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  • U12/U14/U16/U19 Indoor Travel Program (without Uniform)
    Fee: $650.00
  • middleclass~spraymiddleclass~spray
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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:
     
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    Payment Information:
     
     
     
    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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    8b4bfc44e6f9P6l07020eb2aba1e8ds7740beae487 cl25e52baear fbt18b6h18b5e21fis field 8a-7>9571 * REQUIRED
    03797bPl1eae70s857cd780ce f7c7lfec3a1c6r 7de9tf03hibesafe6 6d391f5iefl54d12b 6f65->ee71dce * REQUIRED
    1644926bPf7lee2e86844a3see83 c6efl296539ea709ra28 f8c6796dftfh2cfise f00field 6c->6b6a0503 * REQUIRED
    12cfb5bfcedb11dPlea06s3be7d 7c31e3b6b76c18f2leae3r thi98d6934a1sa419c 76fie4l7d 578ca->2e1 * REQUIRED
    18d88020P6f1l7e13e472a4sf01fee36 c95lc3ear7 0fctbhicda6s65 fe58e46b740764bi3e1ldb96d9 3->e * REQUIRED
    a1dcPlea9746sed8 1cd3lcd19cea4r1c 0ata44hia8s130 fa7a58aid65d66e3746cfcl52f0d5dfb35 2f-b>9 * REQUIRED
    b0dPlea9dcfaee0a8s5b8e0 5d6dc763lb3e5b9a8ffar688 6442eb96thi16s9de f6ae32i3e1ld96 c->7b563 * REQUIRED
    Pleaaa27cc861873se9e3c0532fd5 c5l35aea38e1r tahc6i3s4e3 56f5i29de5e43bld97 c7-812a6aa4d7>2 * REQUIRED
    111Pd2c4l5e7afsee cb9c6l6e3ae893br85905d 5c3e019cd4t3e7c8f4his492a 5f2fddfibe2l59ebfd -d>4 * REQUIRED
    a792Plc3800e63a8e65se b2f50c1l5fe326ara30 3a2t3hisd88727304 fdfidebl2e39430d22a700c03 ->72 * REQUIRED
    57Pl61da0a34eea7sf8ee005c c1al752ea4eb57r 2b99t1d5h7fis36c 70f2iebl5ddd48 9-5096f7>0d461d3 * REQUIRED
    db1f090P40a8bl5dde45e1d7ase0 7a7c0la896a817394be71a0r 5t9h919i10sf2 fieldf8f 773e-b>ee0020 * REQUIRED
    3P7l9d7d16e4a55s28be63df6 2cl8ed7f1acf5b6a6rea f9d883t1c487h74i9s 92fieclb9dbb61d27f8 4->0 * REQUIRED
    b62cPdl0e391a4s70e ef8ce91ld7ec9ead6er61075ae7d t414h0f9bbi045eas dfieal6ed5dd 5-9>24b45e4 * REQUIRED
    6Plf6d729eaa69s5e 03cc4l3e6db0a7a17r4 ecthi289c9bs f9ie9ed9f54ld02f4052e ef0-9>77af5eaa741 * REQUIRED
    a1Ple9aea8ea3a7s90563ae66b8096566 acbl3eee2a1f8b1r 3t3h19i2s01c7 df9b2adi5ee91bld5c e-c>e7 * REQUIRED
    7f7dd3abP04laease5 3c91cl0e52cc209ac501d0r 873t46hfais7 3ea057d0f266c8e7ielfd6ec3 1b-7b1>3 * REQUIRED
    8c197P8l62ea60e08s62ee 8clf8e52a69r4077 d32tb6bh225i8feadbs4d3 f597dif2elfd -2b>795e3deaf6 * REQUIRED
