2018 IMLCA Adidas All-Star Game - STX Rivals Lacrosse Challenge Presented By CSE

You have been nominated by your coach/program to participate in the IMLCA adidas All-Star Game! This is a showcase to highlight and recognize your accomplishments. The game will take place Friday evening, June 15th in the Stadium at Lebanon Valley College at 6:15pm.

Please fill out all of the appropriate information below. Players will check in at 5pm for the ASG next to Field 2 (Turf Stadium).

There is no cost associated with the event, but you must wear all Adidas gear and equipment provided.

If you have any questions please email Travis Puls [email protected] and/or [email protected]

First Name*
Last Name*
Player Email*
Parent/ Secondary Email*
Phone*
Position
Club Team*
High School*
Are you committed to college?*
- Yes
- No, Uncomitted
If you are committed, please list school:
Height*
Weight*
Shirt Size*
Short Size*
Shoe Size*
Twitter Handle (include @)
Instragram (include @)
WAIVER AND INDEMNITY AGREEMENT AND RELEASE Acceptance of my participation in this event is without responsibility of any kind by Corrigan Sports Enterprises, Inc., the IMLCA organization, Adidas and partnering programs, or any other entity sponsoring the event. I do hereby for and on behalf of myself and my heirs and legal representatives release and forever discharge Corrigan Sports Enterprises Inc, event sponsors, all of directors, officers, employees, agents and representatives of each, from liability for any and all claims, demands, and injuries, however arising, by participating in the any aspect or by the actions of the aforementioned parties or the representatives of other sponsoring entities, or by third parties, which injuries may be in any way related to my activities before, during and after the events and any period traveling to or from the events described. The parent or guardian by signing below does hereby agree to release and hold harmless all of the above mentioned parties from any liability which the participant may incur, however arising and regardless of how or when they are incurred. During the course of the aforementioned events, I give permission for any licensed physician or authorized medical staff members, or certified trainer to follow standard medical or hospital procedures in administering any required medical or surgical care. Player irrevocably grants to the sponsors of the Game, the Promoter of the Game (including other sponsors and Corrigan Sports) absolute right and permission to use his name, image, voice, likeness, and biographical materials and any indicia of identity in any and all media, including, but not limited to print, radio, television, film, Internet and for any lawful purpose whatsoever, including editorial, advertising, promotion of the Team and/or the Game, and/or commercial exploitation in connection with Game-related materials. Player hereby agrees that he/ she will cooperate and adhere to all rules and instructions set forth by the organizers without permission from Corrigan Sports and parental accompaniment. Player represents and warrants that he/ she is free to enter into this Agreement and has no prior or other obligations, agreements or commitments of any kind to anyone that would in any way hinder or interfere with the acceptance, and the full, uninhibited and faithful performance, of the obligations of participation. Player represents to be in good health and condition to play in this event. I understand that the organizer does not provide primary medical insurance coverage for participants and that any applicable medical insurance must be provided individually by such participants. Secondary Insurance coverage, designed to supplement and coordinate with existing primary medical policies is in place. All waivers must be agreed to and signed to be eligible to participate. No exceptions.*
- I have read and agree to the terms of this waiver. If I am under 18, I agree that my parent or guardian has read and agrees to this as well.
ADIDAS EQUIPMENT and APPAREL*
- I agree to wear and use all equipment and gear provided by ADIDAS and the event in the All-Star Game including but not limited to: Cleats, socks, shorts, jersey, gloves, arm pads, sticks (shafts and heads)