Friends of Kaena Beach Cleanup 9/15/12
Please RSVP to this event by filling out the Volunteer Waiver and Release Agreement form below by September 12, 2012. Mahalo!
I AGREE TO RELEASE, INDEMNIFY, AND HOLD HARMLESS *
Friends of Kaena as well as their respective officers, directors, employees, agents, leaders and partners against any and all costs, claims, causes of action, and liabilities which I or any other person may claim through me, for damages, expenses, injury, death, damage or destruction of property, or other losses which may arise from the inherent risks of participating in the activities today. This agreement is freely and voluntarily executed.
I attest that I UNDERSTAND ALL DIRECTIONS SPOKEN TO ME BY FRIENDS OF KAENA EVENT STAFF (HEREAFTER ‘EVENT STAFF’), *
and everything written in this waiver and release. If I do not understand something, I will ask an Event staff member to clarify whatever it is I do not understand until I do understand. I have read, understand, and agree to follow all of the beach rules, regulations, safety instructions, standard operating procedures, and all applicable laws.
I UNDERSTAND THAT I MAY BE PHOTOGRAPHED DURING MY WORK AS A VOLUNTEER AS PART OF FRIENDS OF KAENA’S EFFORT TO DOCUMENT ITS PROGRAMS TO FURTHER THEIR
CONSERVATION PURPOSES. *
I give Friends of Kaena permission to use my likeness in, but not limited to, newsletters, reports, and media releases. Use shall be for non-profit, conservation purposes, including conservation, education, and community outreach. I hereby waive any rights to inspect or approve the finished image.
I AM IN GOOD HEALTH AND AM NOT AWARE OF ANY PHYSICAL OR MEDICAL CONDITION THAT MIGHT ENDANGER MYSELF OR OTHER PARTICIPANTS. IF I HAVE ANY DOUBT AS TO MY HEALTH & STRENGTH, I AGREE TO PERSONALLY INFORM THE EVENT STAFF AT THE EVENT PRIOR TO TAKING PART IN ANY ACTIVITY. *
I have notified the event coordinator of any special medication or condition he/she should be aware of. I have taken or will take all necessary and appropriate steps to ensure my personal health and endurance during today’s activity, including getting enough rest and carrying enough food and water and any prescribed medications I may be taking.
I ACKNOWLEDGE AND UNDERSTAND THAT DURING MY VOLUNTEER SERVICE AT THIS EVENT TODAY I MAY ENCOUNTER CERTAIN INHERENT DANGERS AND RISKS ASSOCIATED WITH MY INVOLVEMENT IN THE ABOVE-REFERENCED ACTIVITY, *
including, but not limited to: variable waves and water conditions; sun exposure; stinging and biting insects and marine life. I may be using tools and equipment that can cause injury. I recognize and appreciate that my service today puts me in jeopardy of an inherent risk of personal injury from the above-mentioned risks and dangers, and I agree that I am participating of my own volition.
Address Line 2
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Bosnia and Herzegovina
British Indian Ocean Territory
Central African Republic
Democratic Republic of the Congo
Republic of the Congo
Papua New Guinea
Saint Kitts and Nevis
Saint Vincent and the Grenadines
Sao Tome and Principe
Trinidad and Tobago
United Arab Emirates
United States Minor Outlying Islands
Virgin Islands, British
Virgin Islands, U.S.
Friends of Kaena
Kokua Hawaii Foundation
Are you 18 or older?
IF VOLUNTEER IS A MINOR (under age 18) - Parent/Guardian sign here by typing their full name
Digital Signature of Volunteer - Sign here to complete this waiver by typing your full name
Do Not Fill This Out