2026 Bella Project - Caregiver Authorization Form Logo
  • 2026 Bella Boutique - Caregiver Authorization Form

    Please complete one application per youth participant. If you have any questions, please contact YWCA O'ahu Program Coordinator, Julie Baker at (808) 695-2614. Thank you for your cooperation! Event dates: Friday, January 30 and Saturday, January 31, 2026
  • Participant Medical and Liability Waiver

  • In consideration of YWCA O'ahu accepting my (or the participants) application for voluntary participation in YWCA programs, activities, and/or related events at the YWCA facility, I, the undersigned participant (or legal guardian of a minor participant), hereby waive all claims and or causes of action, including negligence, against the YWCA O'ahu and its officers, directors, employees, agents and representatives arising out of my participation in the YWCA programs, activities, and/or related events at the YWCA facility. I, intending to be legally bound for myself, my successors, heirs, legal representatives, executors, administrators and assigns, do hereby release, hold harmless, and discharge the YWCA O'ahu officers, directors, employees, agents and representatives, from any and all liability, including negligence, in connection with my participation in YWCA programs, activities, and/or related events at the YWCA facility.

    I understand and acknowledge that participation in YWCA programs, activities, and/or related events at the YWCA facility could result in loss of, or damage to, my or another person’s property, serious injury to my or another person’s body, including mental or emotional injury or trauma, and/or death. Knowing, understanding and fully appreciating all of these consequences, I hereby voluntarily and willingly assume all risks and damages associated with my child's participation.

    I have read this waiver and understand the terms in it, and its legal significance. This waiver and release is freely and voluntarily given with the understanding that the right to legal resources against the YWCA O'ahu is knowingly given up in return for allowing my participation in the YWCA  programs, activities, and/or related events at the YWCA facility. My signature on this document is intended not only to blind myself, but my successors, heirs, legal represent, executors, administrators, and assigns, as well.

    I consent for my child to receive medical treatment, which may be advisable in the event of illness, or injuries suffered by me during YWCA programs, activities, and/or related events at the YWCA facility.

    If participant is under 18 years old: Should parent(s) or authorized person(s) not be available, I authorize the YWCA of Oahu to arrange for emergency transport and medical attention to the nearest hospital.

     

  • Participant Photo Release Waiver

  • I grant permission to the YWCA Oahu to use photographs, slides, or videotapes in which I or my child may appear, for YWCA education, promotion or publicity purposes and waive all claims for compensation for such use. 

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