AccesSurf follows strict public safety protocols due to COVID-19.
All volunteers and participants must wear masks while on land and keep a physical distance of 6 feet.
If assistance is required using a wheelchair, we require masks are worn until the water’s edge and the equipment disinfected after use.
We request you not participate in any in-person event for the follow reasons:
If you have come in contact with anyone who has had symptoms or tested positive within the past 14 days regardless of whether personal protective equipment was utilized.
If you have been having any of these symptoms within the last 14 days:
- Fever or chills
- Shortness of breath or difficulty breathing
- Muscle or body aches
- New loss of taste or smell
- Sore throat
- Congestion or runny nose
- Nausea or vomiting
If you are currently sick, feel unwell, or might be getting sick.
If you have any doubt about the safety of yourself or others.
This is not an event registration form. It is our waiver that only needs to be completed one time to attend our events.
The personal information submitted in this form will be used by our staff when applying for grants to assist us to continue to provide free programs.
If you have any questions, please email us at: firstname.lastname@example.org
* We may ask for an updated waiver on occasion when we update our systems.
ACCESSURF HAWAII, INC. INSURANCE WAIVER & RELEASE OF LIABILITY FORM
In consideration of being allowed to participate in any way with Accessurf Hawaii, Inc. and its member organizations athletics/sports programs, and related events and activities, the undersigned:
- Agree that prior to participating, will inspect the facilities and equipment to be used, and to the best of his/her ability believe that if anything is unsafe, he/she will advise Accessurf Hawaii, Inc. of such conditions and refuse to participate.
- Acknowledge and fully understand that each participant will be engaging in activities that involve risk of serious injury, including permanent disability or death, and severe social or economic losses which might result only from his/her own actions, inactions, or negligence of others, the rules of play, or the condition of the premises or any equipment used. Further, that there may be other risks not known to us or not reasonably foreseeable at this time.
- Assume all the above risks and accept personal responsibility for the damages following such injury, permanent, disability or death.
- Release, waive, discharge, and covenant not to sue AccesSurf Hawaii, Inc. its member associations, its affiliated clubs, their respective administrators, directors, agents, instructors, and other volunteers or employees of the organization, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and leasers of premises and equipment used to conduct the event, all of which are hereinafter referred to as “releases”, from demands, losses and damages on account of injury, including death or damage to property, caused or alleged to be caused in whole or part by the negligence of the release or otherwise.
- Acknowledge that each participant has reviewed the latest information and guidance from public health authorities regarding the risks associated with epidemic or pandemic diseases, such as COVID-19; fully understands those risks; and agrees to take appropriate measures to mitigate those risks.
- Including: I agree not to come to an event:
- If I have been having any of these symptoms within the last 14 days, regardless of whether the symptoms appear to be related to COVID-19: sore throat, cough, chills, body aches, body rash, shortness of breath, loss of smell, loss of taste, fever at/or greater than 100 degrees Fahrenheit.
- if I am sick, feel unwell, or might be getting sick.
- if I have come into close contact with anyone within the past 14 days who has COVID-19 or may have been exposed to COVID-19 (“close contact” means within 6 feet of distance to the person(s), regardless of whether personal protective equipment was being utilized).
- if I am subject to a State or local quarantine or isolation order based on my recent international or domestic travel or any other reason.Including: I agree not to come to an event:
- if I have any doubt about the safety of myself or others if I participate.
- Including: I agree not to come to an event:
- Media/Photo Release: I hereby authorize and grant full permission to Accessurf Hawaii, Inc. to take photograph(s), film, and recorded interview(s), to be used for publication that Accessurf Hawaii, Inc. may consider to be of benefit to the organization, and/or to further educate the public on accessible recreational opportunities in Hawaii. Please check the box above if you do not wish to give media consent to Accessurf Hawaii, Inc.