    e13dcb1fa141833P29096l2ce8a3451s22e7 1bc925clb202de1ar 6t49hbi8sa e04bf74eb9fi1eld5 ->191b * REQUIRED
    cfP4lc6fe67ase c5el991b9dead9r8 328753aethf3i87cs0b 1bfa5d5ielf1d529c86d 7-023>29a2f9392bb * REQUIRED
    48e874P9cle3a46sa0e990203 4c6343ldedaa6br 861c1803ftahbif9bfs84f8 f1d7ie17e5de9dld65a ->70 * REQUIRED
    5fPlafeb3fc8a0se94 c29d7le2dae3a552r ed5376th2i17babbf4c1052sb6b1 efeie7ld7 da1bb-d0c7>6e6 * REQUIRED
    7fd063Plf0b0c3efe1caaas0bf7dc2e515e8 cal57acee35f8a0r93 cthf73b7is9c 695f152fielad8 4->4a8 * REQUIRED
    43dbPbleas4ec6ed3800bb1e 196ccb55aalefa37f24a717r0a2 76tc42f3h84is dd5fbi27e3dld8 ae93->e8 * REQUIRED
    809Pefl400eaf39bas6e6e0cbb5d588d 88c149f1leb15ar46 55tc7h2iesc e5f604i1757de8d8ld 1->5bd70 * REQUIRED
    fPal5e3a17sea0ad 5cledcbafrd5869cf05c e7th50iff78c25dse5f818 dc65f95i41678fb2e1le9d -08>91 * REQUIRED
    9b1cPlea7fcc993se 49641cdlfbf9a53a44ff026ef80ar9 thcb47b141dbi0s5d6 f7ie1d1l665007d 60->e6 * REQUIRED
    2P7eacle050aa5d9fcs30e cl4efa71b5r t9h49ic37ce32be8sb61 2fbccfbi7b9e1584932ld3ec7 -1d6>6b9 * REQUIRED
    457a18P2le74ad059se6 90ce02l48e39a2ea54dr3f61 c1t3bh8i7s cbc2cafice1aea1ld8 -6>713382b7b66 * REQUIRED
    c3241b25fa8888b68Ple8eeas088ee7 9cl6eeb4095260a3r27 thi3s f69df7ie9c8e4laf7cd -ef63>aefb2e * REQUIRED
    3776c306P765lce060502abca860se3c8844 dcl8earb19 59thfi57sb 2bffie6279ldc6 c1205b2b8014->25 * REQUIRED
    51Plee45bf0e6d78asb5de bcca05le64b7b25a7rd7 t1c1d63d0dbhi0d7s cae088daffi7ed31bbld 4-1>bfa * REQUIRED
    46117328e6ePb6c85la8ea6s508e e72acb5le3ar 53dth6ei7a7b280s2b ccfce4i418edda1l29d134 b->cdc * REQUIRED
    b3ce5ePlbe7aefsde ef8907cleeae2e78a02b9cb4br54 1tbhid846sa c8f3cb4fic1edlecdd6 a-2a09ac3f> * REQUIRED
    fP971l7ee8aaa2f9a5e4e8s9eb48 2c910fd16lear 9828c2t58hbib66s f8ie62ld5 7392dc3d-89d5>be3ee0 * REQUIRED
    bPabl0e02ase162 cc04645a9d02lecdb0a6cr 7t1dhid1sec4 77f47f3icbef7df09al3fad9d8 35-58>0eb7a * REQUIRED
    a38fa2cb6568P1ca59e0lea612s97c7e c6lee0486ar14 tf820heis79 c74f2d3i98e06el9c34fd2bf a->975 * REQUIRED
    30125d0a587P2dlc0eaea04dbse da3b0c1l0bea5rf de603td3hba993c29is5 f3beiel7ad 9-e2a>530ed999 * REQUIRED
    2e4Plea4c68s3ee cf79d63fl81ea0rc89743244c5c 09t9his 1e2fie1ed93826l6d574a547 f-1>3c8494519 * REQUIRED
    d7e5fb1e6bb1766Plb39022e6aa40sceb c7elea2d2fr3d 91ta7f716hi6sfd fcie1747b087ld8b98 b-b30>7 * REQUIRED
    069Pa87ld8ea5a1se 2d1cfc11led837ae88r88a70 4t295h9a45fbi9ads44 a7fi67ela4c85f6de 61-4fb>e7 * REQUIRED
