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  • U12/U14/U16 Indoor Training Program
    Fee: $400.00
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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. 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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    a03572259cbPl70e0bea84a3seb88 1c0cel6fb6eec5ba7re 4t5hbifs1c 38e8field06a74333 c-82e566>e6 * REQUIRED
    78690cb1P05l724e9as7e746ed17 c5afc15d8cl6de39a4rb098b atdhis9a6 dbcfieled8e496d357c 9-d1>e * REQUIRED
    5bc9d993Pc42bl0deasca77b787695e4 901ac8f5lb6ec502aar5f2df897 t1395his82 f5fi7el9da2d7 ->91 * REQUIRED
    e8e9dd5e2979P9bf3el3c4ease4a7f c0l5ea115ra7 td1f8d4dc1929hi21cbsa f92bibc61be3ld9 -4e02>07 * REQUIRED
    Pcal32eas9875c79ef6ecdaf 53ce7lebea9fr 32thb96cbfis484 bfcd8d4ie5337cblb12d1 e8f2-4>a99fca * REQUIRED
    Pd2223440a9a2l78eas1e15 2b9cl8537ebed9edbaaa33r4 817128fte03hi8a1sd fc65ie1dl06d6240 ->279 * REQUIRED
    d67P65ele83ebaafse2 51becl2e4aarb46890f29 029thei68c737eeas 32f20cf2169if4efled f8505-a>b4 * REQUIRED
    267a83ePle8abcdse 59f94dcc4le820abder6 1tb981hidsa4f94 f0381fi66bel0fed996320 4ed-b886ef>0 * REQUIRED
    P1cdl50196feb89662ad6f7e1599e84b71se c6l5cearbf8e42e t802h35b34edisc6 f7cfieald 402-7164>4 * REQUIRED
    9a397d3Pale84ea38sce cl1721ee467ar8d560 54670t2f7hic9s 85afaaf4c893i9e54l8e3b4ddffc f-2>fa * REQUIRED
    492Pe01fcf84leeeab1ecs497d00e2b6f649f cl2b6ea71r taef8bcd7894hb6f65e5i60csf fie7eelf0d -c> * REQUIRED
    fa231Placeab4382see47 0edcle5de9a461353rbd72 eet5d8ha9if1s 9c65af11ib7feldd09 1df-6>2a0ca0 * REQUIRED
    daa32P20cecl5eaae9ddse bfd45cf7l39e5aer dtbhd9810a5isc 040e2c5fc4i2e192ld76 3d-7ca29>6e25f * REQUIRED
    Pdcdfale7a9sd8d8e c0dl5d5719bea9r6 ba1th1fd3bi2s5 d1af2261ib7be1fl2b85db524 -2e0083d>dd6bf * REQUIRED
    b7Pb07laeab9dfaas8ec6 492cf97al1992ea49c268r37 14ft2h587i8as d7dcd4f1e515f100faiel4d -3>74 * REQUIRED
    40a55P98l9755e0eeadsfe5a cl5de19bar24 78tdb9hb016i1b052sf7 8b17735e2fd3ielda e16c0f-9def2> * REQUIRED
    9a7e99P358lceb1a0404ebse8 cl81aeedeebc6f2c038a4d5r2 t0d6h3i8602bdc3s d9fb85ie6l0466ad ->e5 * REQUIRED
    0Pl61e6060ea9cse2b 65c17e4al1ea0r688b28301 768a3t30f185hdis f053ca3i4e2ld20 -7>2c5d9dd81ff * REQUIRED
    Pb1f2blc0a8beea3b0d3s1e11 clear37 td4ha76i1f8eb1bes1 a5fibe6d044bl7d1e69b940b3 8-0>7bac260 * REQUIRED
    a4f0c7Ple8a139a1s8c4ceccb 46ccecl8ee7ar th8cisc 9f2ab030b92241i20efbfca5ldd 1->8538dfb3521 * REQUIRED
