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MEDIA WAIVER AND RELEASE FORM


By signing this document, I acknowledge that I will be participating in a FAM, press trip or individual visit hosted by the Maui Visitors and Convention Bureau (“MVCB”), as well as other sponsoring organizations, to include Maui, Molokaʻi and/or Lānaʻi and, if applicable, other Hawaiian islands. Offerings may include, but are not limited to, round trip air travel, hotel accommodations, tours, attractions and/or other activities and some meals.

By accepting and participating in the media/press trip, I for myself, my personal and company/organization representatives, successors, assigns, heirs, legal representatives and next of kin, represent and agree to waive and release the Hawaiʻi Tourism Authority, Hawaiʻi Tourism United States ("HTUSA"), its Island Chapters, and those other organizations who donate or offer to donate media/press trip goods and services, and their officers, directors, employees and agents, from and against any and all rights and/or claims I may have for any loss or damage arising out of or in any way related to, directly or indirectly, the FAM, press trip or individual visit.

This Waiver and Release is intended to include, but not be limited to, any injuries, loss or damage that may be caused by the negligence of the Visitor Bureau Entities in sponsoring and/or organizing the FAM, press trip or individual visit. This Waiver and Release is further indented to include, but not be limited to, any consequential damages, which may result from delays, cancellations, modifications of itineraries or complaints that arise from transportation, accommodations, tours or other planned or scheduled activities. I further acknowledge that by organizing and otherwise participating in the booking of transportation or activities for the FAM, press trip or individual visit, the Visitor Bureau Entities are not acting as my agent. However, to the extend the Visitor Bureau Entities are construed as my agent, I acknowledge that the Visitor Bureau Entities’ agency is limited to the arranging of transportation and/or activities and that the Visitor Bureau Entities are not assuming liability for any injury, damage, loss or accident that may be caused by the negligence of those persons or entities that are providing said transportation and/or activities.

I also fully understand and acknowledge the following conditions:

  • It is my desire as a responsible journalist/social influencer to keep visitors safe when they visit the Hawaiian Islands and ensure the destination is portrayed respectfully, paying close attention to cultural sensitivities, areas of no trespass and general safety.
  • I acknowledge receiving HTUSA’s Sensitive Destinations and Activities materials and understand the importance of why these areas should not be visited during my visit or included in any stories I am writing. I will reference this in conjunction with HTA’s Maʻemaʻe Hawai‘i Style & Resource Toolkit.
  • While there are no state or county restrictions for COVID-19 in Hawaiʻi, I will do my part in keeping the island community safe by following health and prevention practices, as well as respecting any COVID-related protocol set forth by Hawai‘i businesses or organizations. For example, some may still require or encourage the use of face masks to protect those who might be more vulnerable.
  • With regards to hotels: 
  • Even in the case of complimentary accommodations, hotels may put a temporary hold of varying dollar amounts on my credit card. I agree that I will be responsible for ensuring that the credit card I use for this purpose is capable of handling this without any problem. I also note that debit cards in particular may incur overdraft charges, of which I will be responsible for, if my credit limit is exceeded.
  • With regards to car rentals: 
  • MVCB’s daily car allowance is meant to cover rental car expenses including gas. Any additional expenses including car upgrades, GPS, insurance, fuel purchase options, additional rental days or drivers are not reimbursable by MVCB.
  • If I return the rental car with less than a full tank of gas, I will be charged for refueling expenses which will not be reimbursed by MVCB. I also acknowledge that when I do refuel the car prior to returning it, it is my responsibility to show my gas receipt as proof of purchase to the rental car attendant. Failure to do so could result in additional fees.
  • I will be held responsible for any citations or penalties resulting from my operation of the rental car, including (but not limited to) moving and parking violations and the use of hand-held cellular and electronic devices while driving, which is now illegal in Hawai‘i.
  • With regards to activities:
  • All scheduled activities have a minimum 24-hour cancellation policy unless otherwise noted. I understand that failure to comply with this policy will result in me being charged the full retail price of the activity.
  • Punctuality is expected for all scheduled activities. Departure times are firm as listed on the itinerary. If running late, I will contact the MVCB representative immediately. Transportation (taxi or rideshare) to the activity will be at my own expense.
  • Services that are not specifically covered in my itinerary, such as meals, hotel services, Internet access, parking, etc., will be at my own expense.
  • If packing or purchasing sunscreen, I will use mineral-based products. Maui County passed an ordinance that bans the sale, distribution and use of non-mineral sunscreens without a prescription due to chemicals in some sunscreens washing off and harming coral and other marine life.  
  • The use of drones is prohibited. Any exceptions must first be approved by the Federal Aviation Agency.
  • MVCB may be reimbursing me for some of my travel expenses at the conclusion of my trip and will therefore be issuing a Form 1099-MISC to me as required by law.

