Printed Name of Participant (Diver #1):  First Name*Last Name*           
Participant’s Date of Birth:   Date* Phone Number:         Phone Number*   Address:  Street Address*      City*   State*   Zip*   

RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT
I, the above-named person, being above the age of eighteen (18) years, or the legal guardian of the above-named person who is under the age of 18 years (hereinafter referred to as “Minor”) on behalf of myself, next of kin, heirs, guardians, assigns, personal representatives and estate (or those of the Minor if I am his/her Legal Guardian) and in consideration of the opportunity to participate in the UVSC SECOND ANNUAL TRUCKER DUKES MEMORIAL DIVE on June 22, 2024 (the “Event”) do hereby acknowledge, promise, agree, and covenant with UVSC, a Hawaii nonprofit corporation, the Rinzai Zen Mission and any and all people, companies, or organizations associated with the Event, their administrators, directors, agents, officers, members, volunteers, and employees, other participants, officials, rescue personnel, sponsors, advertisers, owners and lessees of the premises on which the Event is conducted (collectively hereinafter referred to as the “RELEASEES”) as follows:
ACTIVITY DESCRIPTION
Participating in the UVSC SECOND ANNUAL TRUCKER DUKES MEMORIAL DIVE (the “Activity”) involves swimming, diving, spearfishing, a land obstacle course, art activities, trash collecting on the beach, all of which may occur on uneven and slippery terrain, dangerous sea conditions, unknown under water conditions, adverse weather and around other Participants with spear guns and other diving equipment who will also be in the ocean. Participants, ages 7 and above, may dive from what is commonly known as the baby beach portion of Baldwin Beach to what is commonly known as the Cove portion of Baldwin Beach. Participants, under the age of 7, will participate in land based activities, including but not limited to, an obstacle course and artwork activities located at the Rinzai Zen Mission, as well as trash collecting in the surrounding areas. 

ACKNOWLEDGEMENT OF RISKS
I FULLY UNDERSTAND AND ACKNOWLEDGE that: (a) Activity INVOLVES RISKS AND DANGERS OF SERIOUS BODILY INJURY INCLUDING BUT NOT LIMITED TO SERIOUS INJURY, PERMANENT DISABILITY, AND EVEN DEATH (“Risks”); (b) there is an inherent danger in the Activity that I am about to engage in voluntarily, including but not limited to: walking or running on rough or slippery terrain, collision with stationary objects or other participants, inclement weather, dangerous sea conditions, sea life and equipment and possible unknown adverse weather and sea conditions.  I understand that my participation in the Activity may result in injury, death, or illness, physical or mental, or damage to my person and property and that no amount of care, caution, instruction or expertise can completely eliminate the inherent danger. I understand and acknowledge accidents may occur during the Activity; (c) during the Activity I may experience fatigue, chill and/or dizziness, loss of consciousness which may diminish my reaction time and that of others and may therefore increase the risk of accident; (d) changing weather, sea conditions, rain and/or other conditions, slippery or uneven surfaces, equipment malfunction, my own inability to properly participate in the Activity or to follow rules and directions concerning the Activity and unforeseeable events may all contribute to the chances of accident, injury or death; (e) the Risks and dangers may be caused by my own actions or inactions, the actions or inactions of others participating in the Activity, the conditions in which the Activity takes place, or THE NEGLIGENCE OF THE RELEASEES; (f) there may be OTHER RISKS or SOCIAL AND ECONOMIC LOSSES either not known to me or not readily foreseeable at this time; (g) I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I incur as a result of my participation, or that of the minor, in the Activity. 

I have read this section, and initial to show that I understand and agree:   Initial here*

WARRANTIES
I acknowledge, agree, and represent that I, or the Minor for whom I sign, understand the nature of the Activity and that I have no physical infirmity, chronic ailment, and or injury of any nature. I, or the Minor, am in good health and physically and mentally able to participate in the Activity. I further acknowledge that I, or the Minor for whom I sign, am not pregnant or aware of any medical conditions, such as but not limited to heart, back or other injuries, that could be aggravated by participating in the Activity or that would prohibit my participation in the Activity; I, or the Minor for whom I sign, further agree and warrant that if at any time I believe conditions to be unsafe, or beyond my skill level or that of the Minor for whom I sign, I will immediately discontinue further participation in the Activity.

I have read this section, and initial to show that I understand and agree:   Initial here*

MEDICAL EMERGENCY
I hereby consent to receive medical treatment, for me and/or the Minor, including but not limited to, first aid and emergency transport, which may be deemed advisable in the event of injury, accident and/or illness during the Activity. I understand that the Activity that I am participating in may be conducted at sites that are remote from available medical assistance and nonetheless agree to proceed with such participation in spite of the possible absence of medical assistance. I further consent I will be personally responsible for the cost of any emergency or other medical care that I receive.
 