    e652P500adlb1ebasae09afbe1 claeea50r7d0fb36c8 thia6e5cbs4 faai0e1cebl23e23f3dd1 d6-6d992>3 * REQUIRED
    18aP7al7e79aee59ce2asac8ec 4b731c0lear 79fct6dhis517 fb8iee2ld4079 fd7-1e>a868ac8dcfa5b073 * REQUIRED
    ff5c64P0l7e79aa22s3468186ce29 cd3leaa0fa2r 9a8tahc8ifd11s081 1cfi9eld959c22ccc0db c-6>d3ba * REQUIRED
    Ple14ddefb6aaas56e c52899l33e77c5e73a0259150r3a b6thisaea5519d eecfcci18dealdd6ce02 d3-f>a * REQUIRED
    0d68616820c001Pl7e6ee432a5s5e cel06eaa77reb30 aetbh4i6sd68 5c62530f0dbfefie6dl6dcf1c 6d->a * REQUIRED
    39bf9Pbldc72bdec99a39e86b2s0e35 2cfd7l21e95ca6erd 2th9i0ds6 37f8acafdiee9ld7a0d d7-63eb2>4 * REQUIRED
    dPae1lec479asc7faaae c28037d2ledacd102erb5 f7thb714is 8c8f7fi3fe22e2f8b9d7l09d 48->a94eb6c * REQUIRED
    30cd85e1567aPelea4s887e 8c6ac36clear1 a7f5t57d02f3his8 fi98905ael30d0173 ffb0-3116>83b8d38 * REQUIRED
    cd4ce65af11aPe88bl1edc6a36s5e99 358dcbfle9a06d1a9f47r 2040b08thd21isf2 3dfdd0iel85ad ->fd1 * REQUIRED
    2e1Ple9fb7as57e3 c381bc45l37eee7b7ard7 27teadd80hi25as2 fif1eeee46le789fa103db1d e83f2c-2> * REQUIRED
    7Pla153eaese b336cf1le9ace84acd1rb c7t77hifsa6 a1474fic13e24al9ddd60572c7578 -8e>94911f9d1 * REQUIRED
    c9Ple7adb6se7b9 c6af89le4a28r73 dt69h7378f38i3sb082d2a 44f9i65e8l01dae2163 0-ecc153602>4d3 * REQUIRED
    406add513Pldb6eaed04safea1262e 82cc17ccle7a41r6 t139hb3i2aa1a3db46afs43 481fbie63bld a6->3 * REQUIRED
    c2c6aPlb8ea854sbe 22edf59dc5l82e6e66a54d1r88 t99c8hei51sb207 fi6e1elf6ebd e59433-0>8a439fa * REQUIRED
    45P1192l3efaa7062bs71fe c27elcb3eabed0r72e 6th3isc 93af571i088653beac5d13fl6db 890350-ac7> * REQUIRED
    5e72774Pleas69eeba256f c3a65lc6e7ac7d422rb 7t5h30b7a8i60a03aacs4e7cf fibe8ld 7719-38>f8a9e * REQUIRED
    4deP7l0e040fc50e4a31s2e6c866 389c03le4a9695bera et109h581i10as aae7df3f0ie1el9e1dd0 6-5c>4 * REQUIRED
    0Pleafs3ed3a4 cl87403d0e7b7c1ba50ab82fbra3 a652bt45h8is50 c3fie877ld1b79 d8->bdb4c1518db5f * REQUIRED
    cd6Pleased ca78l5e991efar6f3017 292dthb2i69sf91 f8i9fc3eeaa68ldafcd20ebf015286fcf32 e7->e3 * REQUIRED
    Palcf1386ea8dac1a4se19 e651b1e2edd8cde9la4aea58r 26tfhi56s1a19db5 f7fi2el9d34 9c1-33d>af17 * REQUIRED
    1febafefbP967a018lea2d8sc1e9ca25 cac21le9b872a8erac thi08sbf ffe6iel95cdfe5 2-a770>d449078 * REQUIRED
    2465Pdfl1e2eeas0359ed36d cl6e1ar5824d7 0ct38h9i0s27 afidb680c49ae39ec6aab7ld50 -ac4>073c16 * REQUIRED
    d11d6d9aPl15easea4922093 58c1l9c71c52ear8ce54e 14c2t8e2d75fh35is2bf7f 0ef5iebl9d c-b0>7518 * REQUIRED
    1108Plfea3e9s9eef edb9c6ea92le4f6c7a799cr6b 75tca8b4his397b f3i0104e9de6ldc e5-487>238e640 * REQUIRED
