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WAIKIKI BEACH SERVICES, LLC

 

Accident Waiver &

Release of Liability Form


Review Privacy Policy

I, THE UNDERSIGNED, INDIVIDUALLY OR AS A PARENT OR LEGAL GUARDIAN DO HEREBY AGREE TO HOLD HARMLESS Waikiki Beach Services LLC, Kyo-ya Hotels & Resorts LP, Marriott Hotels & Resorts, Royal Hawaiian: A Luxury Collection Resort, Sheraton Waikiki their officers, officials, agents, staff, lessors, owners and their assigns (hereby collectively known as "RELEASEES") for any liability, personal injury, death and/or property damage that may result from our participation in any activity or rental (heretofore known as “Activity”) they sponsor, including but not limited to surf and SUP instruction, surfboard & SUP board rentals, umbrella & beach equipment rentals, cabana & chair rentals, catamaran sailing and outrigger canoe rides.  

I certify that there are no health-related reasons or problems that preclude my participation in this Activity. I acknowledge that this Activity carries with it the potential for death, serious injury, paralysis, damages and/or property loss. The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, lack of hydration, and actions of other people. 

In consideration of participating in this Activity, 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 Activity. 

(B) 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, whether caused by the negligence of release or otherwise.

(C) I understand that participation in any of the events also includes possible exposure to and illness from infectious diseases, including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and, 

(D) I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, 

I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this Activity. In the event that We/I should require medical care or treatment, I agree to be financially responsible for any costs incurred as a result of such treatment. 

In the event that any damage to equipment or facilities occurs as a result of my or my family's willful actions, neglect or recklessness, I acknowledge and agree to be held liable for any and all costs associated with any actions of neglect or recklessness.

I understand while participating in this activity, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the activity holders, producers, sponsors, organizers, and assigns. 

The Accident Waiver and Release of Liability Form 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 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. 

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Health & Safety of Participants
Please check all those that apply: *
I attest that I am not experiencing any symptoms of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.
I attest that have not been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19.
I attest that I have not been diagnosed with Coronavirus/Covid-19 within the last 14 days. I am following all CDC recommended guidelines as much as possible and limiting my exposure to the Coronavirus/COVID-19.
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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