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Island RV

The Big Island of Hawaii's Full Service Tour & Transportation Company

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Island RV

75-5785 Kuakini Hwy.  Kailua, Kona, HI 96740 email: Info@islandrv.com   

Call Us Toll Free at: 800-406-4555 or In Hawaii at: 334-0959

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ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM

Name of the Activity or Event: Hawaii’s Ocean Day Camp for Kids
Date of Activity or Event: Ongoing

I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN THIS ACTIVITY OR EVENT and on behalf of my child, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault. I certify that I/my child are physically fit, have sufficiently prepared or trained for participation in the activity or event, and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in this activity or event. I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of the activity or event in which I may participate, and that it will govern my actions and responsibilities at said activity or event. In consideration of my application and permitting me to participate in this event, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this event, THE FOLLOWING ENTITIES OR PERSONS: Island RV, Inc d.b.a. The Beach Shack.

I further release their directors, officers, employees, volunteers, representatives, and agents, the activity or event holders, activity or event sponsors, activity or event volunteers; (B) I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity or event, whether caused by the negligence of release or otherwise. I acknowledge that Island RV, Inc d.b.a. The Beach Shack and their directors, officers, volunteers, representatives, and agents are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific event or activity. I acknowledge that this activity or event may involve a test of a person’s physical and mental limits and may carry
with it the potential for death, serious injury, and property loss. The risks may include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, actions of other people including, but not limited to, participants, volunteers, spectators, coaches, event officials, and event monitors, and/or producers of the event, and lack of hydration. These risks are not only inherent to participants, but are also present for volunteers. I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity or event. I understand that at this event or related activities, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the event holders, producers, sponsors, organizers, and assigns. The accident waiver and release of liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL. 

Child's Name:
Child's Age (At Time of Activity):
Email Address:
Father's Mobile Phone Number:
Mother's Mobile Phone Number:
At What Hotel will you be staying in Hawaii?

I have read and understand the ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM and by accepting and entering my name on this form agree to the terms and conditions of said form.

Actual signature will be required in Hawaii prior to participation in activity.

 

Accept
Decline
Electronic Signature of Parent or Guardian(Enter Full name):
Date: