Registration and Payment

Need to register and make a payment? Simply fill out the secure form below.

  • Fee:
  • middleclass~spray
    Spam Harvester Protection Network
    provided by Unspam
    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.
    Important: You dmay 0bef3 maakbing 3use 30oaf automate4d form-8fillinfg3 softwaarec3.4 This5 ty1pe50 of bs7foftwafre cabn td9cr3igger our dhided7en s9pam-6d9detection 6s7ystem, 1wahich wildl blo4ck youb from submeitti7ng fth8is2f2 dfdoerm2. Pleease s5ef0le3ct Fibx6 This281b33 19c3eceb9714243f70d5b37f53654ba71ce3dfdfb1d2e56o8arec6895dbea f537c6o3me5c5aple0tidng ctaa86he 1f54o69b1rm bi0na6 o20r2d1erc t7ao377f c9o6rre18c56t4 e3t06e34he b3p23rdbobl0cem8c1e.96
    Important: You ma6y cbe mfafking use of automated for6m-f37illing7 e9fsoftwfaref. This type 9of software caen ftriagger our hid2d0en aspam-detec2tion 0sy6stce6m,5 whbi8ch 89wi65ll 9dblock you fromce submi8t1ting ethis form.45 3bIt appeaars that5 the problem cdould n2ot be autom5abtically corrected. 5Please clear an5feey fdield whidch224 a7ppears9 bel4ow with correspcdonding instructionse7b54c45e647b78d54cf9052da23e5 84cb9d3e0e7def9d66eo338rcb8ba9be de25ca02b96c090o0mplet1idn852g 9t8hef formb3 in ordber t7oaa cor52rf4ec8t2 0fthef00b pr7oblem. We a3pologiz0ee for thed c1id7ncoencve8n2i5ence ab9nd w7ef bappe4ereciate your u1nde2rsta5n0dfin94g4.2
    Team 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.
    cP1lc9debea9sdb004816d9916e55 28dc4dldc4ea7d82r17 th0f45e8972i4s f6fie2b4fl3932d ->e6f56d6 * REQUIRED
    ef26be2db17Pc7leas4ec fc5986d2ble5a4a3r5aac9 da2th16dibs2 2fi0edbldfd -f59f76b808307>ca04f * REQUIRED
    P5l6a1ea5e02d2ds4e 6e4e486c57l33f078ee3bd6b743ar4 ta91h1f27isb f55a9i38e0ld 96d721-a9>4846 * REQUIRED
    6a0P2lefc0ase2b c04l19efd57c81arfdeee 8t9eh42i8d9ce9s7a efe1eei8el13bd1d 76-9ca1319>aa280d * REQUIRED
    c7292bdb28deP9aabe0adle87ca86se09442 3cdf3315a60a9le6a8r et7e6h9cb4f8d57is1 f25iceld6 ->01 * REQUIRED
    3a3fPldd156e3cac7ffase e9c3lbed67ar7f1 t76c36hi17ca5s661 40c7fci3123560dedb0ld4 7-455>b30b * REQUIRED
    e33a12Pl64e209a1acbdse6 c1la48f06ae5ad7r67 8fthisb0 ac1fdaf0ie8d1488l1fd71b d2c8ca-22>158d * REQUIRED
    3f71416ad4Plee7eef692ae8s856e7d1b 8c3lde131aafr b8ftce9his66a025e8 f29iee7706ldca66 ->de66 * REQUIRED
    acfe08cPb9b9l71ed82ebb4cc5e7f674case 366acdl476e98a7cra thb422509is 4cf5i97eld 930-11a3f>3 * REQUIRED
    54cc099009e89ddcfc5P3l7e80ea7da6bs1ced4 b68302caldcearb 86t33hcifsc effie1ld 3d-c4>5b3f6be * REQUIRED
