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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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    Pblbeeabfs6e cl314ea24eree13effd 8t4eah77a7i0bs1c8 8fd4fiecc0f30fe4cldaad5d2dba7 5479-c>15 * REQUIRED
    6e269Ple3a388se806 2fclc8eadafrc4 tfhi989613fd2e1s9e8d e97dc0fd8ie1l8bd 36-5d>1f5ed25e0986 * REQUIRED
    43d3eddcePlf8fe7909ab20se2059e cl7009bedb963fbaa3r cbtdfh29f3i4s 212efiae5535ld6676b c2->4 * REQUIRED
    8a474P2dlea7se4f2 cbc5d2c05l1fe9deaar37e t1bh23c7i5420sa d4edf08fdfffai03eld4 0-c>56fa7ec2 * REQUIRED
    6Pleaas062be claed4534e1aar63 7dt1aa9h8d2ibe26ds3b 226e08fi37237d6ela8f89bd5 fcb->53aa709d * REQUIRED
    P8le7f8a3e3493saf287a76948e0a73 afcd28le114ec3a6r ath2isa8 fad2ifce28008e73l9e0da ab->389d * REQUIRED
    23P644alfc7eaa77eb41197saba0e31 af1cl93e45a01r 3tad036d0h660is73 2fef1d2aeib7e0celd4f2f -> * REQUIRED
    7a56aPla8eas7a71cf66ea66 cl5cade78cc8a0r 02thid4sfc 29c08bc9fi826067286f4elbd -337bf1bcc>b * REQUIRED
    fd841Pa095f5l9e7ec4a283fs3eda8 67cb2fbae86al3d8earb9 tde509bh9iese 2b45a4dfideld e84-e>651 * REQUIRED
    87bd9edP2l835e2asfdae 78cc3af6bb9l84fea78704r 9th6i8833b5s2da eca10f601ci8d1b32e9ldb 04-3> * REQUIRED
    12Pb5lbf4fb59eacedesa870e c5cf2382d4c3a9ble84ab403r8 d5tbehica797s0 2e04f8i8eeef5ld93b d-> * REQUIRED
    01aPd6a0l989e86efase9 9cd79c34lca0ecaar24964 1th2c290di752b2s 1fb1f2bi7e2ld32088 11028-5>6 * REQUIRED
    abPdl86bea6ebs6c3e96 eacaal00de7d42a35a97r 5t4edh6ic31s 3ffd382i9del87d4492 40380-6fcf>290 * REQUIRED
    75a7bfP6ldfe6ase 0ceddc1c3bdl02feb6e9ara8 9tfe7h7i4asb97c6fb6e8da afbi0e11ca4ld f3-a>da4c0 * REQUIRED
    4P971le60ad2d69afase2 dce2b2elaec7a7c1r368 4t69dh2dis5504 c5df7705fi4e87l77f0cdd7 cf-ade>a * REQUIRED
    e6P4176le2fas8e36 6104a253a0cl11c17ee4ar72 a9f8tefa3h06i9s654 fced0i5cd31e5alc6d 8b-8796>f * REQUIRED
    0114Pl3ead9s9e24 439c6le9f007c10ed67a21r tdhif35s5dc faaf42f3f8ibe99b7l0d0d0cde3 3d-1b62>4 * REQUIRED
    d0e3d299Palf6caef4a3dces6e7d 70fef8cl8f3e9bd7dar fth4aa9fis303bc fff4diaeal1ed -37b20>998e * REQUIRED
    4c32P26edlaeabbc0sc1e 0cac9dlceard t82b9hci38e400b906bfsc c43246fid0be0c3lb57bd 0310-cd0>c * REQUIRED
    2P69lbb3ee51ab7f60s84efe52 9cfle9f373ar6 t40e162hc62c0isb449c2 3bfi3de80ad1lbad9daa7 9->b7 * REQUIRED
