KA MOLOKAI MAKAHIKI

After submission, the details of this form will auto transfer to a Google Sheets log which can only be viewed by members of the Ka Molokai Makahiki board. The log allows us to filter and search for each student by name, grade, school, etc. which helps us to keep track and confirm waivers properly submitted for participation so please enter student's information CORRECTLY.

SECTION A: PARTICIPANT INFO

SECTION B: PARENT/GUARDIAN INFO 

Media Waiver & Release & Permission for Publication: We/l understand and agree that my child's work (created or otherwise generated) & photo while in Makahiki Events could be published on the Internet at the sole discretion of Ka Molokai Makahiki, Molokai Digital Bus, & the Maui County OED. We/l understand and agree that my child's picture or video footage taken while participating in Ka Molokai Makahiki could be published either in print (i.e. brochures, fliers, newspaper) and/or on the Internet at the discretion of KMM, MDB, & OED. I/we also hereby give permission to photograph, film, tape, or otherwise record myself - my/our child's name, voice, and/or person and understand that there will be no financial or other remuneration of photographs, news releases, open-circuit (broadcast), closed- circuit, and/or cable television transmission and any other media releases of myself - my/our child to publicize Ka Molokai Makahiki within or outside of the State of Hawai'i in perpetuity either for initial or subsequent transmission or playback. No home address or telephone number will appear with such work or media. Children appearing in a group photo will not be identified individually. On my/our behalf and on behalf of my/our child, I/we agree to waive and release Ka Molokai Makahiki, Molokai Digital Bus, Maui Countyʻs OED, any & all partnering programs, contractors, & funding sources (its board members, officers, directors, employees, and agents) and agree not to sue any such person for any claims arising from the publication of my/our child's work or image generated while I/she/he participates in Ka Molokai Makahiki as set forth in this waiver form.

General Waiver & Release:  I/we give permission for my/our child to participate & be transported in a non-school vehicle (as deemed necessary) and therefore waive Ka Molokai Makahiki & Molokai Digital Bus' liability for responsibility. I/we give permission in case of accident or need for medical attention to transport my/our child to the doctor, dentist, or emergency medical facility and consent and authorize a medical professional and others working under their supervision to provide medical treatment for any injury or illness arising from, or related to, his/her participation in this event. I/We understand that Ka Molokai Makahiki & Molokai Digital Bus does not provide health insurance or compensation or otherwise indemnify individuals with respect to injuries or other liabilities arising out of participation in this event. I/we further agree to pay any and all medical expenses, costs, and other charges arising from or connected with such medical treatment or care for the participant listed above. On my/our behalf and on behalf of my/our child, I/we agree to waive and release Ka Molokai Makahiki and Molokai Digital Bus, any & all partnering programs, contractors, & funding sources, (its board members, officers, directors, employees, and agents) and agree NOT to sue any such person for any claims arising from an accident/incident/illness that arises from participating in its events. We/l have read and fully understand the PARTICIPATION WAIVER FORM and agree to be bound by, and to comply therewith.

After filling in all required information click the green CONTINUE button at the bottom of this page which will take you to a preview of your waiver submission. After review, the last step is to click the blue SIGN DOCUMENT button which will finalize this submission. When you receive this message below it signifies receipt of this submission.

Mahalo!