I hereby certify that I am 18 years of age or older and that I have read this Waiver and Release and fully understand its contents. I understand that I am giving up rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law. I understand and agree that this Waiver and Release will be construed in accordance with the laws of the State of Hawaiʻi and the United State of America and that, if any portion of this Waiver and Release is held to be invalid, the balance shall continue in full force and effect.

Today's Date: November 17, 2024 

 






First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

Job Title

Publication(s)

Story Angle

Height and Weight (Mandatory for helicopter tours, horseback rides and water activities)

Preferred Departure Airport

Preferred Arrival Airport
Swimming Ability? (for water-based activities)*
Do you have a scuba diving certification?*
No
Yes

Names of any additional travelers

Special Requests

King or Two Queen Beds
Do you have car insurance?*
No
Yes
Valid driver's license and able to drive*
No
Yes

Please list any allergies. If you do not have allergies, please enter N/A *
Any health problems, dietary needs or phobias?*
No
Yes

If yes, please specify:
Do you have health insurance?*
No
Yes
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

Job Title

Publication(s)

Story Angle

Height and Weight (Mandatory for helicopter tours, horseback rides and water activities)

Preferred Departure Airport

Preferred Arrival Airport
Swimming Ability? (for water-based activities)*
Do you have a scuba diving certification?*
No
Yes

Names of any additional travelers

Special Requests

King or Two Queen Beds
Do you have car insurance?*
No
Yes
Valid driver's license and able to drive*
No
Yes

Please list any allergies. If you do not have allergies, please enter N/A *
Any health problems, dietary needs or phobias?*
No
Yes

If yes, please specify:
Do you have health insurance?*
No
Yes
Third Participant's Name

First Name*

Middle Name

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

Job Title

Publication(s)

Story Angle

Height and Weight (Mandatory for helicopter tours, horseback rides and water activities)

Preferred Departure Airport

Preferred Arrival Airport
Swimming Ability? (for water-based activities)*
Do you have a scuba diving certification?*
No
Yes

Names of any additional travelers

Special Requests

King or Two Queen Beds
Do you have car insurance?*
No
Yes
Valid driver's license and able to drive*
No
Yes

Please list any allergies. If you do not have allergies, please enter N/A *
Any health problems, dietary needs or phobias?*
No
Yes

If yes, please specify:
Do you have health insurance?*
No
Yes
Fourth Participant's Name

First Name*

Middle Name

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

Job Title

Publication(s)

Story Angle

Height and Weight (Mandatory for helicopter tours, horseback rides and water activities)

Preferred Departure Airport

Preferred Arrival Airport
Swimming Ability? (for water-based activities)*
Do you have a scuba diving certification?*
No
Yes

Names of any additional travelers

Special Requests

King or Two Queen Beds
Do you have car insurance?*
No
Yes
Valid driver's license and able to drive*
No
Yes

Please list any allergies. If you do not have allergies, please enter N/A *
Any health problems, dietary needs or phobias?*
No
Yes

If yes, please specify:
Do you have health insurance?*
No
Yes
Fifth Participant's Name

First Name*

Middle Name

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

Job Title

Publication(s)

Story Angle

Height and Weight (Mandatory for helicopter tours, horseback rides and water activities)

Preferred Departure Airport

Preferred Arrival Airport
Swimming Ability? (for water-based activities)*
Do you have a scuba diving certification?*
No
Yes

Names of any additional travelers

Special Requests

King or Two Queen Beds
Do you have car insurance?*
No
Yes
Valid driver's license and able to drive*
No
Yes

Please list any allergies. If you do not have allergies, please enter N/A *
Any health problems, dietary needs or phobias?*
No
Yes

If yes, please specify:
Do you have health insurance?*
No
Yes
Sixth Participant's Name

First Name*

Middle Name

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

Job Title

Publication(s)

Story Angle

Height and Weight (Mandatory for helicopter tours, horseback rides and water activities)

