Loading...

Beach Boy Hale Surf Company Liability Waiver Form

Assumption and Acknowledgement of Risks Release of Liability and Indemnity Agreement.  Inconsideration of being allowed to participate in water sports events and activities and/or being provided with water sport recreational property or services, for myself and any minor children whom I parent, legal guardian or otherwise responsible, and for my/our heirs, personal representatives or assigns.

Acknowledgement of Risks. I acknowledge that water sports and water recreational activities are very dangerous and involve the risk of serious injury and/or death.  Risks include, but are not limited to changing tides and water flow, collisions, capsizing, inclement weather, equipment failure, operator error, all of which can cause serious injury, paralysis, and./or death.

Express Assumption of Risk and Responsibility. I agree to assume responsibility for all the risks of the activity, whether above or not, even those arising out of the negligence of the release named below. My/our participation in the activity is purely voluntary. I assume full responsibility for any minor children for whom I am responsible for any bodily injury, accident, illness, paralysis, death or loss of personal injury even if caused, in whole or in part, by negligence of the releases named below, to the fullest extent permitted by law. I understand that I am the only person authorized to operate any watercraft provided to me, and I will not allow anyone else to operate the watercraft. I am familiar with and will comply with the rules and regulations for safe operation of the watercraft.  I understand that I am responsible for any damaged or broken equipment and that I will pay for such equipment upon request.

Release.  I hereby release (Name of Lessor) DIGE Corp DBA: Koa Beach Service, Beach Boy Hale Corp DBA: Beach Boy Hale, Honu Kai Beach Service, Waikiki Beach Boys, DYC Enterprises DBA: Waikiki Shores Beach Services, Waikiki Shores, Duke's Lagoon Waikiki LLC, State of Hawaii DLNR,  its principals, directors, officers, agents, employees and volunteers, and each and every landowner, municipal and/or government agency upon whose property and conducted (“owner”), if any, (Collectively “Releasers”) from any and all liability of any nature for any and all injury or damage (including death) to me or my minor children or any other persons as a result of my/our participation in the activity, even if caused by the negligence of the released named above or any other person includes myself) to the fullest extent permitted by law.  I hereby agree to indemnify and save and hold harmless the releasers and each of them from any loss, liability, damage, or cost that may incur arising out of or related to the use of any watercraft provided to me, or arising or related to my participation in the releasesor otherwise.

I HAVE READ THIS ASSUMPTION AND ACKNOWLEDGE OR RISK, RELEASE OF LIABILITY, AND INDEMNITY AGREEMENT. I UNDERSTAND THAT BY SIGNING THIS DOCUMENT, I AM WAVIING VALUABLE RIGHTS, INCLUDING ANY AND ALL RIGHTS I MAY HAVE AGAINST THE RELEASES, THE OPERATOR NAMED ABOVE, OR THEIR EMPLOYEES, AGENTS, SERVANTS OR ASSIGNS AND INTEND MY SIGNATURE TO BE COMPLETE UNCONDITIONAL RELEASE INDEMNITY TO THE GREATEST EXTENT ALLOWED BY THE LAW.

First Participant's Name

First Name*

Middle Name

Last Name*

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

Email*

Confirm Email*
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Participant's Information
Can you swim?*
No
Yes

Enter your date of request *

Enter your time of request *

What is your hotel name or place staying? *
What activity are you doing today? *
Standup Paddleboard
Surfboard
Bodyboard with Fins
Mask Snorkel Fin Set
One Person Kayak
Two Person Kayak
Private Surf Lesson
Private-Group Surf Lesson
Private Standup Paddleboard Lesson

Please enter the amount of each equipment you will be using? *
What location are you wanting to do your activity?*

Please leave any additional information.
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*

Middle Name

Last Name*

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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!