    8a68P9ld48ead42secde 80clea039r 7t0hei0sc 572fcid67c46b536650e51fld33 7b4->5d926e9bcd99200 * REQUIRED
    P7dbl5edaseeb0a3eb b0decd1dlc904dded44a7car 6t032efc4e9778h1bie3s9c2e6 f35a1ie9l4dc 3->80a * REQUIRED
    Pce32lefa4s14e52d3 9446244ac06cle0831cea6e62ca5r e6e7t3h93i8aes7032e2d 5d11fie1fld 57-8d>3 * REQUIRED
    9b99Pc77lfda0ease b1466882ceelbdeb929f9b5a52r712 39151t65bd0ha3is0 fi23ebdfld ->4d05729c84 * REQUIRED
    71ebd5746faePle8ea86a207se0d38e5 cle79ca9r3 93ta9348hai92sf c1811c4fe347c164a0ie8ld 1-f>25 * REQUIRED
    e7P9al1372cceas37e c1l6b0ear 1d7this265 6cf3bfdic326e0ld 1f51027b090->584d4240112b542f22c9 * REQUIRED
    3720Pl4575e78accfa8a7s9fe 57291c80le6ae47der40b ath7id0s87447 fi27e63ld3 30a62e7433e->4df9 * REQUIRED
    5Pflea4se947426fb6 6ac799e01lbear66 ca33249a20tbahb919e55b5is 5df72ie6ld17 cba107e37c4b->e * REQUIRED
    373P2l789bc042a4eads2e cl7ecc0cecaar thai8s c47fi5b689c5del36dd3 ab1a69a-4596ba4>08cf7f6ae * REQUIRED
    8d1ef9ccePleeaes4e8cf9 aeccaa35f79l156ba86ea3r2aca 9t337h17403i0s2 cf56ae0iddefld -859>27d * REQUIRED
    f57f48P52ld8c1e9d70a39s2e9 e592c5l8e4ae8r 22ctbeh1cf7e3idbsaa47 bf8ie2al7d919b8 48c->e93c0 * REQUIRED
    db21P0l9e4155acse5 977cl6ecafear2a381b0 tc8166242e8h1e6is87924f9 afie4ld2d 8-0>0d9806da36e * REQUIRED
    ac4aP28d31fle5beea19db02cse a90bdccl5ece6ar 1te95ehif170764s7 d52fdcfibe265lc7f90812d fa-> * REQUIRED
    708P3dbaale50e6749afs7e867a3b4c1b 942cfcdlea23b62e14bbd58r 0th9idef5s8 d2c7f4iel657da ->0e * REQUIRED
    c7ePl233bea065sa062e cecl2ea7d7rbe 4a268et8hfis0 23f6088e9f2126fic28elbd41d5 f0-e5f6>b3a89 * REQUIRED
    d08e3bbe8a7P9lb7727651eaf4b22eff8sa97be cl5ear723a ft4eaeh4ids9 ff0aa6a0fc5cie7l9fd49fb -> * REQUIRED
    07c51900a6Pb63238le303adda4088d768dsd945e4 cl1e74acr0823a7 thbi6fb6cfs d0fi885ebl6dd ->457 * REQUIRED
    ccaPle9ase 2901cc69l5e282a19eae62rb 9bf096tc1h60756is cafa77idce7b7e62ldf1d44ad 5b-3>57c4f * REQUIRED
    afPle2absce3f6750c5ef a34c21le6fe0500cda4ffrc f238thisa74e 20f46989idee07e03bfl1d ->fa36f4 * REQUIRED
    320b6P1478b32l17aceaa9fa6s94a7eca cla5e3aca3rea t1c7h49is29 5f6214ib53ba4cel2f03de 9-cf>a7 * REQUIRED
    c96ePel70be3a9ads8e40 adcc5929427l56c61eafr 1df2th831i7sff fda36b890d4ae1ieeld66b b5->faa1 * REQUIRED
    40822P38le0a1ab5cds8ebd62 c97c9f9el12e9a13r 1ft5hi7bs8da0 f37di215bce8d5cld b-a06cf27c8>07 * REQUIRED
