Powered by WebWaiver.com

Koieie Fishpond Volunteer Waiver


Kō‘ie‘ie Fishpond Volunteer Waiver

‘Ao‘ao O Nā Loko I‘a O Maui 
RELEASE OF LIABILITY FOR VOLUNTEERS

IN CONSIDERATION of granting me permission to engage in volunteer work and other activities, including, but not limited to, the inspection, reconstruction, revitalization and maintenance of the Kō‘ie‘ie Fishpond and related areas, the undersigned hereby releases ‘AO‘AO O NĀ LOKO I‘A O MAUI, its OFFICERS, AGENTS, DIRECTORS, SUPPORTERS, EMPLOYEES and OTHER VOLUNTEERS, hereinafter referred to individually and collectively as “RELEASEES”, from any and all claims, demands, actions, causes of action, responsibilities and/or liabilities of any kind, whether for damage to personal property, for personal injuries, for death or for any other injury or damage, which may occur from any cause of any nature arising by virtue of or during my performance of volunteer work as heretofore described, during my travel to or from the volunteer work and/or while engaging in any activities on land, in the ocean or on the fishpond wall which related to said activities in any way. 

I agree that safety is my own responsibility and that it is not the responsibility of the Releasees. I understand and agree that I may be  permitted upon request to enter the ocean and/or be near or upon the fishpond wall in order to provide volunteer work, and I know that the  ocean and the fishpond wall are dangerous for many reasons, including slippery or loose rocks, currents, tides, wave action, weather, boat traffic, marine life, actions of other volunteers and persons and many other reasons. If I choose to engage in or provide volunteer activities of any kind, including those which may require me to enter the ocean or be near or upon the fishpond wall, I hereby agree that I do so at my own risk, and I realize and acknowledge that this release discharges Releasees from any and all liability and responsibility for any harm or injury which I may incur as a result of doing so.

I agree that this release is effective as a release of claims which may be brought by me personally, and that the release also applies to any and all claims which may be brought by my family members, spouse, heirs, personal representatives, executors and/or assigns. 

 

Photo/Video Release

I hereby grant ‘Ao‘ao O Nā Loko I‘a O Maui permission to use my likeness in a photograph or video in any and all of its publications, including website entries, without payment or any other consideration. I hereby irrevocably authorize ‘Ao‘ao O Nā Loko I‘a O Maui to edit, alter, copy, exhibit, publish or distribute this photo or video for purposes of publicizing ‘Ao‘ao O Nā Loko I‘a O Maui’s programs or for any other lawful purpose.

Emergency Contact Information
If any of the participants covered by this release form have any health concerns that we should be aware of, please list them. Example: back, knee or shoulder injuries, etc.
RELEASOR:
This waiver is for only one adult and/or his/her minor(s). If participant is under 18, enter parent/guardian's name.
Enter the legal names for all minors who will be participating, separated by a comma.
Electronic Signature and Acknowledgement
Enter the date and your full name to acknowledge your electronic signature of this document.
Your Electronic Signature*