I have read this section, and initial to show that I understand and agree:   Initial here*

Emergency Contact Info for Participant (Diver #1):      First Name*   Last Name*Primary Phone:       Phone Number*     Relationship to participant:   Type a label   
Secondary Emergency Contact:    First Name*   Last Name*Primary Phone:Phone Number*   Relationship to Participant:*   

RELEASE
I hereby voluntarily release and forever discharge the Releasees from any and all liability, claims, demands, actions or rights of action, which are related to, arise out of, or are in any way connected with my participation in this Activity, including specifically, but not limited to, the negligent acts or omissions of the Releasees, for any and all injury, death, illness, or disease, and damage to my person and property. I agree, promise and covenant to hold harmless and indemnify the Releasees for any such injury, death, illness, disease or damage. I further agree, promise and covenant not to sue, assert or otherwise maintain or assert any claim against the Releasees for any injury, death, illness or disease, or damage to my property, arising from or connected with my participation in this Activity. I further agree and promise that if, despite this Release and Waiver of Liability, Assumption of Risk, and Indemnity Agreement, I, or anyone on my behalf, make a claim against any of the Releasees, I will indemnify, save and hold harmless each of the Releasees in conjunction with any injury, disability, death, loss or damage to person or property that may occur as a result of engaging in the Activity as well as from any litigation expenses, attorney fees, loss liability, damage, or cost which may be incurred as the result of such claim and to reimburse them for any such expenses incurred. Furthermore, I consent to the use of my image in photos, videos, audio recording, and film by any of the organizers of the Activity in their sole discretion.

I have read this section, and initial to show that I understand and agree:   Initial here*

JURISDICTION
Notwithstanding the waiver of liability, release, indemnification and covenant not to sue, which I am signing, I hereby agree and confirm that any claim, action or dispute arising under this agreement or as a result of my participation in the Activity shall be commenced in the Second Circuit Court of the State of Hawaii.

I have read this section, and initial to show that I understand and agree:   Initial here*

ENTIRE AGREEMENT:
I understand that this is the entire Agreement between me and the Releasees, and that in cannot be modified or changed in any way by the representations or statements of any employee or agent the Releasees, or by me.

I have read this section, and initial to show that I understand and agree:   Initial here*

Printed Name of Participant (Diver #2):  First Name*Last Name*           
Participant’s Date of Birth:   Date* Phone Number:         Phone Number*   Address:  Street Address*      City*   State*   Zip*   

RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT
I, the above-named person, being above the age of eighteen (18) years, or the legal guardian of the above-named person who is under the age of 18 years (hereinafter referred to as “Minor”) on behalf of myself, next of kin, heirs, guardians, assigns, personal representatives and estate (or those of the Minor if I am his/her Legal Guardian) and in consideration of the opportunity to participate in the UVSC SECOND ANNUAL TRUCKER DUKES MEMORIAL DIVE on June 22, 2024 (the “Event”) do hereby acknowledge, promise, agree, and covenant with UVSC, a Hawaii nonprofit corporation, the Rinzai Zen Mission and any and all people, companies, or organizations associated with the Event, their administrators, directors, agents, officers, members, volunteers, and employees, other participants, officials, rescue personnel, sponsors, advertisers, owners and lessees of the premises on which the Event is conducted (collectively hereinafter referred to as the “RELEASEES”) as follows:
ACTIVITY DESCRIPTION
Participating in the UVSC SECOND ANNUAL TRUCKER DUKES MEMORIAL DIVE (the “Activity”) involves swimming, diving, spearfishing, a land obstacle course, art activities, trash collecting on the beach, all of which may occur on uneven and slippery terrain, dangerous sea conditions, unknown under water conditions, adverse weather and around other Participants with spear guns and other diving equipment who will also be in the ocean. Participants, ages 7 and above, may dive from what is commonly known as the baby beach portion of Baldwin Beach to what is commonly known as the cove portion of Baldwin Beach. Participants, under the age of 7, will participate in land based activities, including but not limited to, an obstacle course and artwork activities located at the Rinzai Zen Mission, as well as trash collecting in the surrounding areas. 

