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  • U12/U14/U16/U19 Indoor Travel Program (with Uniform)
    Fee: $735.00
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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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    79Pbbe64le08das9ed c8a9a4400c2le1e1b9abr tf13chi8851s8ab b7fi267a6eb2ld28d ec5a3f-79b10>a6 * REQUIRED
    1adf665P8el9de75c5a6s293bd70eb 96fa4b60c661574l7earc768 tb28dhi2s fi1aedl5cd 8-0a5e>96c18f * REQUIRED
    62Pl65ed1absd795cae 9dc2aele8earf 73tchis79 f4b86f4538cfi9e4l64fd5 4d38dfce8b9b2a0af-42>06 * REQUIRED
    35ba6494Peale714ae6aes4e 5cdlaecbab4a178r 50ftfh398ei2s 3ficf915e1lde31d5ae b76-3>fa648526 * REQUIRED
    449570P2a5l2eadbff4sae0f8 3d6c1e6b0lc6d604e0aa3cr tdf41hics8 93f1i21631eldc3d -6ab270>d2c6 * REQUIRED
    07dPf16l66e5ca901sf8ce04479 f8cl1ea4f6cr821 tcaa27h4372idsedb2d2a6db fid9c4aeb05ld7 98-dc> * REQUIRED
    6dee6983Pl1f4ce20d35aase d06c9b423cfcc4l15dearea9 28th1777i5s 661afi0ebl8d7e -d3423c71>bc7 * REQUIRED
    2d117P5fealddbaea56ca51s7edc 1dcc17c15lebe570864ard t4f98138hi3af4868a9cs61 feie4eld6 -1>0 * REQUIRED
    6370Plaa5cc3e5ae7asc9ee0 dcl9e75c9ad2c72rf2b97 t2bh7i4sae f080i53e7ld36 c49-f7>10163b33f8d * REQUIRED
    5Pl7e2a51s03fec2716 dbc1fl0cearec 07t6181ahcisa dc1a92df4ide7l01d3f57 9a-721075>b93ea303d0 * REQUIRED
    d73c5P03l5e4e7asf3e3cf782bc9 cfl8ea80r5e td9ah1c46is 114c6640fia14ef5ldf9983b1cc0 b-65>dc5 * REQUIRED
    54a18515Pa2ld7e322a4s76ea cael89ee74far1 14e2te2h6di7ec12s 07cfi8e2db4l7e5dd3d7e23 0->ce8d * REQUIRED
    5099a2Pf3d3l4d0ea4se10010b 3e55clea16e9r 3a5a4t795h1i86s4c3 3dafi36feld0 b57ca48-0e>ee9574 * REQUIRED
    0P3leb13d3d2ase fc913ac1a89d7552d72lear cthif9sd fe3d0ad32i5ef13l7d3219aca -557be50>ee5953 * REQUIRED
    6a18P659le3f6f1ccafs95fe dcfa6lbe45acer297d8 4etc1c67bhi3s f4dfbdib4501el4fbc11ddabb f->2a * REQUIRED
    18182P00l3fe3a4c2dcs91ef74 ccb8elb5dd42c6e6ab1564r e1163teh65is0 fi6el59ed 2-17970>07791d2 * REQUIRED
    42P10flbeba271s6ca2de62f2ee0f 3c39a0cfleare 2this 56e7fd9i8ea2ld 5-4397fd2ed23>c8e0859a5d8 * REQUIRED
    aP371al9e9e0478da2c495sb540ee 15cd7b5le2arc a85this37 914c746f21i5d97e608dl0dc 2->c879ebba * REQUIRED
    1Pl4e2a21721ff1da9cese6 4e0claeaf8999r1 c1th7bf2c28idf33s7a3317 f0ic4eldf -f44f22e7c>5e8bb * REQUIRED
    4010Pl5f6eaea9sc1ce33 3326f2c42c66eefl5e522c4ar3dff8 thi07sb3 d6bf9ie3a6l3d7d264860 a-e>b4 * REQUIRED
