This form will only need to be completed once. This is not an event registration form, since we do a “first come, first served ” format at most events.
The personal information submitted in this form will be used by our staff when applying for grants. That way, we can continue to provide services completely free for our AccesSurfers.
Pre-registration is only required for Wounded Warrior events and specialized clinics.
We kindly ask that groups of 10 or more volunteers, please contact us at firstname.lastname@example.org
If you have any questions, please email us at: email@example.com
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.
- 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 below if you do not wish to give media consent to Accessurf Hawaii, Inc.