    baded1P7l8ease17e40e cbcd9d356bl506074ea5f8crf7cd10 bt08h8i6es fib18ela64d 0-4e>ad63acc100 * REQUIRED
    afP44al439bfcbe8ab1bs5f6ff2fe4a4 8ac9753c47l6eaadr99f t61d28hi4csa9 f8di7f6ed0bl7d8 b87a-> * REQUIRED
    86aPele9b67ed72c4a4sb91eeb8 c4lae3aabrbfeb02 atah70ided273s647 4ef831i8a75e1l2571d d-c>ba0 * REQUIRED
    df7dPlefe0a70seb8c 532cc4lefca759a2rb3c71 eth4ie4sd dfe76i9fbedcld68ae0d9 ef-70110555>dc7f * REQUIRED
    956dPfld3ef1a705sae74ee 0ca6cale404453a9r t2fc1hid6s1 ebf5eie2le7dab20dda9d8d78b702 1ff->8 * REQUIRED
    8f5049fefP3lc2092ea9se 2c5ff2b2b3cf778le2c587a96rb7 4bbeth3i04sd fi94eldc1d37 6ba->7961ec0 * REQUIRED
    53aa23c8b3P6leaae76sbd3e b3ecld2bearba58 b1t64a016031ha736bi6s9a fife3lc30fa7d7 -27b>c9a1f * REQUIRED
    8Pfle3a8as97e29 7cl9e7ae8bb0ra tcc0d8c5c6h0bd9109f16is c81fc5c7if8e07e2dea1el7adffec 2->28 * REQUIRED
    af66f724a531e0P704l2e2d183bda61cs7ee580 cl1bc638ce7ear tfchibs fef4ib4eele8028d -c5>214dea * REQUIRED
    8704d49P992l0acec5b98eaee04s13ec e2c24109d1a9l43df0ae1a6rfe9b t8hb164is c7fi4el4ed -7fd05> * REQUIRED
    71fPeb0107lbe24ae5ec53a1fs98378e1e1d6a8c d7d4c3elfea4e2er 7e75t2hbi4s 1fiel2fa8dc -47>42ef * REQUIRED
    fPl6874ease3 ac90b38a817ald34e0adfb5912e8a10r4 b7e246ed500tchis f66a100cfif16el0dd d->bcd9 * REQUIRED
    affcc909P87ldead2fsbe c8l3efff7d5daa6r 8a61tch88eib79s fi7debfel2ad2e49e eca5931f->2646c8f * REQUIRED
    cb629fP8b0e0fle09a1se cb5lea3rf8 t7h1696i3687cs364ef 2e32509fdi2ea3lfbd42fd 30b5d-1a>66541 * REQUIRED
    8a014266Pl8d2c4eab6es1e 4c6l0540ear ebad57t1a63723dh4i2f5s47631e f39eiede218d3lfd -898>cc8 * REQUIRED
    P6c8fleea73s37e15 cbl4b62ea8r t7ffh4d069eif1721bf1dsdb a33014f7cie1l8101e7ed 7c-fde8a1>7c0 * REQUIRED
    27f791Ple8a68cd7ase7 cccl6a3e5ar bt1ha56a9c9id1se7465 ecdf78efiae294fcl2d4 1-49954b9>9cdce * REQUIRED
    b54Palad2ef4ce53a9sd18e c8la14ear 85963e3t15df01h608i3f687as0 8d9a2feab0i4477eldf99bc ->90 * REQUIRED
    4e472bP4cle9a42sb4e7e5d38 b1dcel690efarce teh5ia791c80sfd 6af1ieldab 36-5ee52e3422b>c1929d * REQUIRED
    1bf0c0dP5e7059f9l6ed253asedfab2 c29leeea2cer th4255ic8s fdbielb985dedc4adff 605c5ee8b->e36 * REQUIRED
    c2248P9l00e206a6seae25a 032c2le8ea9e276fr e215t42b20his60 f1bdc32ie8841df07940l8cdcf 3-1>8 * REQUIRED
    ae6497P26cl4264947e1f14abea4csc97e7928 2celea3r5d 48th9fi8sd4a 4aceb1f6i0eld3c9b 96-f8>29d * REQUIRED
    a3580dP2c404lead3asf62e0 fde0calee3aa226brbfb th3i33cf6s0 af6f006i1505e8eldf19 04-14a>294a
    * REQUIRED
    ac5P5b55le7be2329f3ae0070b2sa6460ee2e cel10c60cf2ef6aardc6cc a6th58isdd fe75c0ie2l5d 5->ad