    f2f66Pfl9eas6e c0b9lfb6efeecbar78 4e6273thif4s8 cdf68ff2eiel527ddd66c1 8-9ac71>494c586e0fa * REQUIRED
    8d1e9098aPblb5eaf0sb58df169eb591f2f2 561c5c7lf4ee15c68bacr thi91s885c 5fie9ld e8099e-d>6ac * REQUIRED
    ePflfbd4cd0b8eas5ae5a6 0837630ec1e057aale8a3aaarf 6t2f9h3is ffieldd6d6062d3 40104-01>90d33 * REQUIRED
    P9le4dafd8sa8b52f7e9b8 fddc2lceafa01r0375 th3i0s5b2ea1aa544 5bfd051i6fae648l9da2 0637bd->3 * REQUIRED
    ed15e4Pde9fledab57sd1aea 4cl1eca85ra16 614thieasaf fe74d4ie2aefc61cdlf9dd30f f5fb-c3>61e13 * REQUIRED
    e8ddPld7eeaf6as5e4c0c 7a0d9dfc62le0c24ae5r2b 27cebtdf7fh9e0fis400 f6ie6d54206ld 0ad946b->e * REQUIRED
    8dd7P49le459ada9s8e24 a8559c811cl2021e0d2ac7200br 5tf9c3797h996is5 3b9f726ie2ld6 -1a7dcc>e * REQUIRED
    65fP65l85de69abes0ef99769e5ac312c a52cle6448ar9 bth9i05ds 1f3i8ed584c0c842l9d77 490c-aef>a * REQUIRED
    5efP7aelbfbfe7ba7fd3854202se7 84bcleeaddr 2btdd7h19cei7s3b537 6ee8fci2el9bdc4 c-9f1e0d6>d8 * REQUIRED
    9d65Pfl5e48fbd9e6b2bba593esce524dcc fc62c1e1bleba18ar 4th2iads 67a0f7i0edl02d5f 4adc-6>ac2 * REQUIRED
    50Pcale35bf1ee755a6a97bs0508ad69ee 907bc57le5a747012r8 tc7h0is54053a1 fi1e99cdlcdc 75->f28 * REQUIRED
    5ced4P8f1cel0ease5bcdb438 7acb5l89aebaf442080r 3fba3thf8is670ae93c51 8d8ecfa7ie3l0d 0->889 * REQUIRED
    5Pale3a9s449998eb cleaebfrd96a01 thci2cef7se014921e 51fi228df8d610e92dld 2-8>12d03a10b3f75 * REQUIRED
    38dP1bl1eff8f97fa6s4ee339 7cl30e0a3r4 10t26h8i50s8 cf3ef91cc318ie459e3l9b6bd5 10aeea7-8b>7 * REQUIRED
    8fP293eleaacac1a3fsa24e4 91e2c6e4l1f940e6ea2ra521fd1 t3h3is6 741fif5ceel59f4bb93d a2->5e4a * REQUIRED
    fP0le11531dfc5dadse1 c3le36a2r4ee t4c7b4chbca70c0isb cfa4fi88e5l1bf342d9 5a3->64bf8bc1152d * REQUIRED
    b92d37P1dl36ea1s6b718bb3e ab26285fe47a2cealec95a8rbb at8ahis 2ead2c8fe6ife0ldd79d -b0a>e6f * REQUIRED
    13563b9d0Pld91fbefaca29s4e e0bc80610e1l726641ebar24 924fthb99is b3b3fac7bie8l46d 4-2>07b21 * REQUIRED
    0Pbf9afle8e2b3ca5a0s9e6b3b23 cal2e677ar2b64 dtah7i4aa5sfe71 2aef8bdie5d9l9da1 -5>c33868aab * REQUIRED
    P1le93747135db5eas6e 9bdfc9bdl9e033ed1ar9812b tc6hfi010s fdc9fie0l218085d 7d2a2efd-a7b>a52 * REQUIRED
    6545P9fl83683cef7269as89e clb19ear7 5a9ctch64i182s9a17 fa79fai53e2l3fda3b 9-2e7>959a2fcde0 * REQUIRED
    5c6745e2P24lease9137f5cd39ece8a0 94cl3d7163efa92edc1ea8f6r 8th01b8a3i22s15 4f2i74eld -3>e2 * REQUIRED
    264bPad760leeease 79facccc79le7adbr57bfd019640 3b6d6atbh9icc7se 570feb1e20iel0d7d ->fc6950 * REQUIRED
    2Pl2f9e7a84fsae8 ac8l782ea946bf361r26 t3bh816ie1sc f10f2ie0eflfd42b03c06 5f-b7351ab1a1>afa * REQUIRED
