Visitor Sign Up

Waikalua Loko Ia Visitor Sign Up for Educational or Recreational Activities

School Groups, Other Groups, Individuals

Primary Contact Name (must be 18 yrs or older)*
First Last
Email*
Enter Email Confirm Email
Phone*
Activity:*
Preferred Date for Visit*
Date Format: MM slash DD slash YYYY
2nd Choice*
Date Format: MM slash DD slash YYYY
3rd Choice*
Date Format: MM slash DD slash YYYY
Total number of registrants*
Please enter a number from 1 to 40.
Type of Registrant(s):*
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
First Name Last Name 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.
Will you need a Community Service Certificate?*
- Yes
- No
What entity requires your completion certificate?*
Do you currently live in Oahu? Or are you visiting Hawai'i?*
- Local in Oahu
- Tourist/Visitor
E Komo Mai (Welcome)! Where are you visiting from?*
- Other Hawai'ian Island
- U.S. State other than Hawaii?
- Oustide the U.S.?
Island*
City State ZIP Code
State*
City State ZIP Code
Country*
State / Province / Region Country
Any additional information you want us to have?
Electronic Signature
Date
Date Format: MM slash DD slash YYYY
Name
This field is for validation purposes and should be left unchanged.

Save and Continue Later

In your household:

Has anyone tested positive for COVID-19?

Is anyone on home isolation?

In the past 5 days, has anyone had any of the following symptoms that are new or worsening, and not attributable to an unrelated pre-existing condition?

- - - Fever greater than 100.4 °F or feeling feverish (chills, sweating)
    - Cough
    - Shortness of breath/difficulty breathing
    - Sore throat
    - Unexplained muscle/body aches
    - Nausea/vomiting or diarrhea
    - Loss of senses of taste or smell
    - Unusually weak or fatigued
    - Runny or congested nose
    - Headache
    - Skin rash
    - Chest pain or pressure

In the past 14 days:

Has the Department of Health told you or a member of your family that they have been in contact with a person with COVID-19?

Has someone who lives with you or works closely with you been told by the Department of Health to stay home?

Has anyone participated in a group gathering of more than 14 people?

Has the student/participant traveled out of the state and, as a result, currently under quarantine orders by the Department of Health or your medical care provider?

Has the student/participant been in close contact (less than 6 feet apart for more than 15 minutes) with anyone that has been diagnosed with COVID-19?

During activities, we take steps to keep students/participants safe, and ask you to assist us:

Learning tools given out to specific individuals may not be shared amongst students/participants.

Learning tools will be cleaned and sanitized by the individual who is handling it, under direction of staff to ensure proper cleaning and storage.

All participants/students shall continue to wear masks and physically distance at least 6 feet when practical. When distancing is not practical and cannot be maintained, after a period of 10 minutes, children will pause work and step away from each other for 3 minutes before returning to the activity.

Student work, when complete, can be photographed and emailed to the field lead instructor.

Waikalua Loko Ia Visitor Sign Up for Educational or Recreational Activities

Before coming to activities, each student/participant must perform a daily symptom screening. Please help us keep everyone safe and healthy.

In your household:

In the past 14 days:

If you have answered YES to any of the above,

please contact PAF and do not come to face to face activities.

Before coming to Pacific American Foundation (PAF) in-person activities, please help us by following the recommended guidelines:

When you arrive:

During activities, we take steps to keep students/participants safe, and ask you to assist us:

At the end of the day:

First Name	Last Name	If under 18, please indicate age in years.	If K-12 students, please indicate if Native Hawai'ian (Y/N)