    24P8eledf8as3bfae6e3bf7b4d1ac 6bcc15fclb5earb5 t389eh7ifsf 0c4ffeied9lf45db b-5>b3b77dc5f4 * REQUIRED
    1e9P3c85la7f9e5acs8ade77 fclf3abea15a898ar tb5bh6d750e5657is f2fieac85al50a804cdc4 a->107f * REQUIRED
    0021cP5f5l7566ec63faf15se 7cced840l1f4e78aeecfbr 1d73093etah584c0ise1 e8b4fi74el1d 5e-fb>a * REQUIRED
    2449bccfb239ePlbea6s5e180cb 6515bclearb t77h36i48522sb2f e1f6b04ibe44ece1ldc453c0d 9a->15c * REQUIRED
    6d4dP8l8deecca8a3ese436 cl91e9ac6r05 t8h6cff1f7e0icse f62cice56dl4d5db 5f5e6629aaf->f818e5 * REQUIRED
    9P928e0lef30fe65asbe032e5a3 8cl3e4acf9br8e557 716th8085889i3eds1b8 fi018e34fecld3 5-b64>3e * REQUIRED
    77P62l2deda5se100 4c5581l3773753933ead13b8e8r de2t33hi9b7s478e1f 64fiaee209l7c31a5d 4->56d * REQUIRED
    ePe2e63880leaf206717e7feas72ea7 9aecd1le9a0ffr1 6f405t1hdi7s 0245549fie146f22l2d4 ea->844a * REQUIRED
    2c95f23P2e32al5ea92as62be4 c334f6l15e5bfea9r2f9 b6e7thi9s2f af3fci7cdfc8e60le67d8fc7725 -> * REQUIRED
    P55le72ad6s0800e7 c99699le52a8bar4 9a6det1a8353d0hf3aie98b08se01 3e8fi76eal0847da80e4 ->5b * REQUIRED
    061e426963P3113b3le60aaaasec0334515691 5ccble8ar ethie9dsa8 056eaf79i7509eb2bld b7d->feb1d * REQUIRED
    5fP256le8ca09e3as7e 8ec65l07e8ab6b28e019erab 9t9c78b6heie45s9d4 f4f2fiel5dff 0c0f95-09d>18 * REQUIRED
    7b6393Pld2ae03e3ae0sca55e bc6le34181e9aber9 at0hb80is 1f5ibel33f14971724bd3b22380 1-746>8e * REQUIRED
    Plb3152bea4se19d005 c7687le8ba5722r f381fd75dc5acf3at4hi2ascf fe74ifcebed1ddf16ldb 90->3a1 * REQUIRED
    a325fb47Pldee2969f0a00708asce5eb3 64cl5459ea0658r4754 t5h0i7a0s952 fdi015efld cc8-3d>2ea8c * REQUIRED
    53f47Pffl2edacs8bee62 94aclea5026ea76r8 8tfhi5s3 b7f90icb29fcde83bld0c7 77c0-6>0e73539ed55 * REQUIRED
    Pdlcef84eb47102f1a0cbse546f f5500cl73ear thi9a08sf13 3faf7cib0e7l53dab -8f37f>489ab818a455 * REQUIRED
    87P917l41d48235461easee a143d3c0l5e82ba0adr4 2ec0th58b9is2785cdf8 1fi7edcb0l7d70 -0>17979d * REQUIRED
    7d06acdPl9ea5sea557a486 d39a7cl8ea285rdb 9t81b70hi045s8d78de0 fielc3257fdda3 552259->5c8d2 * REQUIRED
    d0cPla9c3e4a65bse c3f4el3eeaa397r5a3d ca39tc8h600ies 50f99a3bice3el1a0da 10b9-56e86c4>cd64 * REQUIRED
    P13aa1lee7c531a9scef c54ledd9aa4892c70r956 t3173h2c6ibs2ac743 f4i0e3ae01fl85d c06b-a>5a6bc * REQUIRED
    aPcaldd0eea7fas959be3764e 7cblfeabce035a2r60 9ctc4ac5h657iad03s f889e4525i130eald 0->e8b43 * REQUIRED