    fb9Pl1e4as76e9b3f9 1c14f8le383defard7 751t46fh5i1d2s 9ffaic3d957aabce4ld 2a9af-70>76945fa6 * REQUIRED
    c45Ple1ase 6c887l741e8eea909r b21atc6cfhi9bs febe067212ab7i036ela9723461ad 00c-57d00c>2f9c * REQUIRED
    d29dP0leas05ae9e79 2a8c067cc509l41570136be80ar53 t4ahfi92s0266f fie4l0d0 -3>e4f30df0b38362 * REQUIRED
    bc505839bcP35blafeas0eb291c27560 9799c440leabr 6865t0h4i25sc80 3f5fia8el4aed5f4e e5-5b>08c * REQUIRED
    8c33eb17P9l8ecadsce50 c2l309e94ad776ar59 tbf4f8a3735hci4acs7a1ff f689fbieflb1d93e706 02->7 * REQUIRED
    96109P8lf433eea6ecbbse503f9a 95bclb8eaa7r55 4f3th0i1s84f9bb 9f6i006el5dbce 7710->cc52f4ed5 * REQUIRED
    aP328f1lceas3770a489eccd4 dcl0e1b8aa0r37 c9thfeieefb65a4s7 fif06ee5e5c89l7bdd 1ec1b-96>552 * REQUIRED
    d82dcb1e9c0c4c0P507le19as2e35 cle3ee32a53e35a567re52 t4hieas6 2f5icc2224e05l610d -ac2>da80 * REQUIRED
    3ea678f5Pl89119ace72e6fcafsc6eb c4l88ae9df5arf433 this430e fe4ie0ldb5e8dd83a 0d41b7->7aed5 * REQUIRED
    3c5P3le83a9aseef56063bbddb fbcle0b604ab5e062r71bc 4thi03c7fdefa0s 4f0dif4e51l0305df225 ->e * REQUIRED
    d752Pcl927ee81b8d95eas1ec a921clea4rb 4fthids55 ffe3eiel4efd8927 93b52c0a5-abc>ec3c0921337 * REQUIRED
    049Pc9el167edadfs9c1e0 0dca9l2e4ab3r5f74e4085e 4d4bb9dt1h5366is fi28ebl159d -4f1e04>40434f * REQUIRED
    0c739P2lef614as6ed 9clbe01e2319abdr0 9t0012b008h0i8s a87fi989edl38d187ac5708f13d5 9e9-9e>4 * REQUIRED
    5Pdlef0a036s4b18ee a34cb3f09flae64fad9fb03re 65t5a7cd8d8hicse07 21fd9i24ce7dlcd 85c-776>7e * REQUIRED
    ecfa80952c3024cP9fl4ceas2aee cl7e51arcbea95 d74te76ehf7i0ccscbd990 fba0dibfe941l31d 8-1b>e * REQUIRED
    a6bfPlea872dsb37eeeb3a0b 1c5cl8ce1ar d2a9thisc21 d706d9fiea6la8322d 428af-24>c32b9d52b603f * REQUIRED
    Pl6f2f07def7fa1b9s2d10eb cc3e8leeab97240r 9c3t636d4d47hcdbiecs04 0ebdfiel3d3 -fe>46d37aa59 * REQUIRED
    153P726763le2a7d8sed4547 e2c9f69c4642913ledar7 0td82bhi937ds34 fiead6e92ld5 236->c6508e5c6 * REQUIRED
    0P1l1ea1s7e87eed2bb 0b7bbce4b9bldecar00537e 3d2ft2fc85ca2h07f9isf5 bfc59ie6l9d9a7 ->a0abd9 * REQUIRED
    eaadb4Peefl0d16fbea91c2sb73e 97d8c5daf5leca7r ct14chi3989s01 9f1i394ea04dacal8d11 52fa->58 * REQUIRED
    aa5d2P72l5ea5fse67 7c6l6efab909r6f1e0 thf0180267i4s fic7c9c246b92e591lc1940fc1edc -9>ad0cf * REQUIRED
    78f6c988b3Pleas2a2a9b0b0e ccc85bbl23ae7a9r24 2tf28fe0hfie0bsd 14f165d0d7i5eeelddd7a a5-5>4 * REQUIRED
    ePbdlbe80cfa20se 6dc43leba9ed2rd tfch11i1ed8d75f86s 2fi478ed1e00f44554dlf6cd5556ef7 ->86bc * REQUIRED
    e11366P1593e7dl00e71a4s773be121ff 46c2cle1a8ar2 4t530h6is5efd35356a 2f7fid925ebabl1da ->43 * REQUIRED
