Loading...

Access Waiver and Release Agreement 

Over the Palehua Properties Owned by Gill 'Ewa Lands, LLC; 

Palehua Ranch LLC; and Edmund C. Olson Trust No. 2 (the “Property”)

 



I acknowledge that there is an inherent risk of personal injury during this trip and other subsequent trips to the Property, and I agree that I am participating of my own volition. I recognize that I may encounter certain dangers, including, but not limited to: riding in vehicles over unimproved and uneven roads; hiking on trails that may be wet, slippery, and steep; hiking in areas where solid footing may be obscured by vegetation; and significant visibility, temperature and climate changes. I recognize that participating in service projects and other activities on the Property, which may include but are not limited to planting, invasive species removal, fencing and trail building, may involve the use of heavy and sharp tools on steep and/or uneven surfaces and may be inherently hazardous. I recognize that shoes with good traction and a heel are recommended for hiking and service work to minimize the chance of slipping or injury caused by sharp objects. I am aware that the Property may not be suitable for small children. I also understand that there are no bathroom facilities, potable water, or telephones, and that emergency care and evacuation may not be readily available. I will take appropriate steps to ensure my personal health and endurance during the access, including rest, food, water, and carrying any prescribed medication I may be taking.

I acknowledge that Palehua Ranch, LLC, Edmund C. Olson Trust No. 2, and Gill 'Ewa Lands LLC, (collectively or individually the “Parties”) make no warranty or representation, expressed or implied, regarding the conditions that may be encountered during this and other subsequent trips.

I am in good health, and am not aware of any physical or medical condition that might endanger myself or other participants. I have read and agree to follow all Property rules, regulations, and safety instructions listed herein, as well as all applicable laws.

I hereby release and agree to indemnify and hold harmless the Parties and their respective employees, officers, directors, trustees, agents, guests, and invitees against any and all expenses, costs, claims, causes of action or liabilities (including, without limiting the generality of the foregoing, attorneys' fees) for damages, expenses, injury, death, damage to or destruction of property, or other losses, which I, or any person claiming through me, including accompanying minors under my supervision, may have, which may arise or result from my trip. I further agree that I will be responsible either for personally supervising the minor(s) or for making arrangements for supervision of the minor(s) by another responsible adult.

I agree to follow the Palehua Property Rules, attached below as part of the agreement.

This agreement is freely and voluntarily executed.

Initial here:  

  I am not an employee of Gill 'Ewa Lands, LLC; of Camp Palehua, LLC; or of Palehua Ranch, LLC and am not entitled to Workers Compensation for any injuries sustained while on the Property. 

 

 CONSENT AND RELEASE TO USE IMAGE

I understand that photography, including flash photography, videography and other recordings, may take place during my visit to the Property and while participating in activities on the Property. I hereby give my permission for the Parties to photograph, videotape, or use any other electronic method of recording my likeness to be used at the discretion of the Parties in any publications and/or websites. I give the Parties the absolute right and permission to make, copyright and/or use, re-use or publish said photographs/video footage of me in which I may be included in whole or in part, and waive any right to inspect and/or approve the finished printed materials, videos and/or websites where my image appears. I understand that all such recordings, in whatever medium, shall remain the property of the Parties. I waive my right to compensation for my appearance in these printed documents, videos or websites and in any and all future uses of the photographs and/or video footage.

This agreement is freely and voluntarily executed.

Palehua Property Rules

In consideration of the permission granted to me by Palehua Ranch LLC, Edmund C. Olson Trust No. 2, and Gill 'Ewa Lands, LLC to travel through and over the Property, I agree to act in accordance with the following policies.

1) Campfires and smoking are not permitted to minimize the risk of wildfires.

2) Firearms, archery equipment, and/or weapons are not permitted.

3) Camping is not permitted on the Property without prior written consent of the Parties.

4) Bringing plants or animals onto the Property is not permitted, with the exception of plants or seeds intended for outplanting during service projects for which prior approval has been received from the Parties. All gear (shoes, clothing, packs, etc.) must be inspected and cleaned as necessary to remove seeds and soil prior to entering the Property.

5) Visitors may not cut, remove, or damage any trees or vegetation or collect souvenir specimens, or collect, trap, kill, or otherwise molest any animal on the Property except with written permission when such activities are directly related to a conservation, scientific, or educational project.

6) All refuse must be packed out, not burned or buried.

7) Visitors must stay on predesignated roadways to prevent trampling of native vegetation, minimize the spread of weeds, and ensure visitor safety.

8) Visitors may not interfere with the activities of Property staff or others who have been granted permission to use the Property.

9) Visitors are expected to notify Ranger Thomas Anuhealii of any destructive or suspicious activity observed on the Property.

10) Call Ranger Thomas Anuhealii (808-570-6264) when entering or exiting the Property or to report any issues or concerns.

11) Visitors must follow any special rules that are in effect at the time of their visit when informed by the Parties.

March 3, 2024


First Participant's Name

First 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 Information

Age (if a minor):
First Participant's Signature*
Second Participant's Name

First Name*

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

Age (if a minor):
Third Participant's Name

First Name*

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

Age (if a minor):
Fourth Participant's Name

First Name*

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

Age (if a minor):
Fifth Participant's Name

First Name*

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

Age (if a minor):
Sixth Participant's Name

First Name*

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

Age (if a minor):
Seventh Participant's Name

First Name*

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

Age (if a minor):
Eighth Participant's Name

First Name*

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

Age (if a minor):
Ninth Participant's Name

First Name*

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

Age (if a minor):
Tenth Participant's Name

First Name*

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

Age (if a minor):
Parent or Guardian's Email Address

Email*

Confirm Email*
Yes, I want to receive invitations to future Volunteer Events at Palehua.
Additional Information

Please print the name, address, email address and phone numbers of the participant's Emergency Contact below, should someone need to be contacted during your visit.


Name *

Relationship to participant: *

Mailing Address *

City *

State: *

Zip: *

Telephone (mobile): *

Telephone (other):

Trip Date(s)

Trip Date(s)

Permission to enter and access the Property pursuant to this Access Waiver and Release Agreement Over the Palehua Properties Owned by Palehua Ranch LLC; Edmund C. Olson Trust No. 2; and Gill 'Ewa Lands, LLC ("Agreement") shall expire one (1) year from the date of execution of this Agreement. Thereafter, Participant shall execute another Agreement prior to entering the Property. Palehua Ranch LLC, Edmund C. Olson Trust No. 2, and/or Gill 'Ewa Lands, LLC reserve(s) the right to deny entry to the Property to anyone for any reason permitted by law.

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*

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 Information

Age (if a minor):
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!