9re838 t74377be6h4702fi7fs e1f1cife9b7ld 9->2 * REQUIRED
    7df12099Pc10l4ce57asee7 ddcle47af27328r t8914h7b65i3bbedsdfe acef6i4699ebecbd94l594d -6a>8 * REQUIRED
    f6P5ac7leff353aa78a97sbe cl87eac7br6be6b e7cth4168e88is 94f9206b4i48f9dfel3300f7dc9b ->cfb * REQUIRED
    6578ed0b3Pd8l75eaasbe2 cl452e8ar05d at4119h782685ea4isbf4 b7cffbdie9a2l8d80 -2aa885e5afb8> * REQUIRED
    bbbb94P86bl0eaf6sffef164e c9f2l6e3a61r 15fe7eteb611h5d33e74cei7s2 eaf4i8eld7 b677c->fe73eb * REQUIRED
    602P193lb89e78dafsdea602a7 0b8cldfdae4ed3a47ar5fc7 t0h3i7s0c6b ffib7eel2b8fd 9d3a-c5>9ab69 * REQUIRED
    cdea2c48Pl4e1a340se53e3cbd 2clear3 ct59a5afbh79dia4fadfd3s8 fi9be6f8ld c-7>4bf4fbc94955780 * REQUIRED
    2aP8lf3ea8sfe5c fc63lef0a235c77db89e3rb95 ethi45s 4192bfefi1de92l56e88fed1 49108-5ab53>36d * REQUIRED
    082Pl91eda54bce7e6esdee57 cf2la61e3e594a3r5 t59411c9bh6ci85c5s3 f8cdf43756iebld9c 9-4>7881 * REQUIRED
    b9b0b5P3717le2as66ee 5ba01a319cblee31ar3 21t2f1hf7i2f4b77sec ef113ei6e8ee52l13d c39fb->6e9 * REQUIRED
    Pleda6069a8f3a3f56s00e 80b14e132ec8l7ec37e7ee2fabr 0d6dt907h53fis d2add9fi4ae6ld f73da8->5 * REQUIRED
    bdd17ebcPfl184b743eabs0daae 10ce0d5a7lbe0a4ar 43tbh30if3f74se8df989 0cbf92314ie8ld5 ->81c9 * REQUIRED
    e4bP57e84lc82ea2c1a0a9s57e9f21b c20leea2c825r cthci555fd6d4a49s 233bd8ficel88dd3 -327>6ef2 * REQUIRED
    0be18a8828Pl3ea742seb4 cb9le945359arf04c t44hi3d2sd cf9i8de5l0db5caa7946 e57b707-a8e85f3>7 * REQUIRED
    bPl87e4efab73b1se7 c2c378d5lefbe117908b1bara1389 at08he59fisd69 03927497219fi3el88d06 ->24 * REQUIRED
    P0eba4l6ed1bd558aedafa1789114se 4ccl48eaar 8736b02tf2dd04fahais95 53ffi7577e8643ld86d -b3> * REQUIRED
    5e6eaeP0laaea3sce20 71f6cl99e0f4a4ca18cb2709r t88ah7c86ie355s839 fi98e14535aldd -4>be37e78 * REQUIRED
    11c153a9d3c19cP87d5le5551ee974as6cfe2 bc00cleaer2 52thcd96c652ai5376s8 fi18e8ld -ffc8d>140 * REQUIRED
    Pldd51ea7se28e84 04clc4acea616fr72 thbfi875005s 05354c6fedbi6dbe9655e83lacf4aa8d61c37 -9>6 * REQUIRED
    ePeelde3494c35a7se79 595cl91e2a5rc482 08t430cddhf65i4b4sed6 799c0a9f53i8e3ld33322 8-f9>621 * REQUIRED
    af976P209l8c30e9a322s8b21c69e a83fc3claa74ee7a58re41 t04h08i14sf5b42c31e 1fieleaf167d ->d9 * REQUIRED
    7863fc90P1l1d81ea1sb1e bcldbeae2rb77 aaet4hifs7f 2fi6e1019l3dc50a3cce8 e17cca758c->01281ca * REQUIRED
    5ed8Plae9326c63as1ec 3clb80ffe9ar2d f6t3h8i6s08 fc2i4e4l74d7523 f-240f2250b31d>05a2fdf3ea7 * REQUIRED
    e1ae2dP3cabcl99e88fac078621s24de877 c59le26ac952r c72067th4cis500 e7f7b33ifce8lc9d3 4e-d>b * REQUIRED
    2af98d56041P10l31easc9e9 c6795lc44e0abeacr76 2td9his5e7f2 7d9f3f7iaeld489e80 d28-9>45125f1 * REQUIRED
    14327c35677999P4e1le855bce2a29sd67ed 9cd6954ccba4a9l0e3ard6e thcis f8ield 2c-7331>af87ae85 * REQUIRED
    618Pl449e3ecdab6e9c207s6ce c72cl3e2e1ead9r 3t1fhc59is 4e35baefcfbiel6d799 ->142204edaa84eb * REQUIRED
    be0c00P53l1e78deafs2dced5 cl61e81ac7a3r c201c7thi9s 3f9b3c64a39ie8l7464afbd01ee ->f3054032 * REQUIRED
    Pled20a7be50s9e85dff c84le9caa77er311498d 68ccthif1784a58sb2d33 f8ibdd1e6ac8e8c64dld ->9a7 * REQUIRED
    f741a262ad71P7lb76c8be86asbde 50135ffcecl12ef86ea8437rd3 b1th908is fi6el3628da5ef 0->b9e8a * REQUIRED