    785b82eaaP2l509ea12bs87c23e 5c62blbear1d 3ct5his 9f47fi80d5ba80285494ede69l8d -b6>d4adb00b * REQUIRED
    87P5b4ldd24671ea1se e97e893ec2bf86308lf1e4aa8r1 006td1h2i37s d5c75f1fiel719701dd13d2a ->6e * REQUIRED
    a9P7el5c2cf505e1as1fbeef1 cc61e36761l8ea2bd292b0ac350r f61tdhia6b424sa ficf2e8a8ld 5666->d * REQUIRED
    0Pl7ce8a37fd43481dsee3 bc4lb35eab076f2r 4590td2hf5dbifs 0f3bei4a5e8l9d63856c 7-8>ae4d4de4a * REQUIRED
    76cbP08lea0afs031efd celea6er5a555b7 12dde1thac2ic5es39 24fbaebfbi2ab3efe6lbfdb9 641ff->fe * REQUIRED
    d4b718f59P58aleaf998ac1a2sea5 a5208c2f2dl1e8761a65rc3b854 t6hf6is bf93bb6d3idefld 0->6a366 * REQUIRED
    aa0463Pl50834de61a2s39e e35ccl8de99arbf0 a34e2ft7ch89271fi684s 1fi48eb24aab8l5addb -9>9e4a * REQUIRED
    d70P9594a1l78d4ee48as498e5d8e8 clc4e6ce51abr819a0 e20235c9fthics47 e0fi0beldd f-e27b9cb2>8 * REQUIRED
    48e823P5026led3a0dbdefsef cd0el3064e9fa49r3eed7 tb4chis4bb6 f285bf1i71ecfd5dlfd bc6cfe->5f * REQUIRED
    943d314b2b76Ple6asd8c271ec5d2dcce 5d497ccel97e75aar8bb7 2tb5he6eicfscc1e03be94 2fie2ld ->2 * REQUIRED
    9P55el22a1e8c7e7cea6bsceb7 c7e2lea9fr7ab6 18eeb594th1is fa228e14ec3bfi0ec61le8da83 ->514f5 * REQUIRED
    47P01757le5072ae6sced6 67clfea16f8r8a eb97t47c2h8cidc8es 094ffied20805ld5 74b6cf4-10>b2e5c * REQUIRED
    7Pf6le6as773619e 6cd712fl44227a18bea32139erd 4atdch39b2is2c5 f2ie6f7l0605df0d6c5 9->a98374 * REQUIRED
    Pclfeasd863ce7a4 8113cc8dl40566ec6aa7c0d5r 61ethc218i9b7cs788 cffi2e5fl307d2e -c32ea>5bfad * REQUIRED
    15383dPf5230dle6ac6fba4fdb422s4be clear5bd6f0 1tf4h0idsb 0c41ddbb2f892ice6blad34e3 3678->d * REQUIRED
    6Pl328ea0se686 a00c97le4818adfa4a6arb7a th4i24s8 e34aff300ice5c7ld736749 0d82a-2>bfb9151bf * REQUIRED
    8b3ePf0f2l36eb74fas0ed7b 43cfclededafcr0 355taeb0h3isaab f7i0661ceel32d3 9a07a-3b>11586dcc * REQUIRED
    f106890P0l8e81dbae6cas4eca99 cl6ea3r0d6201e7e66 9923321fetb13b8545hfci4s9 fide27l73d -4>45 * REQUIRED
    68aPl6e2accase48c 1c9l9eear2b 8e986e962c3ct8a94e9263b08his2 bac4fi8da3elbd c61a9081f-b>9ae * REQUIRED
    5e2b9P0c558df0lb82ce12case90ce0e 2e513b0e85473eeccd7d6fl40eard f7ct4hdis ff2i1eldde -474>8 * REQUIRED
    b9P875l3e6d45ase0 625cele4cee7a799a096966a63dra 632th27is59d cfi7e46ldc13fea e-d8d9a8>0950 * REQUIRED
    9b3P64lea44csbef9ea5b1184eb cf29ecle431a9e21a9dbr 0et7b64hisc5 5b1af66ieldc6 880d-c>82b687 * REQUIRED
    4c4P7839l1eas8ce1b b2bdcfl242e16a5rc4 thai82s 48b7627ccd8f7462441i7el5fd5 -b1683c>89f19bfe * REQUIRED
    c1e63f0Pcleaasa09386ee001150c3 cl5deara3c td109hacied5bsa0cc0 a2bf813i8e05l34dd94eb a->cee * REQUIRED