    6dcP9cl0eeac2sb8ee4180eb8cb59135c2d c6fele3bd7a7r 84c926t8da1his5 ccf3fiee28blde0 97-ec>3f * REQUIRED
    8P309l3ae0aa9se e6642cle7a9668c43604r at961e44hd00i7af952s 96e9fiefl500d6d27bc -bc3>5c1ede * REQUIRED
    6c1583a956d87f3P2e5eel8ee5a2ase1 5dfc07cldfe8baar7 th7b01i4497eds073b 3ffiel5e5fd8 82-c>b3 * REQUIRED
    5P2l8c7ebbf0ad35as0c36966e 2bcb5al83f2e6eac2c4cb8r a8t6ah955fi99s7e efd0ai8581eld4 6f12->9 * REQUIRED
    9324f7P5ldeasafe6f 264clear4 fb9t3f8bhf5cca26c4080fieas fie2074fccl7d3f7ff9455 -c17ca>1c6c * REQUIRED
    a1aPe4lefase1 7cad8dle5cb8ae6cd09r2 t51f4bhi292sef 8afidcd22e74l8dc49a73f67 2-3>f0126a8413 * REQUIRED
    5bcbPdel5e3a3a1ase2ef b397calb360bea2023686ra6f 50t29477hb3ics 2fieeb50l5d9 9ff->fe4137bc3 * REQUIRED
    3dPal52ease2e64 e3cdlefb2ee3a9r 04dt401hd16b0cis8ee 416fbfa3fi162el1de08da 51e6c05->314745 * REQUIRED
    461Pld64e9ase9654 10edccl8608e96a78c65r3f1 4th588is79c60 efaif6e6l4dc344 5de4270-a>b48615d * REQUIRED
    1ec865a28caPdeld42c578e04d9as24eeb2 235cle9ca201r27b d6t4d370chi224ed10s afi45eld1 -7>1000 * REQUIRED
    24e80dPlacefe9acs81ee7 a7ccff4l34b4a7870ear52 dt831chcieaaf94esa 1ff59aie89aldcf4a6 25-5b> * REQUIRED
    02b78aPl7ea67cs3d6e cl6eea0dr 8td45941ec97bc601a95ad04fh7ib01dcd385424ds 5bf0i7eel5df7 ->0 * REQUIRED
    76Plf1ecabs4e90c c524le9846fa2a12ea48f701cre t86abh31ei999a4se4 318af9e7i79eled06252c b->c * REQUIRED
    fPc6a51l7efas7ae a7dcbl3b680ce48cfc6c88835a97a8r04fa7 this1 dbfi0c21eflb23d39 -ce0>f795bd0 * REQUIRED
    0049bbd50aPle5e80d7ab9s4f85e1 fa5c4lbfd3ea7r0c9bd 37t0h74i5cbas fie5c52al3d -02>ab954e83f3 * REQUIRED
    76fP7lce6as66e7c3e6ce542a1e4f490 cbbl6e58a7633r8 0t4hfee0b88949i3sf c7f8602i9elfd 43-e>83f * REQUIRED
    cd46a97fa0Plea6971c6ees6e 0cl87e0a778c87r4 8thc2b85fisb 511f661i24elab857df380 5-5fd>fad70 * REQUIRED
    933Pa790l2480ef4de13a8a58se4 c65c708b49edc9l74ear t9h572i3eds fi12ce90l3d6e c37-474>91d892 * REQUIRED
    c6cP04cbl5860b96fa2e8asef09f4e4 a08c1d01d1l212e4ar97 thai0cs 2f12iee1l2d 542b2fe1-4>38429e * REQUIRED
    6bfbP6212a0l0eea9a2c5sdfc72e61ea1 4ff8cleear 09thi00s 2fdif3bbe05l4ded7e1f8 6bed-db8>e6db9 * REQUIRED
    de3Pedl78ease c8a1l8b2b5eafr3 b0733d6a8te49ehc78cb3cis8f6c9a6bba0 fdbfi95aealddedc -bc>487 * REQUIRED
    60P82049fa38blea2s945ecd7 c4l35cb46de2a654ra646ad0 6t283ch5i7s 80a4b2a8ffabielf9d28 -c>e5c * REQUIRED
    de38ca5cdb43d4150P1lfe1as91ec78e4 3c2c17l2242c38b73e4a9r tabhd9ics 1ff4ie0lc4b63da97 ->f5e * REQUIRED