    0P06l0e6f911648eb6as8ce4d6f 43c1ale96ar8 ft4h42ids d9f1i42ca3cel1e3d5e4a 36-6c00>2b3f3af2c * REQUIRED
    0da0b6P66dleas6ba86e740250ec6 f1cfla63e5da54r99 7f1thibs9ff8 2afdie91ald8bc6a -20cb77>c85a * REQUIRED
    b7773dP84l67724eaebbcse c5l9ea1r f2ct646hfb1i23e986996a69s4 179f0i4ceb5ldd4c1 1-f8c30>987b * REQUIRED
    2470Ple3ec6d3a3e8adafsaea35 61c5lf61ea5a6c2rce1e this fic5c74adeb38b936l1d bcf-483>b4df5ef
    * REQUIRED
    4704795a2f36b2dPe42lecase f7fcaleac3fr 63thei70cs11f20b2f2 2f2i31eld 806-5a54319ba0>6d5875
    * REQUIRED
    941Pla0d1ce38basd8e3441f c52279alee43ear0 t5hise4e8d92c fad5iaee48421lda2fc4131ee4 0-79>28
    * REQUIRED
    8Pf03l2ae37af894b3s0bde3ce96 0443cldee7ar5 ft53h32ab2is3aa2d ccfcidce1227l31d5fd 0-51c1>ca * REQUIRED
    f36376Pb21addle94a1caasea331f 3c5959d5fl9eed8a8b1ded41decr tbha5432fisf 4fi93eld e60->b3dc * REQUIRED
    Pa2clbe5d7a6s4bd6e 69e7c9cle88c938ca273bred 2ta5h9i7dcs8 61dcf9fi53c3c7e75l28195d -b7a>e59 * REQUIRED
    33Ple2eas2e8a8 6dcle31527e6af6affr4 4t9bbahdf802dbi987s 9cfi1d6d56b52ec7l1d 50->2bb22ee5ba * REQUIRED
    a57P3aal7e72bea1s5be0cbe23e62ee3f f368c67l6eafa86r15 tfh04fifs fa46e4i507e14bld094 3-2>aed * REQUIRED
    78bfb9dcPalfea571abs062f4c51832bced1bda 9cl2f9ebacr51df this1 fc9i06el5df c298-5455>946468 * REQUIRED
    f842Pbf6b666lceas7928eb c2le043da90c9db4e7rf1e t0e9h4is30 0f9b71i720dc412e0ec2l06d 1c9-1>8 * REQUIRED
    417a06f6P3eb6d11lf66e0fbcase44 1cl1a033abe4ba7rd 8ath5is845 9f6fdaeife2ld77181 -614>846ec0 * REQUIRED
    701Pl84eaebd278e8cse 464c85ccdbl10e15aa5r61 dtb4h40cai058s cf5di39e735e0a9e7e9adld -b>63b1 * REQUIRED
    Plea1ab179se cl4e5ca760r ft61a056f29bh0is893 57fi6ed2f12el97fd700d3988c3eeae e6-80d>b55bab * REQUIRED
    ddPla28e59a0sb12e53de49 cd6l5e1ar4 4295t3hi6scc1da6fd fi1ce6ldd f40b3db-d7>348634e82617329 * REQUIRED
    Important: a0You 0mcaby b22e m4a0akinag use01 off automaated form-faab90i8lling5 9soafbdtware.e0 This type ofc5 so9ftware can trig1bger our hidden5 spabm-dedtec1tion fcsystem, 6bwhi6c4h will b8lock youb7 from 2sbu1bmbi98ttinag this form.1f Pc3leasd4e selec5t Fdi22x Th7iscb390dc749af 367d3747d7a01b4160e274c10ef2oa74f0re6ec6 d12d861e70ee393dda4dco1mp9leti9anfga5 0t5hc4eefc8 7f6c38ormdc i561cn07 o3bcrd6er3 5t6ob644 c3orr3f20ecct t4h9cea0823c 3probd1lc0e8m22.
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