Preferred Departure Airport

Preferred Arrival Airport
Swimming Ability? (for water-based activities)*
Do you have a scuba diving certification?*
No
Yes

Names of any additional travelers

Special Requests

King or Two Queen Beds
Do you have car insurance?*
No
Yes
Valid driver's license and able to drive*
No
Yes

Please list any allergies. If you do not have allergies, please enter N/A *
Any health problems, dietary needs or phobias?*
No
Yes

If yes, please specify:
Do you have health insurance?*
No
Yes
Seventh Participant's Name

First Name*

Middle Name

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

Job Title

Publication(s)

Story Angle

Height and Weight (Mandatory for helicopter tours, horseback rides and water activities)

Preferred Departure Airport

Preferred Arrival Airport
Swimming Ability? (for water-based activities)*
Do you have a scuba diving certification?*
No
Yes

Names of any additional travelers

Special Requests

King or Two Queen Beds
Do you have car insurance?*
No
Yes
Valid driver's license and able to drive*
No
Yes

Please list any allergies. If you do not have allergies, please enter N/A *
Any health problems, dietary needs or phobias?*
No
Yes

If yes, please specify:
Do you have health insurance?*
No
Yes
Eighth Participant's Name

First Name*

Middle Name

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

Job Title

Publication(s)

Story Angle

Height and Weight (Mandatory for helicopter tours, horseback rides and water activities)

Preferred Departure Airport

Preferred Arrival Airport
Swimming Ability? (for water-based activities)*
Do you have a scuba diving certification?*
No
Yes

Names of any additional travelers

Special Requests

King or Two Queen Beds
Do you have car insurance?*
No
Yes
Valid driver's license and able to drive*
No
Yes

Please list any allergies. If you do not have allergies, please enter N/A *
Any health problems, dietary needs or phobias?*
No
Yes

If yes, please specify:
Do you have health insurance?*
No
Yes
Ninth Participant's Name

First Name*

Middle Name

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

Job Title

Publication(s)

Story Angle

Height and Weight (Mandatory for helicopter tours, horseback rides and water activities)

Preferred Departure Airport

Preferred Arrival Airport
Swimming Ability? (for water-based activities)*
Do you have a scuba diving certification?*
No
Yes

Names of any additional travelers

Special Requests

King or Two Queen Beds
Do you have car insurance?*
No
Yes
Valid driver's license and able to drive*
No
Yes

Please list any allergies. If you do not have allergies, please enter N/A *
Any health problems, dietary needs or phobias?*
No
Yes

If yes, please specify:
Do you have health insurance?*
No
Yes
Tenth Participant's Name

First Name*

Middle Name

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

Job Title

Publication(s)

Story Angle

Height and Weight (Mandatory for helicopter tours, horseback rides and water activities)

Preferred Departure Airport

Preferred Arrival Airport
Swimming Ability? (for water-based activities)*
Do you have a scuba diving certification?*
No
Yes

Names of any additional travelers

Special Requests

King or Two Queen Beds
Do you have car insurance?*
No
Yes
Valid driver's license and able to drive*
No
Yes

Please list any allergies. If you do not have allergies, please enter N/A *
Any health problems, dietary needs or phobias?*
No
Yes

If yes, please specify:
Do you have health insurance?*
No
Yes
Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
EMERGENCY CONTACT INFORMATION

In case of an emergency, please list anyone who you would like us to contact, and with whom you will allow us to share information about your location, situation, and logistical requirements.

PRIMARY CONTACT


First and Last Name *

Relationship

Phone Number *

E-mail Address
W-9 Form

Once you submit this form and confirm your email, you will be redirected to the online W-9 Form. Please fill out and return to: sheree.quitevis@finnpartners.com.


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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.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Job Title

Publication(s)

Story Angle

Height and Weight (Mandatory for helicopter tours, horseback rides and water activities)

Preferred Departure Airport

Preferred Arrival Airport
Swimming Ability? (for water-based activities)*
Do you have a scuba diving certification?*
No
Yes

Names of any additional travelers

Special Requests

King or Two Queen Beds
Do you have car insurance?*
No
Yes
Valid driver's license and able to drive*
No
Yes

Please list any allergies. If you do not have allergies, please enter N/A *
Any health problems, dietary needs or phobias?*
No
Yes

If yes, please specify:
Do you have health insurance?*
No
Yes
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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