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DEPARTMENT OF PARKS & RECREATION (DPR)
COUNTY OF MAUI
Wailuku, Maui, Hawaii

ADULT'S ACKNOWLEDGMENT, WAIVER, RELEASE
AND INDEMNIFICATION AGREEMENT

IN CONSIDERATION of the permission and privilege granted by the COUNTY OF MAUI to the undersigned (hereinafter referred to as the "Participant"), to participate in the: Shredsgiving Skate Event on November 30, 2024 at the Mayor Hannibal Tavares Complex Skate Park (hereinafter referred to as the “Activity”) jointly conducted by the Department of Parks & Recreation (DPR) of the County of Maui & One Love Skate, (herein after collectively referred to as the “Event Organizers”), the undersigned agrees as follows:

1. Participant acknowledges and understands that the Activity may involve physical activity, and participation in the Activity may result in bodily injury or property damage to the participant. The Participant’s engagement in the Activity is entirely voluntary.

2. Participant agrees to defend, indemnify, and hold the Event Organizers, its officers, employees, agents and servants harmless from and against any and all losses, liability, claims and demands for personal injury, death, illness such as, but not limited to, COVID-19, and/or property damage arising out of or in connection with the Participant’s participation in the Activity, and further agrees to reimburse the Event Organizers for all costs, expenses, charges, including reasonable attorneys’ fees, in connection with any defense or judgment of any such claim.

3. Participant agrees to defend the Event Organizers in any litigation in which the Event Organizers is made a party, arising out of the Participant’s participation in the Activity, and further agrees to reimburse the Event Organizers for all costs, expenses, charges, including reasonable attorneys’ fees, incurred in connection with any defense or judgment resulting out of any such litigation.

4. Participant hereby releases the Event Organizers, its officers, employees, agents and servants from and against any and all claims, demands and/or causes of action the Participant may have for property damage, personal injury, or death arising out of or in connection with the Participant’s participation in the Activity.

5. Participant confirms that the Participant is covered by medical insurance to pay for expenses that may be incurred due to personal injury resulting from the Participant’s participation in the Activity.

6. Participant acknowledges that Participant is not an employee or independent contractor and is not entitled to any pay, compensation or benefits for participating in the Activity.

7. Participant confirms that he/she at least 18 years of age, and has read, understands and agrees to the terms of this ACKNOWLEDGMENT, WAIVER. RELEASE AND INDEMNIFICATION AGREEMENT.

IN WITNESS WHEREOF, the undersigned has executed this ACKNOWLEDGMENT, WAIVER, RELEASE AND INDEMNIFICATION AGREEMENT on this day of October 31, 2024.

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
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*
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Participant's 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(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*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
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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