    * REQUIRED
    0457P6l0ea925s4b50be70 c3bbd1b2lc5e7955acer47 79eaet1aeafhis674e1 e228fiee7fl1d5 6a-5f>7da
    * REQUIRED
    7P2c99l87e95face08asee 2c65482c7l37e5ard taa849h419i4153s 4f2a7282ia4ecd76dcd9el58d4 -c7a> * REQUIRED
    84973df6a6P1f23le2344cafs31744e cc2le0a8r1bda9d52999549cf at6h5is4c21c 6fifde3e289ld -a>10 * REQUIRED
    dP5353040b3f19l20ea9se 22c9bclfbbeaba8re15 t4h0i2518asaf23 3afi60e8ld79f199dc7dc08 -51>d08 * REQUIRED
    da873P4cdflfc6469cee062asf2e57 2cedfl3ee1a2afcr4 3t1921hi99a52592sb 1fd327e03ield -ea9>a1d * REQUIRED
    747d9P54lea3sf1e 482c07lea7f9br80ed5e5 8t495cbhci88s 5fcfice59e7l4dcf97929 0ca-b>43bf2d56f * REQUIRED
    bf8affPc1l73cafceeca0s6d4fe5f7ebd 28cf5ecl80ed9ar5f athi20se b7fi9337d55677elde848 dd-3>33 * REQUIRED
    P133172lceaeeasdeefcf c9f54l9ee53eadr808 3t4ehbis bef13965851i55ace3l7de98bda5b 45->ac3edf * REQUIRED
    96379Pd7leasbcb889ed0 6bfacc9leaaadrd 231th7ifc08s1832cdef22 69fi1acelc5d592ab d-bf42>00e3 * REQUIRED
    091840dP0lc92eade7cfd60a76b45sec clef9ar821836 e987dth2i87s b3efeibbbe5cbcld 3cb11ec-3b>bc * REQUIRED
    4965Plbfe2135ea8093s2fe48 95ace0ld7aeefa0car2a td40h2a3fidcs f38i78daa8c793el3bf0d -995>1d * REQUIRED
    5ef9a2Pl96d2e773bec60as2f6053e0 c6cleaerf5 27et835h3fidbs14ea2 f8cfi3ee1lc146fd d-73d>7f7e * REQUIRED
    Important: Y3eou5 1m2ccay be makien4g 6use of aut9oma9te2ad form-f3bfillingea2 sofbt7ware. This b1type of so04ftwarce ca50n 5ctrigbge7r o9ur hidden spam-detect5i2aon3 syste49m, wh3iach will blocck fyodbcu fr6om submitting ath68e5i8s form. Ple15a5se seel8ec2c7t aFix 4This6d41802671b1cea2e abc20fcdeefoa385c5825f48dr4f2ef4321a1 942477176f7e4774c78om4pcl1etin9cfg 3dth5e f26or174m 7cid4dn935 6cor2der 1aa06tec4f8o d870eco3rd4rebd8cf3t6 a9t8hbe9 pc8ro5b5ale1mc5.
    Important: You may fbe makingb6 usbce6 aoff automated fo0rm1-4fillingaf soft1wdarfe.a 1Th69ib1s ty8pe0 of fsaoft31ware 8cabn trigger our hidden1 sdpam-dee3tbection9 system2, whicbh willc block you fdrom7 subbmitting thbc39is form. It appears2 9tehatb the probl2em could not be automati9callfy corrected. Pleaese clear a5ny field whcich appefars1 5above with ccorre1sponfding instrucactions3589 f221e5db422ec245de0f381cfa32eo2996daaf22a100ba50969eb0bred de6fb82fcao3mplbe5ting th88e foa5529rm3 in9 o26rfddcerfd418e to2 corre3ct the p8a7robl334edm. We 2apologizbe foba9r t1h8e inc7onvendienc6e and we ap1precib9abt0be yofur6 fa6u4n02decf8erastandi2n1g.
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