    38a3bP6ldcefa5c6se3 4570clf5535eeaar40 thisd 5dafe8e228i7dfc8e88317lb4e85bde 7a8137-51>63d * REQUIRED
    Pl19dea60s0ee8f ac25bc460l82e6bacaar78 2th75di0s721 30fi3e3e2dl19d68c7 2078d26dc0363->bea1 * REQUIRED
    Pdl4ee1e2d7a386sd218ee ca55cb4l8e395acr4b91 8e83this55 78d72f6234adi0e2l6684a21d048 -12>2b * REQUIRED
    cc7534faa06Pfc40l7e71d9a8c3se80a cle3607ar4 44bbeted764hb6i3s9 99fcieb079l2dd 2f-d03>33b63 * REQUIRED
    35Pl2eaafs2e 1d9f5ac676922lea4dbr fbd4t71ae2fhaff73i5c3cs1cd7db fi41eee7l60da3ab ->55ff8f5 * REQUIRED
    P4fl7eabs7be8b6 c1declea6r 4bftc29dc42hbdisae67d4af f9cd142f8di24d67f8ecb9ld75da50d -21>a4 * REQUIRED
    bc3Pea18d2efe9l5bbe9a53dease cl9ec2afr th4i7357sf41bf f09fieccf4273228lf69d5a8 7->b3bdcf47 * REQUIRED
    09Pfleaccs6e 0cale37ea4r98 5tah2i35s7e 2ffi8a5e1d1f8l3fa8a4d5 dd712-9ebeb0a8655d1118bb>802 * REQUIRED
    8cb725P64dl1d98e215a631easee68577 2fcdelcear17f8 thi1s39e471d5 0245f4i2eel549cd3 -b4130>18 * REQUIRED
    aab5P3lfeabcas6fdbfbe8 da75f3e1ca7d1clear20b 0405t2622h7i0af8esb 3ef4ie6lea7bdb516 -7>b230 * REQUIRED
    f2Pdle0dc1b0a2se 3b1d1ccal0bf1e48a72r43be5596 e266ae35t8h0isa f1i6470106d3feld 65-7a810>5c * REQUIRED
    aa0f22698fPl3edacb37fesb6bbed 4ce8a2lf69e830ar796 08tfeah5fi575s fdfia132eal725d83 4-5>264 * REQUIRED
    86718Pcele0f79a8s3fce c9l8ecaacr0 7f1th3659i4ds fcfbi5e8el80dddd442477e30 5-99>13807c8cf03 * REQUIRED
    b00799233Pb6acfl8ea91as38219a79e0 5baf1cldeadd129r4eb b3d2tfhe48i106ecs f8iel6db ed1b-6>61 * REQUIRED
    fd077bP68l4faf84eadb02deds9ee3 9cd4c5alear5 b1t19hi8a4d3s3 c0bf8eiel53db00f 5beb63b18-bee> * REQUIRED
    P08leb5aa0d2s350e537 f2c47le8dbea0r5e 8th81ai8858s fieb78fe03f0b90fld8c1ef37d 6e-d>085296f * REQUIRED
    153P40la97cf6eeas5edd 593eccl0e9ar t5fh60ais97 55ff45d6f1f96b0ib7de94e06lb62deb cc62fc->f5 * REQUIRED
    69bePcle4a9a27s4520ae4 2e1c1le9ar c9t80h0101d469ce054e5ia3438se ff86ie6efl33db5 64-3ee>752 * REQUIRED
    b8dePlaed0aef2sae63 c9e07leac8r121 1et0hid4s6 f44i8e7el2d644e83184d31 3bf2825a-1b>f23fce39 * REQUIRED
    6a83Pfae7le7a5dsb1b8d6e927e193a clb77befa547r15f a24d84e2thc1is9bea dfic889el29ebd -3fa>e5 * REQUIRED
    0cbP72e8969l22ce9907eaas4e5 cl58016ff0beaa722r dabtfhie4sea872 2fc82ieeabdbfldf0d0e 6d-fc> * REQUIRED
    d0Pl15aeasdbe4be611e c01le3a1e57r04a 2d8t0hc6is fie53e1eal21c76fcd3d307b dbc6->2a3a4f55b41 * REQUIRED
    4ff3d5cPc5fa36la7eea36sedbc7 f35c6ele2fa9r6d0 t9336ac0h56is3 5caffi8471fefc9ld76 f718->e48 * REQUIRED
    aP6l80ea7b1sef6a 13acle9305ear7 f34tb60b8e7h8i8e78eds dabcf53di89bceee74d14ld05d2 4-fe83e> * REQUIRED