ACKNOWLEDGEMENT OF RISKS
I FULLY UNDERSTAND AND ACKNOWLEDGE that: (a) Activity INVOLVES RISKS AND DANGERS OF SERIOUS BODILY INJURY INCLUDING BUT NOT LIMITED TO SERIOUS INJURY, PERMANENT DISABILITY, AND EVEN DEATH (“Risks”); (b) there is an inherent danger in the Activity that I am about to engage in voluntarily, including but not limited to: walking or running on rough or slippery terrain, collision with stationary objects or other participants, inclement weather, dangerous sea conditions, sea life and equipment and possible unknown adverse weather and sea conditions.  I understand that my participation in the Activity may result in injury, death, or illness, physical or mental, or damage to my person and property and that no amount of care, caution, instruction or expertise can completely eliminate the inherent danger. I understand and acknowledge accidents may occur during the Activity; (c) during the Activity I may experience fatigue, chill and/or dizziness, loss of consciousness which may diminish my reaction time and that of others and may therefore increase the risk of accident; (d) changing weather, sea conditions, rain and/or other conditions, slippery or uneven surfaces, equipment malfunction, my own inability to properly participate in the Activity or to follow rules and directions concerning the Activity and unforeseeable events may all contribute to the chances of accident, injury or death; (e) the Risks and dangers may be caused by my own actions or inactions, the actions or inactions of others participating in the Activity, the conditions in which the Activity takes place, or THE NEGLIGENCE OF THE RELEASEES; (f) there may be OTHER RISKS or SOCIAL AND ECONOMIC LOSSES either not known to me or not readily foreseeable at this time; (g) I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I incur as a result of my participation, or that of the minor, in the Activity. 

I have read this section, and initial to show that I understand and agree:   Initial here*

WARRANTIES
I acknowledge, agree, and represent that I, or the Minor for whom I sign, understand the nature of the Activity and that I have no physical infirmity, chronic ailment, and or injury of any nature. I, or the Minor, am in good health and physically and mentally able to participate in the Activity. I further acknowledge that I, or the Minor for whom I sign, am not pregnant or aware of any medical conditions, such as but not limited to heart, back or other injuries, that could be aggravated by participating in the Activity or that would prohibit my participation in the Activity; I, or the Minor for whom I sign, further agree and warrant that if at any time I believe conditions to be unsafe, or beyond my skill level or that of the Minor for whom I sign, I will immediately discontinue further participation in the Activity.

I have read this section, and initial to show that I understand and agree:   Initial here*

MEDICAL EMERGENCY
I hereby consent to receive medical treatment, for me and/or the Minor, including but not limited to, first aid and emergency transport, which may be deemed advisable in the event of injury, accident and/or illness during the Activity. I understand that the Activity that I am participating in may be conducted at sites that are remote from available medical assistance and nonetheless agree to proceed with such participation in spite of the possible absence of medical assistance. I further consent I will be personally responsible for the cost of any emergency or other medical care that I receive.
 
I have read this section, and initial to show that I understand and agree:   Initial here*

Emergency Contact Info for Participant (Diver #2) - DO NOT INCLUDE NAME OF DIVER #1:      First Name*   Last Name*      Primary Phone:       Phone Number*R elationship to participant:   Type a label   
Secondary Emergency Contact:    First Name*   Last Name*   Primary Phone:Phone Number*      Relationship to Participant:*   

RELEASE
I hereby voluntarily release and forever discharge the Releasees from any and all liability, claims, demands, actions or rights of action, which are related to, arise out of, or are in any way connected with my participation in this Activity, including specifically, but not limited to, the negligent acts or omissions of the Releasees, for any and all injury, death, illness, or disease, and damage to my person and property. I agree, promise and covenant to hold harmless and indemnify the Releasees for any such injury, death, illness, disease or damage. I further agree, promise and covenant not to sue, assert or otherwise maintain or assert any claim against the Releasees for any injury, death, illness or disease, or damage to my property, arising from or connected with my participation in this Activity. I further agree and promise that if, despite this Release and Waiver of Liability, Assumption of Risk, and Indemnity Agreement, I, or anyone on my behalf, make a claim against any of the Releasees, I will indemnify, save and hold harmless each of the Releasees in conjunction with any injury, disability, death, loss or damage to person or property that may occur as a result of engaging in the Activity as well as from any litigation expenses, attorney fees, loss liability, damage, or cost which may be incurred as the result of such claim and to reimburse them for any such expenses incurred. Furthermore, I consent to the use of my image in photos, videos, audio recording, and film by any of the organizers of the Activity in their sole discretion.

I have read this section, and initial to show that I understand and agree:   Initial here*

JURISDICTION
Notwithstanding the waiver of liability, release, indemnification and covenant not to sue, which I am signing, I hereby agree and confirm that any claim, action or dispute arising under this agreement or as a result of my participation in the Activity shall be commenced in the Second Circuit Court of the State of Hawaii.

I have read this section, and initial to show that I understand and agree:   Initial here*

ENTIRE AGREEMENT:
I understand that this is the entire Agreement between me and the Releasees, and that in cannot be modified or changed in any way by the representations or statements of any employee or agent the Releasees, or by me.

I have read this section, and initial to show that I understand and agree:   Initial here*

Printed Name of Parent/Guardian of Participant (Diver #2): Printed Name of Parent/Guardian (if diver is a minor):    First Name*Last Name*Parent/Guardian Phone Number:      Phone Number*