Waikalua Loko I’a Home
Visit the I’a
Huaka’i, Schools, Groups
Lā Ohana Days
The Pacific American Foundation
A 501(c)3 Public Charity
Tax Id: #54-1696134
Herb Lee, Jr., Executive Director
Main Phone: (808) 664-3027
Visitor Sign Up
Visitor Sign Up
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Visitor Sign Up for Educational or Recreational Activities
School Groups, Other Groups, Individuals
Primary Contact Name (must be 18 yrs or older)
About Your Visit
School Group/Field Trip Visit
Other, Fishing, Recreational
Preferred Date for Visit
Total number of registrants
Please enter a value between
Type of Registrant(s):
Individual, not college student
Individual, college student
K-12 School Group
Other Group (Social, Club, Organization)
About your group
School or Organization Name
Identifier (Class Name/Group Name)
Number of children/youth
Number of Adults (teachers/staff/chaperones/parents)
Students from grade(s):
Please tell us who will be attending
If under 18, please indicate age in years.
If K-12 students, please indicate if Native Hawai'ian (Y/N)
Or upload your own list
First Name, Last Name,Age (if minor is under the age of 18), Native Hawai'ian (yes or no).
Accepted file types: pdf, xlsx, docx, xls, doc, jpg, png.
Are you registering to fulfill a Community Service Requirement?
What entity requires your completion certificate?
Are you local or visiting Hawai'i?
E Komo Mai (Welcome)! Where are you visiting from?
Other Hawai'ian Island
Continental United States
Any additional information you want us to have?
Please review, and sign below. We will be attending an educational field site visit/community workday at Waikalua Loko I`a located at 45-231 Kulauli Street-in Kane‛ohe, `Oahu.
We agree to conduct ourselves with great regard for our own and others safety. We further understand that Windward Nazarene Church and its members, and Pacific American Foundation and their officers, agents, employees or representatives, hereinafter the “Released Parties,” do not provide liability insurance, or otherwise indemnify us against injuries or any other liabilities arising from our participation in these educational activities.
In consideration of us being permitted to participate in these educational activities, we EXPRESSLY AND VOLUNTARILY ASSUME ALL RISK OF PROPERTY DAMAGE, PERSONAL INJURY OR DEATH sustained during or that may result from participating in this event whether or not caused by the negligence of Windward Nazarene Church, and its members, and Pacific American Foundation or the released parties.
We hereby release, agree to defend, hold harmless, indemnify and discharge Windward Nazarene Church, Pacific American Foundation and the Released Parties from any and all liability claims, demands or causes of action that we may have for injuries and/or damages arising out of our participation in the educational field site visit/community workday, including but not limited to, losses CAUSED BY THE PASSIVE OR ACTIVE NEGLIGENCE OF OURSELVES AND/OR Windward Nazarene Church, and its members, and Pacific American Foundation or the released parties.
We further agree that WE WILL NOT SUE OR MAKE A CLAIM against Windward Nazarene Church, and its members, and Pacific American Foundation or the released parties for any damages and/or other losses sustained as a result of our participation in the educational field site visit.
WE HAVE READ AND UNDERSTAND AND AGREE TO THIS ASSUMPTION OF RISK, RELEASE AND WAIVER STATEMENT, AND WE SIGN THIS STATEMENT WITH FULL KNOWLEDGE OF ITS CONTENTS AND MEANING, AND WE SIGN THIS STATEMENT OF OUR OWN FREE WILL.
I hereby give permission to Pacific American Foundation to use photos of me, my group, or photos of my child at the work day or school visit to the fishpond. I understand that the intended purpose of the video or photograph will be used solely for educational purposes. I waive any rights of compensation or ownership thereto.
BY TYPING YOUR NAME YOU ARE ELECTRONICALLY SIGNING THE AUTHORIZATION AND VERIFYING YOUR IDENTITY AS THE PERSON LAWFULLY AUTHORIZED TO SIGN. You must be 18 years or older to sign and submit this form.
This field is for validation purposes and should be left unchanged.
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