    Plbea05se12eb7698e3 cle49a085c62re9a2 2b8a967fthdi1saf9e01c6f4e55 fieaedlad04c3a6a 4-d06>1 * REQUIRED
    3eb3P33le4c9ad386ba836d154se b7cbb4183c37leaarcd6c thicsb5 fi29d47eelddb 8-ab4de0>32934a86 * REQUIRED
    35bPf8leea21ese7c cled75f9ca5a5a61add8fr 3tch2898417cidsc1dc df4df84fa4idaeedld 507-a3>75e * REQUIRED
    P2lf8ee9fadese784e1e989 4ccl249e1da78r0ec 38the203i47094aas65a915 0ffciecld2 d9->c4d7417bd * REQUIRED
    Plefff16e6a7sef 25cff623bl6fea5643rc020 ce6th55ids4 d13cf22iee7lca0a537fc00edcf 6e12e7-73> * REQUIRED
    07e2821P4l6df96e499773ba4s4efcd29 c9c916le4ar tdha9is9 efb848di7c6defle7da ->6059f4ab74d22 * REQUIRED
    0ef0068P62fle21f51afb8f5sfe2 6cble5bdfa1a3dre t37b801h12ibs1560 0faaai379el2a4a93d 3-8>074 * REQUIRED
    06cePle376dab09a9bds8ee 446c8916l468c0fc86daeafer 497bd78the08is6 9a7977fiddeb2lcdfe -a4>f * REQUIRED
    e9P6lea9ase196 377c7d1c351e7f5l312ecar1ebf f3753tbb60hai5s fc7ield2 4edcc3de0b-f>3dee7dc25 * REQUIRED
    bePledbab98a66920s55e ca4337b9lea0rd72151 6bt2fa5ah45isbdbf4 3ffi12975e43eld e6-b>15f06004 * REQUIRED
    b2P4e39l3f58eb283easee clc1ea19rc tahb7cid7f529s efbi3d7d70effl824d7e d3bbc286fea-b>da95b9 * REQUIRED
    5Pb7f1le9af7s08e ac52c100691l3361ear t85hb9is6356 fi130333fda6e2ldf536 8f3-fae>1b92e3fcb13 * REQUIRED
    6ab2a6bd78253Pb064dleasecece144 ccleca12drc4a7215 5e3t1h7i28se972 cf6bield3 c95-3bf1b26>49 * REQUIRED
    4b161Plec1ca8401d02secf3e 11clcdeare6e28 748bt1ehi5cfb4sa3efb563c495 fid73elfc14d fc-1>eb4 * REQUIRED
    638773c9Plee9cfa4s78e 81e9cld2ear9 a76bcb634t02heie42s 64afiaf3e1d0l03e9d62270 f->42bf0d17 * REQUIRED
    1a8beaPlee062e5baa6db7s25eb bf7cle7c2c3ar0c 5ta44hias f7aace1ie2l9d deb76-c2481295>33a29f2 * REQUIRED
    ePlbee2a3adse5b 0d15ecl7945ea3r7 0t288977hcisc bffeiac33aealca05cd 002534c-b>cd879210c0d6b * REQUIRED
    Pl0e4as8de c0d0ac2cale391a14r3350c 685dthi052s fie8e4lc936d54cd217 b4c43bd994ef2f->b88fd2d * REQUIRED
    9ed5c22794P9c3lea0se4 c2l5efa83e1r 4395th5cic29b1s0fd50 fcie8clcdd7a954995 c5a49b->69f0d85 * REQUIRED
    e5fPblceas405e000d cl3c85eccbb27d3dfefa3r 21t96he2is721 fi7dee6e843366ld 16aa834a6-a>abaf8 * REQUIRED
    ebP7le03ef79ac42a1sa5e1 bcl2a0e0442acd2bea45fc03r6 9dabaft7fh8idcsb56 fid862e13ld a7->2068 * REQUIRED
    5e74P7cacb492le6adbf5s8e1e0 99c44fdfle53arf2 c2tbf4d8h5a26bi16s4d 8afielc6d42263c 0-ac>b27 * REQUIRED
    e7a5aP1lfc9c6ea27s502fe 1c9cle29ar 0tf6dh6is8261 f20eieadae61e55a3578fl7dd2 35cb6-c0bee>ef * REQUIRED
    Pcf13b12cd25l3bea14asea ab74cel152efadf760er347f 3ethisc2f5 b5f72ieeabcl4d50ed90d a-ed5>00 * REQUIRED