    825e748c15e34P2lceadsec c3l4eae9r10fba1872c 3t2fc7h0i0s7 1cbfbide5ed581lac2ad -e5f900a68>7 * REQUIRED
    933Pl5e2549d3ab7a83s6ee8 1c47cle1aer2f t8fah01cfe52ids 2c54fi40aa46f0eff107lddb c138->3a49 * REQUIRED
    8P8e44l9ee956810e6a9535bsea dec0l9ea92r6 etha2i3336b87c00sd 7bfi0f53e62el2d d5da1-2edf6>20 * REQUIRED
    053757Pl5ae1ade49sbb3be3 cf6lb7ea3a42fr1ee8f51b7c ftfha88i9s e2f0iebl1e09d2c7 -d7cbd2>6c74 * REQUIRED
    Pl9bc40379c9eac7d8345se c92ele5ae8a485r d2tbdd74f308561hie78e1s fcd75ielac40d e6-2d8>3c04c * REQUIRED
    P10008lcedaae22esae7c0c4e0c82 4f9ccled3a4er t3dhbi7f2s89 fef5i23c227e09f8flcdf ->d05adb0c2 * REQUIRED
    6eP9le7a785se9 2cle6a9r12 e2f59f6a2088tf2h53917ice2s ceafib8d6088feld 6b08bf-8b>9d79674964 * REQUIRED
    P1l67e1ebacsedf 8956cflddea6r 1tf563bhis23ab888b 5580b2fde6ifebe43lad 2-ce>71a10117cbf5ca1 * REQUIRED
    0feP5f3l7fe056cb4a4840b73a219s7e 39ecle25ar6441395 ft1ffhiac86463s fieaeld9d16 9-4dd>78f82 * REQUIRED
    126c3ddPle2ad5sea937757b0e4b04 c5l1e2d4aa5322r a3thbi6bs 8f9a7ib700e8e046231ledd215b ->7bd * REQUIRED
    3P0lec3da4a4f6sa4edff0e e83a53231dcl08edeear 5b6th5dise296a22ca f2idel58ea6df1 -4>074a0b97 * REQUIRED
    aPdl088ea3047s89d933e219a156 c1647l3ecaf77r 7t0hi0768s7c 275ff09i15el63a08d3bb a79-88>2944 * REQUIRED
    99cePele0829dabed55367s0cae0fed c3ea90335clbec66ar3a71 tfh32i9s 0fc8iebl7d 0-f0>34e658f9e8 * REQUIRED
    87deP013blde2efascbe8c0 c3776bld4e92aea2ab42c3e70r 660da8e1this90 fi7e54e2ald c-8>363fe985 * REQUIRED
    114c0cPeddl8e2e77a523s6e cd39flf3ea8r 1d947t51hdia4a87084dsea7b ef9cfc8ield686 -1d9e3>f19a * REQUIRED
    f3e5fPlee7edcase4a5f374 3dbc9d5le081ea6fd18r bat55h5f913bi3a8e55sf5 fdield -5>cf7632e546c6 * REQUIRED
    105abPfe2alc36ec4a152s6ed4 c5l21ecdarc617ab6 t7db67hi00bs92872b 2fie11e3d86l7df -5>4fed04e * REQUIRED
    7e48cPa43l4efa597s15e9c 033cdcle6a97930r43 aate4e5dhei3s9ed fiedl12ed08d 62196b-8>33632c4b * REQUIRED
    4dP59l53339ea2e48a9aa5s7e 5b9cd746lea358ca02ar6a 49t453h7i58s76 2fi8c6f0el82a30ab7d3 -28>6 * REQUIRED
    a70f530eP6471l15deea70f1s40e cbclear 7t4h7c771ia5s6 4f564i2489778edl3d -a1>e874fe1588f32c6 * REQUIRED
    5aP2431lfeasee clfe8e052a07r 713019ta045h8bce63407baisb55 fdi39f1e90c5lb4edda 63->91abf030 * REQUIRED
    0f3b3Ple939e910a8bs11e 6b66fcl61755ea050rf0 91ce9ct3h43i6es d1ffi6dee2eld495c7ccd -a>e36b3 * REQUIRED
    4dc82aP3le48b9cdas80ebe082257b01 bcl8e4ea5era5d6d58e 3th98is80 5cf4ei46d117ec61led bb-f2b> * REQUIRED
    2P26lb20790ea4sebbf617ffa80a57a c5939le7acr 309t869hedi3fbs69 c1049f948ieed5l16dd -80>31fa * REQUIRED
