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Search for:
About
Video Channel
Online curricula
News | Updates
Programs
Community Schools
Imi Wai Ola
NALU Studies
PNP
WIRED
SOAR HI
21st CCLC Mālama | Lōkahi
About
Newsletter
Enroll / Apply
Video and Online Activities
Fishpond
Oral History Archive
Lā Ohana Days
School Visits – Huaka’i
ʻIke Kūpuna
Contact
FishpondWaiver
webmaster
2023-02-08T20:48:01-10:00
You may Sign a Waiver OR Register for a specific event here:
(Required)
Sign a Waiver
Register for a La Ohana Day Event
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Event(s) now registering:
La Ohana Day SEPT 2023
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Who is attending?
(Required)
1 adult only
Group/ or Family (adults and/or children)
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Register Me/Us Please!
(Required)
1 adult
Group or Family (adults and/or children)
Legal Name (if under age 18, please ask a parent or guardian to complete this form).
(Required)
If you're under 18, your name goes in another part of this form.
First
Last
Email address
(Required)
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Are you a Malama or Lokahi afterschool student
No
Yes! Mālama
Yes! Lōkahi
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Name of Group or Family (optional)
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How many adults total, including yourself, are in your group?
Total # adults in your party
Please enter a number from
1
to
1
.
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Names of the Additional Adults
Please ask your other adults to sign their own waiver at thepaf.org/waikalua/waiver Thanks!
Minors (children, students, anyone under 18 yrs of age) (if applicable)
#
Please enter a number from
0
to
4
.
One per line please.
Name(s) of students/children, minors (under 18 yrs old).
Agreement
(Required)
Waikalua Loko I'a is owned and operated by the Pacific American Foundation Hawaii, Inc. and Pacific American Foundation, a 501(c)(3) nonprofit organization for educational and charitable activities that benefit the public.
I will attend a visit, community workday or other activity at Waikalua Loko I`a located at 45-231 Kulauli Street in Kane‛ohe, Oahu, (hereinafter "Event"). I agree to conduct myself with great regard for my own and others' safety and expressly agree to the following:
I. Assumption of Risk, Release and Waiver
Pacific American Foundation Hawaii, Inc., and Pacific American Foundation and their officers, agents, employees or representatives, docents, volunteers and all others acting on their behalf, hereinafter "
PAF Released Parties"
do not provide liability insurance, or otherwise indemnify against injuries or any other liabilities arising from our participation in the Event.
I hereby give permission to use photos of me, my group, or my child during the Event. 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.
PAF Released Parties are not responsible or accountable in the unlikely event I / my child/children contract COVID-19 due to participation in the Event. IF I AM FEELING ILL or have tested positive, I WILL NOT COME.
II. For DOE participants only, the following terms apply:
The STATE shall be responsible for the damages or injury caused by the STATE, STATE's agents, officers, and employees, in the course of their employment to the extent that the STATE's liability for such damage or injury has been determined by a court or otherwise agreed to by the STATE, and the STATE shall pay for such damage and injury to the extent permitted by law. Pacific American Foundation shall be responsible for damages or injury caused by Pacific American Foundation, Pacific American Foundation's agents, officers, and employees. In the course of their employment to the extent that Pacific American Foundation's liability for such damage or injury has been determined by a court or otherwise agreed to by Pacific American Foundation and the Pacific American Foundation shall pay for such damage and injury to the extent permitted by law.
III. For PAF Staff participants only, the following terms apply:
I understand that community work days are not part of specific work duties, unless specified in my work contract, and are undertaken by me in the role of volunteer. Any injuries sustained are not part of my work duties, nor the responsibility of the PAF Released Parties, and are my personal liability.
I have had the opportunity to read this entire document, and agree to be bound by its terms. I release, relinquish, and forever discharge PAF Released Parties from any and all claims any and all causes of action that I (and minor children accompanying me, if applicable) have or may have, past, present or future, known or unknown, anticipated or unanticipated.
I agree to these terms
Signature
(Required)
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