    P9lea8405284s5be9a 831c4cc6b0le8a6bdbr95676 t06hids4f fd9i6ea45e3edba41l6ddc7ff7 09-a>6835 * REQUIRED
    b07ea4P6260cl1e1cba1a7s2d4ce5e cl71e43a2ea4d221arc eth650ie5c7sa 3566f0iea96ldf -64638be>9 * REQUIRED
    7ddc6b970P3lce0677a6s09e7 cflfedc66a33a3afr89c2e f9thies06 f43ie20a611b9l2f65dc6 -b39d16>5 * REQUIRED
    85fb0e6Pl7ea2s6b6e c1l2ceda34r4153 tbbc816h3is 9897b9c19fecf1c259i5e45l3d39507 f3->a9db67c * REQUIRED
    78P4aleaads9e c71la82e3d090e604ar3b07b 4f6t39fh34is7ec 1c47dfb6c61ceff1817iac92e4el0d c->4 * REQUIRED
    c2aa7818dP7ade58dcleab08seb62 5ca238lfe1edar 4ab83f92tbe80246h3ics df7iafcdeel5d0 -9>0c422 * REQUIRED
    5949cb0dPlafe0a2c15acas11ec20fb 7cl7f0e1abdr94 t0h0i45s96 4f46bai82el94202d7aec a4-79>2503 * REQUIRED
    404f11f46b3fPclf7e58cdaae4scbc7d39e29d ecfc9ec54le22a85r40 this4e bf27iea4elc77d 6-7c>c90c * REQUIRED
    09Plfeas0bb0e5 4554c1a5f02bd9af2l932ebar3fef f7t7h4cis70f4 9fc1i7945e64l036bdf1c07 f6-d>b3 * REQUIRED
    Pcf855lbe8a8cse01a5 c69l1fe77f1eaf94e42re t23185h8ci4f22se3c 14fide3l9aed c98143f-6e34>62a * REQUIRED
    b3dP3l8ease c3f27alee7e60243ar d7t07hfib8s dfbb27iedb12200l8dad36fa163761966 3ca7830c2->d3 * REQUIRED
    20c3P4l8e8a3dd003d9fs3eb 4cccf2lfeaaa317r21d t2b86eh2bf9e39i7sd2e2 fibelc7d5f 38756c6b-6>6 * REQUIRED
    7c29Ple7a44b437d8s0d7e 0e0cl8e5613a57r1 646t38he163i8efs12 8d26e2f145idec0lf7d1 54-0d>7034 * REQUIRED
    797379P7clcea46c2eae7s2c8ea9a3 89fccle4ar835 2f13t7he0i8b7s3d fbffb4cc8i7fe1lb85dbd7 7->39 * REQUIRED
    126P87dlceea3s2a0a3e cd51l6ee342e1aa34cfrf 41thia01d9s1 f2ci9e502l260d1cfe9b0 685c4d-9de>2 * REQUIRED
    1Plaeabae3acsd399e7f c8l01a30bb0ea579rc thd6i8770c890s2c7 fie7l66a8d8a4 220-afd>f519733da0 * REQUIRED
    0ff5f0b0e44aeae235Plf0e758d06aas7e cc0fl24eac2r f1tda529678hi8afd2s fb310ebfi9e296bl4da -> * REQUIRED
    cdP22le5efe9da69f9s8dd5346ce9c6a c6l25e9efaca27ra7c 08a0et65c9hdis 0f2bfie6l8d3 ->0abee222 * REQUIRED
    44Plf8eb5ase7 6f2ec0l4baeae4erbf 87btbd8ehi2sa23997 efei88e7l05a0fbed8e 3508-3b>dd2fdaa135 * REQUIRED
    fd7Pdlb32e2a0cesade2908f e382ec7lea60a169bba41rea377d ct9d3h4f35ies fb7b0ie8l7d -4bfe>5a80 * REQUIRED
    6cePacfl12eb6as607eea81 dclea5r4f63 abteh8a7i0sbd2cfd 311fa7fie73121e9aeldec4a7018b -0e>01 * REQUIRED
    Paalea3s63eb860e3a calc45af5e2639ca30a8445a2r41 e955d410ct8dc18chi06s 8c2f36aie50e25ld ->4
    7cf93dfPld383aeb25c562aa35ecd6sae cle8aa6844ar td16b47dh4bi391bbs ff8f41ieb02d74c65ld -5>f