    5P0lefa353sfe0 77c7c65cel7e9924ae31b2ba4bbd7ae23bd4a9ar ef8e5detdhis5 b5fidelec3d e2f-266> * REQUIRED
    414fb6Pl51454e4c09a12fa31f79se25 dcl9e63ea6r05fc 3a9th90is87d 6f784f32eia5c3el27d ba08->fb * REQUIRED
    38P15d54cl7ea24e7a0974ese6 7cl7a0a5e1c9f61b63adr 8th9b529eis6 d7df6ied8l9db14 c71-f>b63a34 * REQUIRED
    8c0cP5l2e1ase7e463de 01fcl3e83abf8r562 t9h914dfa8a798e6id07de5s9e fi03e2662b7elcd3d 3f->1b * REQUIRED
    15Pflee15bdedabcd5s48e cl3ec3a2d8r45a c8th622e29fei9d066d2b5s8 07f51ife8e8l7d6 196b42->d74 * REQUIRED
    7Pe5bb1c67lcea5csef cl9efb6c0aar08 a72dt3c3bh9ci2s8 8f0492d82940i1elada4 2-914da>3107eba45 * REQUIRED
    26e06526P327d92bc1lb3fdb8deacs4e f2a0clbbedcb0cc0ar 92th4di71sc fac090ac3iel0d2 12b1-e>2ff * REQUIRED
    dbe92P69l0abea89a9dsbae cle7e0cb9dad9363r33d785e 3ft37a5hi7s fdfi5edf3l0013c3a96d -5cc06>9 * REQUIRED
    96aaP217713leaa14sebad dacl49e8f1eab6r7 73tffacd51bcac564802hif1s fbe3ib53ce7lad5 c->12fc9 * REQUIRED
    027d1c23b2Pe2c2l5d83e5ea8e4eseddf bc8la1ea1car7d t9926c8f90hd8is1 fiel62ffdd 31e1-1e5945c> * REQUIRED
    Pl8b9dea3fs853c677ed cc425a8f482af5f07d32la0e5ecaa7r et0ha2is fai3589e1ldee3c597e 22e3->d2 * REQUIRED
    38908Pla507ecacs0c6ce 6ccle72acarb 7t99e1h917a6iaas fb7ic0e4c7aac8e3l3cda00342 ad19282->35 * REQUIRED
    d7fPlcea36f9c4484cs869e3cde 2c9c3flbd8f46160e240ar this 75fi77006edd4e5ld8dfd0 28c2-f>08ed * REQUIRED
    Pleaas3e 8ea5e27c78le6dcbadara14d67 ct681hi3e6025ffs336c fab6eiel2d 02d2fd1a->6ff9bb1c4ece * REQUIRED
    d0Pb3e1cl36eab6ae653as283e0 c7alea625r7a 0a4thc4f19973i7e1sc185 84ff7i67ebl6d00c24 e2e-8d> * REQUIRED
    171P6a6le3a255sdee 540c89lea3d97d82r250fd t7c5h8fi37s40 f0fi0f55edblcdc5425bdcaa c-ed0>ff2 * REQUIRED
    5P3df5391f010le96a7se4 ce66le9666a40cr66d613786 td32chic60988s0 27e61b22field be-34d74>a3d * REQUIRED
    c6P830e5lf4062dd5eaas6e7a77 e25clb7fdeada73dard65 868t946h9is7 6df3ie8588ldddf7 21e7d-34>2 * REQUIRED
    eb4e42P3500la0082dfc365e6bab3c28s6e104 c4ab1l2feaar7a t77hif56d1cc574ces 4cfe6ield8 -c5>cb * REQUIRED
    7Plee1a896845se99e1 66cfl6b3e8fa8de1e4e973rd271 fbt0ec1fhei0s fbci7ebc9cldf434b -73e1f>86e * REQUIRED
    b8520e89d0e3df0Plead14576s74eb77 dcel946eadr 99d670tf3hids cf8if825b5el53250cd9c2a -1bbe>e
    528P60ld179eaabcs756ee0c0 b4fclea3d2d0r02 t1a77136chi19s8c f35i829e0cl63d3bcb c580b->7eb00
    5d03Plea65acabd50cse 427aae7fe6d7bec4l2f5111e88a1r 4tbh8cies f4c7i411e4ebbld525 -7>af19b19
    f0599Pleba9d7ca2se7809c1e0 7cl70e6ar t0dbe7hebis6 3fbi1b0da6d1a0ee8e2642l03de98 -2fb>43b08 * REQUIRED