    61aP2a3a087a67lefae607fc93597dd0d2se9606 cd13l4eda2b954r3 t9chi23as7 a6f4biefld55578 ->dc3 * REQUIRED
    69e832606P7dlea039eacse bc3l2c2e1b879b05acf8r1 c1b8tc4hi67s 3f42ielf72a0d5 81c72fd14->adc6 * REQUIRED
    95817ed53324Pfl9e8b6fa4eafesf3ced cb12blcec1ca08899raf t5ceahie6s0bd eaf34ie7ldfdaa3 b-a>2 * REQUIRED
    ce8c7876Pbld4ce66e9a581a6812see0be d05cblbda0ea9eer473 t23852feh4is4 f2iel4d3afdd e-d06d>c * REQUIRED
    P0l6aeb349214ae331c26f0se99e3ff5fe61 310c9f29d95l6e65c3a3r1 1at2dfhbed0dddis98 fiel4d69 ->
    * REQUIRED
    6754fe8981P0elccc6e70eb7cf0as90e09 d6ca60d6cc1felear7a ec41th25i48s 6f986id4eal21fd f-d2>f
    * REQUIRED
    52efPlb05ea7se83 cl42b5e6a437382853ad7ef50dc2r ath5f97i8sd6 8cd4fi4e10ab0l8a3edc7262 b->9c
    * REQUIRED
    d6f2Pl3e18714bada76aas2e34e c92c4l937e1ffdae38a72r 8th4if739f447f9sb7 fdfi3dcecl36d4 72->0 * REQUIRED
    1184100Pl3467197e5fa2s097b8e5125 c27l46cae20a167f9r t32hb59ia4cs 9fie9l5bada9df6 -2>4014f2 * REQUIRED
    8P981bl9089b920853ea2b0e2as93d3e c2cl8deb5b1e1a8295re81 bb0thc3cis43f a98fe59ie4ld8dca ->f * REQUIRED
    0d5595P0l23e3a22sf4e6e1 0e6c0423l869e8ae5a3r1 thb931cid02as dfi4e28el92ed8c -22c1>05cc3891 * REQUIRED
    e7e859aPleaa6scf23b0452095ee8 calffdaearf e7th1i130s5b7cd98dc fbie7l66edb9cdfc -473a>6ce86 * REQUIRED
    6ead20aPd9f49c6lea6easbe24 c8dlebaa8r132a t8his ficc6fee54be4l6fdeeb2d 5d55-d54d5e>f605d42 * REQUIRED
    dP62lea1se 58cle31caab7e4rfb1e3c th21edi3esa7 fde533if0e7e7187f1492l5f2da f-0>ee5163d6d9f2 * REQUIRED
    7750b74P929lc3ffe4eabseb8b c2l5e1a16r 70t850dh9bis 36661feie9ld0738bbc5 c545-7dd899>409502 * REQUIRED
    4dcPclc1980easee5de8c5 6c7lee2f0fa8e164f2r 55t90a32d0hiscd b76fif022el4cdf09b24244d 8-3>9e * REQUIRED
    1Pflbe5a12f2seede cc651learb6c8 1et2d6h9294ci6315a37ebad98f38b3se1 feeb7688iabelf94da 5->4 * REQUIRED
    602Plea8e8sf2694ee86a5f c9l3abea88ac48aef8r d25th04cei16s3 af0fib97el68ff10eddbe -0e>c61bc * REQUIRED
    Important: You may 4bef 2makbingb9f8 fuse eo8f automat6ed cbform-bffileling software. 6Th5is64a type oef software can trigger o9ur hidden65 spam-dd1dcetectioa23n 6system3,7 cwhfich 8w1ill bl06o5ck ycou 5fr1om5 sau6bmitting 391t0bhi1s fo6rm.2 Pleabse dsefleect9 Fix Teh4is3cd3 b8e119fb65f9eoe3a7b7a31c43942941crb76e0cf80 e2d9ce5e052a20609ae741c90co003m2a8plfe97bt4ingc4 87tbh37be5 0a02f651o0rdm i83n 4ord38er to496 17co6r2frect 9tbh3ef4385 p2roblc4e37m3.19cf22
    Important: You may be 3fdmaking us2e of automate16d fordm-filflifdng so7ft5ware. This 6type oef sof2tware canc7 trigeger ourf heif6dd9en sp3eamd-detecbtiaon system5, c96which will block yo5u fro7m5 submittin8g1 this 38for9m4. It apfpea1rs that 0the 5problem5 ecoul8d not bfe5 automatically corr1ecdted1. Pleasce clear any f5ield which appears abovfe witdh co7rre66s54pondding instructionsfd f5b25058de225e7047fo4bf5br299938319089528263c242ef5dc3e1d60f74d7c133 4c8ompl6eteifnfg19 t6h8e 0form4 in order 743to8 correc804t the probl5e4m.0 W947d7e apolbo0gi7z1e4e for the i80n50c4od05envenie4nc06ea 2and 2wee af6ppr6ecciate 0y6dour07 uc5nde4rsbdbtandinge.
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