    2acPlee3fcda59339cs7e 19c2lae26a8457a8a3r4e eb8thci7dd1c1ae0256s5 f0iefle2fd80 -ab566627>2
    624Pled7a79s3aebd60e03ae7 7cad9lcceadr010 e8t5h444dciaf8801d5ea9s 93fib9ec0lbb206d8c ->c5d * REQUIRED
    4ff30433P8ec8e709lfc7ce8asc8f00cef3 8cl2feard tahif69a5d3953d4s 262fiea29cl4138d5 6-b40>fb * REQUIRED
    3Ple1b2aes4ea09e8 e038clbe49are9 20t6h66isc6ae 4a4ff05i7fc47f9f7e9bl49d f-5e0bfc4d5>d7374f * REQUIRED
    d9800Pl5ebase11251ddaa cl1ccea53r 6th1bcic879s86a7bf49b fiel8adb9d6a7 26-8>603c481c7bde532 * REQUIRED
    0faP5618961b119lb419a6ec8a85819se clea4r23 2tehi6ba38bsf 0cc0fe45d42079ie6e9edl2d3b52 ->82 * REQUIRED
    ccePl31efebf58fa9sce65dc 82a6c2dle62ac9frd t1ead89f3hisa7 fd8ie7a3877b6ld73236bec164 ->a41 * REQUIRED
    aPcle7992b1e06a8as6a3feb7ed3 a330cl0fe3ar 3e22t58behi5cbb3s8b fffi573eldf e0e9-5561f25>8b8 * REQUIRED
    0f0f00283eea2208Plea1dsfe4 40cle441cc7adc4a7d387dr e5the70is3 28f4ief9ld7eed0198f505 9->da * REQUIRED
    a50e9b4daPl6fb8eed488d548a49s1edd6a 0963c1lb03ce3499are 3t0h24aisd4 4fie42l055bf5d971 4-d> * REQUIRED
    P6b7lea87sd06647ec97 clb35408ea86fafce6r2358 57t43af053hifs 5af4i89fe72l53fd28 5->91028f40 * REQUIRED
    072d8P39f69l9e81ase8e 3clae378faff3ere 03aat0hi098sb1a9 08fi4ea4da887bfe0laedce7af -7a02a> * REQUIRED
    Important: 9You m9ay be m4aking usde1 3of auto0matedff b9for2m-fil5fl8icng so6ftware. Thifs4 type6 of sof3tware canca trigger8 our hidde4n asp0am-dete30cc0eation s7ybsb12tem,4 4wh7icch wb6i3llf b9lock yo6u ffrobm5 subm3citt7i3ng this form.0 cP2lea4se selec0t Ficax Thiscfe8586c9d13f6 b4e5fddc03fd9cce28eaaod61d84c07rfed 9be1dca29bb74549ec584f589c4co53m0pl7a44efting t4he8ecf7 bfo7cbrcm in5 ord8fer2 to450 c6a9corre2ccaet176a 25thced05 0pre9fobalde7m93374ae1.6
    Important: aYou may be makingb us1e o9f 2autom3ated form-fialling soft6ware. This 7type of softwa1re can triggcer 66ou0r heideden sp0ad11m-detection sysddtem50, wh0eicfh wcilf2fl block you from e7s7ub3mi9ttin8g 7t1his fdorm. It afppears that the problem could nobt be au85to4mdaticcbally corrected5. Plaease clear an9y fie3ld whi20ch apapeabrs ab0ove with4 correspondin0g 4instru1ctido5nsd78e8d62a 474f1d6b4d4b3e8eff64oere23939a64eb81205bacdcdd0e9a9b9 ae481095abecompl4eting the for4m 8ine5 cforderf09 tfoe 6co1rrect t7bhe pr2co0blaem. 7We 9apofdlogize fo622r43 0teeh1ee ifncdon6veni6eeence a5nb4d bweb appfr0ec8iate ydour6 d71u7ndeeabrst18can1fding.
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