    9fa18Padl3eecfa3fc6921bfs91fefd 0c1lea5r et7h6i7c22fedfs6b8 f6a403i19e884381edld05 -da>946 * REQUIRED
    840fPleacs67e5844 cl70188bd65ear7b7 3ft9f5hdd12i84s9 eff0f8ac7ide1b429l3a5dcf3cc4c 2->bd29 * REQUIRED
    fbPl4fe6a73s4efc1 1cle9ada3r6e64c thaiadb6s2d f328b627dde79bi6eel12b0022d 5->61bbcf325b66b * REQUIRED
    406P9cl9d641e5e8359ase774a7 ab58ccl80ea676r04 8e8thias63 8aafiealad5b -033>9497c78dd17a885 * REQUIRED
    25P1l8eea1ba5edfs7e69bd352 cf63dl3c4a2a55ea9rc8 2th846i81sd 9f8i9e1230435ld9 37e94f-dc4c>5 * REQUIRED
    6Pd5709fle223as0aa7e cl9e828bd1e13bc0a3arfd 7td482h3i5ecs4b 80fdibeefb4dl5bddd66 a4-9a5e>6 * REQUIRED
    ed2P6lea5a355d0se31 29bcle5738b4ar9 edthi5sc9b1 ffi1eal2d753786296a 40b->b10d5fb8ca1eb92e4 * REQUIRED
    b47a4Paleab8se bec9l1cffca2ea5r40bf574 910thc2isc f128a2if4ce3l3ac2ce54ced ->70ed69874b84a * REQUIRED
    ad76P77l1dccea9s9df3825e7de 4cl168b1eea6f97672ar b6act7h5788i77s 27efeie297ld3da9f7b 57-9> * REQUIRED
    c0b1ea4ePblf7c5bbe9e41c7as4934eeffa d2ec9ed3le3e151b3adr16f tfh9dias f768f0fd7d67iceld ->6 * REQUIRED
    Important: 6Yf1dou 41may 5becd mak56ing use of8 auto7m1ate8da3 fform-fillia3ng8 s8of8dtwaarcbe.96 dThis typ9e of s2o5ftwar2e15 can tbrigger oeur hidden spabm-d2etec8atieon 9sycstem, ewhich will4 blo3ck yofau fro3m s4ubmi2t3ti8ng 3th1is2 form4. Please se1lect Fixb8 Thais7b5a920e ab1595b8f7aeabfef44oc1bddac23939r37f20a294e1e88cdb07 62f539f62a8ac0omp3b211l9e4td4f52fd4icnbg27 the0 f6bod5rd18b0m5 e0511in 1o608r8d0ecfr0 77toa5 correct0 thef dpro384eb8blf167edm.
    Important: You may be makinag us1e of dautomaatede forem-filling softwa0577re6. This type o6f s9oftware cdan 3trigger ofb6ur ch2aidden spam-detection systeem,c8 wh8ich wi8ll blocak you fro3m subm3itt3ing tah2is form. 7It appears 91that the9 pro55blem c73couald not be 19automatically c9902orr7ecfted. aPb0flea9se7 clear any0 field wchich appears abod0ve 6with correspon3ding ianstructions45 57bb42bc75da3855efdd21ade6e8e9efo5e6d4facr7c552715a6df5fa3e1d149c 4696fcompletin3g the3 9f3orm dinb or99de9r to 4dbcor6r8ectf the p46ro9b2a7lem.7 4We ap6ologiz0e afo753e59r athee 86inconveni9d7e7n1ce5 20and we appre6c47ia99te you1r uneda8berb2as383t02andcing.
    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.
    Secure from Hackers
    What does this mean?:
    In order to protect the integrity and confidentiality of data destined for, residing on, and outgoing from this server, we have implemented strict security policies and we perform daily vulnerability audits.
    Last Scanned: Today at 8:41 AM EST
© Element Athletics Element Athletics