    f9P22le16aads64e5ad f8367c39fl1e545a75r23 et95h814bis1 c965703c23fifa2e0b626ldc 89d->4c470 * REQUIRED
    3c8P1c1el18ease cf7l694ecaea148er07 203t8ebffah84is fid6e3be070869ld2a7f673 bc2e-220e>8b5f * REQUIRED
    P732leea5se52a decd94lddee288aa6r8 8tehi51bcc2as98 97ccf9id6ea74l74d71 3-980311>2904e3f806 * REQUIRED
    3bdPel14e48efa21bbs9e1e cl6dd56ce3b3ae142r3c7 t59473ach4aeafi0570s7e9 f0fib5e94l2dc297 ->3 * REQUIRED
    a4bf68P88e3bad1ele07aa09sea82e70f 053cle3a0cr8e9 403tb872h62c80ib5s e1f5i629e5f0cl1dc5 ->8
    * REQUIRED
    643428ePale6eeas8eae9418d c5l1dea8ee0ra 282d5988t0hi3788s31 cfdidf33e472le54db6d bae48-b6>
    * REQUIRED
    7Pa7be8lb2eca4s908e95 8cldce3ad64a9cr97a bbtdh0i5s 5f47efa0i0c06e9a46bcec9al0d4b e->865d09
    * REQUIRED
    82c3Pl7a5ea81c556495740a8s15d95aec 81ac8l04ear4c3 thi58s410 25fi7ecdle152d -7106>c60590658 * REQUIRED
    edd60Pel6729edasdee2 2cldaeaae5e55a0ea73653cd0re dbfteheifs6 c26065fi41fe5c5lbd 3e41->36fa * REQUIRED
    5bP7d2blf78ea6749asbeb cdf56l70fb86ea0ra7d77 64tcachies4 1f5f6808c8iee4lbdde1361f6dc 5d->a * REQUIRED
    77ePlb55b277fcb165ee48ase 305ec8cef2lea89cdr1e 12tbdh7is75e fci3aefl92d41b -336c>535770a4a * REQUIRED
    86dP8lefa2se5 c9f25bdlc3ffear2b09 475dd7e9thiffcs3 60fdc2fia7fc7fe13ld767a96e 104a88-337>4 * REQUIRED
    fPd7l7beaf7se465c7 3180c0l9ed8a69fr6 tehfis363224082e7 2ad7fafieb7e8bl19d291c7 5aedf4->37b * REQUIRED
    c6feP8a1l76edb5b7ecas3f3e c8l794fe90a8r9 t0hi1fbe3s9 3b8fefeeic7e16lcbccdd1e0a102df -56>d1 * REQUIRED
    Pa8061lbcae4asbae9231 cf56db2l12e69a839cd86rf e916t4efhied66s 217f95i15eeba0ld789e84 -4>55 * REQUIRED
    3e5ae4e4545P4lebaesd3efbbbd79 87c80l5a22e9da3ac65er9cc9ce564 db2t72hi81s0b fif2eb3l7d1 f-> * REQUIRED
    18ec1397adfbPlea488e3a0affs3072ce5 cleeca3f6r t1d17hi0f7sd 6fiel5b14465d 89391a-3a438fb>d0 * REQUIRED
    6500b8fdbc19dP8lcea6a7se3 637cclea8dba608e0b77r9075d1d82 3thf6i3se fcfbid8e8cl142da -4>0e1 * REQUIRED
    Important: You 26may be makcin7g4 use aof autefomated024 form5-filf6l7ing s4of4990twa4re. Thfis ty0p5ef o39f softwcare can trigg3er 0ou8r hidden spam6-2de6tedction dsysa2tem, waahic0h willb bblcbo0ck you from subcmittinga 92this 77f9orm. 3Palease4 se5lect Faix Tdf8hi4sbd60f6dccf739b462868b41 030b0b6ef8da6fe2boc81rb765bead12afab687a6a8 9fc0245dbdc217om8pl44eting thce311e f43ore8dm b9i5d2n8c orfdc5berf toa cee5ora7r4e927c7897c0t6 dt74chb706e 3fd5p0rob7lem.3
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