• Ryan Lochte Swim Clinic

    Release and Liability Waiver
  • Participant Information

  • Date of Birth*
     - -
  • Format: (000) 000-0000.
  • Complete this section for participants 17 and under only. Parents and guardians listed on this form will be contacted regarding program information, for emergencies, and are permitted to pick up minor participant from American Renaissance Academy.
  • Parent/Legal Guardian Information

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Emergency Information

  • If an emergency should arise, parents of minors will be contacted first. For adults or if parents are unable to be contacted, the individuals listed here will be contacted. Emergency contacts are also permitted to pick minor participant from American Renaissance Academy. Do not list parents for minor participants.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • NOTICE OF PHYSICAL RISK, COVID-19 WAIVER, MEDICAL AUTHORIZATION, AND MEDIA RELEASE

  • I, the participant / spectator, understand that physical injury may occur while at American Renaissance Academy and related events. I voluntarily and freely assume the inherent risks and dangers associated with these activities.
  • One of the goals of American Renaissance Academy ("School") is to provide a safe environment for our students, teachers, faculty and staff, even despite the novel coronavirus, COVID-19 ("COVID-19"). This document provides information we ask you to acknowledge and understand regarding COVID-19. COVID-19 has been declared a worldwide pandemic by the World Health Organization. While medical professionals have confirmed that COVID-19 is extremely contagious and potentially deadly, there remain many unknowns regarding this disease. COVID-19 may be contracted in a variety of ways and has been confirmed in the State of Hawaii. While the School will endeavor to take reasonable preventative measures to reduce the spread of COVID-19 and to institute procedures to attempt to decrease the spread of the disease, the School cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending the School and participating in the School's programming and activities on campus and/or in person could increase your risk and your child(ren)'s risk of contracting COVID-19. By signing below, you confirm that you have read this document and understand and accept that attending the School and participating in the School's programming and activities on campus and/or in person could increase your risk and your child(ren)'s risk of contracting COVID-19. You further agree to waive on behalf of yourself, your child(ren), and your representatives any claims against the School arising out of any COVID-19-related illness or injuries, to the extent permitted by law. You, on behalf of yourself, your child(ren), and your representatives, also agree to indemnify and hold harmless the School from and against all claims. You also acknowledge that you or your child(ren) could contract COVID-19 from outside of the School and unrelated to you or your child(ren)'s participation in School activities.
  • I authorize all medical and surgical treatment, X-ray, laboratory, anesthesia, and other medical and/or hospital procedures as may be performed or prescribed by the attending physician and/or paramedics for my child(ren) and waive my right to informed consent of treatment. This waiver applies only in the event that neither parent/guardian can be reached in the case of an emergency. I understand that there may be resulting expenses or charges, and these charges are my responsibility. I will pay any such charges when due, either directly or through my personal health insurance.
  • My consent is also given for visual (photos, video, etc.) taken of myself or my child during the programs to be used in publications, promotional materials, and social media. I understand that financial compensation will not be given for use.
  • WAIVER AND INDEMNIFICATION

  • In consideration for the use of the facilities located at American Renaissance Academy/Kapolei Events Center/Kapolei Aquatics Center, I/WE agree as follows: To the fullest extent permitted by law, I/WE shall indemnify, defend, and hold harmless American Renaissance Academy; Phase 1 Hawaii, LLC; Vertikal RMS, Inc.; CBRE, Inc.; Kalaeloa Ventures 7, LLC; Hunt Development Group, LLC; and Hawaii Renaissance Builders, LLC, and each of their respective members, managers, officers, directors, employees, agents, representatives, successors, and assigns (collectively, the "Indemnified Parties") from and against any and all claims, demands, damages, losses, liabilities, costs, and expenses (including reasonable attorneys' fees) arising out of or related to: MY/OUR use of the facilities; Any acts or omissions of MINE/OURS, its employees, contractors, agents, invitees, or participants; Any breach of this Agreement by ME/US. Exception: This indemnity shall not apply to the extent any claim, damage, or loss is caused by the gross negligence or willful misconduct of an Indemnified Party. I/WE further acknowledges and agrees that participation in activities at the facility may involve inherent risks, and I/WE voluntarily assumes all such risks on behalf of itself and its participants.
  • SIGNATURE

  • If signing for a minor, I hereby affirm that I am the parent or legal guardian of the identified minor participant and I am legally authorized to bind the minor child to the terms of this agreement. I agree to be legally responsible for the acts of the minor child described herein. On behalf of myself and the minor child, I agree to be bound by the terms of this agreement.
  • By signing below, I certify that I have read, understand, and agree to the terms and conditions set forth in this Release and Liability Waiver
  • Date*
     - -
  • Identity Verification
    Please enter your email address below (the individual signing this document).

    • Verification Required: A unique code will be sent to this address to verify your identity. Please allow a few moments for it to arrive.
    • Check Spam: If the code doesn’t appear in your inbox, please check your junk or spam folder.

    Issues receiving the code? If you are unable to verify your email digitally, please CLICK HERE to download the PDF version of this form and email the completed copy to forms@arahawaii.org from the email address of the individual signing this document to begin your registration and be sent the payment link.

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