Enrollment Hub (Part-Time) - Earth School Hawai'i

Earth School Hawaii Nature Day

Assumption of Risks Waiver and Release of Claims Release and Indemnity Agreement

In consideration of my child’s (printed full name of the participant below) participation in the Earth School Hawaii’s Nature Day program with Emily Martin, Heather Adzovich, Kehau Davis, Nur Simons-Wilson, Cheyenne Atkins, Heurra Heheia Aliikoa, and Kathleen Brickner, I the undersigned, the Parent/Guardian Acknowledge the following:

Printed Child's Full Name *

PLEASE READ CAREFULLY:

1. ACKNOWLEDGEMENT AND ASSUMPTION OF RISKS

The Parent/Guardian acknowledges and agrees the he or she is aware that there are many inherent known and unknown dangers and risks associated with being outdoors and with the participation in the outdoor nature program including but not limited to, the risk of minor injuries such as cuts, bruises, burns and scrapes, insect bites, insect stings, broken bones as well as the risk of serious injury or death. The Parent/Guardian knowledges and agrees that he or she understand the risks associated aforesaid dangers and risks associated with the outdoor nature program activities caused by but not limited to campfires, hiking, fishing, swimming, using tools/carving, encounters with wildlife. The Parent/Guardian acknowledges that being outside has many hazards and that there are risks that cannot be eliminated due to the nature of the wilderness environment and agrees to provide his or her permission for the student to participate in the outdoor nature program.

2. RELEASE AND WAIVER OF CLAIMS

The Parent/Guardian release waives and fully discharges Earth School Hawaii and all said employees and independent contractors, from any and all claims, demands, obligations and all liability of any kind or nature arising from or connected to, directly or indirectly, with the student’s participation in the outdoor nature program due to any cause whatsoever. The Parent/Guardian accepts that this release covers and includes, but is not limited to, all unknown and unforeseen claims, injuries, damages and losses, and any consequences thereof.

3. INDEMNITY

The Parent/Guardian will indemnify and hold harmless Earth School Hawaii and employees/independent contractors from any damage, loss, liability, legal costs and other expenses the Earth School Hawaii and Nature Day Program may suffer or incur by reason of any claims against Earth School Hawaii and the Nature Day Program arising from or connected to, directly or indirectly, with the student’s participation in the Program.

4. PLEASE CHECK ONE OF THE FOLLOWING BOXES BELOW

Swimming/Snorkeling Consent: I give consent for my child to participate in swimming/snorkeling activities during the nature day program. I understand that all swimming activities will not be conducted under the supervision of a certified lifeguard and that my child’s participation in swimming/snorkeling is done at his or her own risk.

Swimming/Snorkeling Consent *Yes, I give permissionNo, I do not give permission

Name of Student/Participant *

Date *

Name of Parent/Guardian *

Email Address of Parent/Guardian *

Phone Number of Parent/Guardian *

Signature of Parent/Guardian *

Date *

Permission to Use Photograph

PLEASE READ CAREFULLY:

I grant, Earth School Hawaii, its representatives and employees the right to: take photographs of me and my property in connection with the above-identified subject. I authorize Earth School Hawaii, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Earth School Hawaii may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.

I have read and understand the above and I: *

Child's Name *

Name of Parent/Guardian *

Signature of Parent/Guardian *

Date *

Liability Waiver & Release of Claims

Campus Location *

Release and Waiver

I agree to the following:

That (the “Student”) is enrolled in Earth School Hawai‘i, operating from an Earth School Hawai‘i campus location in Kauai, Hawai‘i (the “School”), with Earth School Hawai‘i faculty, staff, instructors, independent contractors, and volunteers. I recognize that certain activities associated with the School may cause physical injury to the Student, and I am fully aware of the associated risks and hazards.
In consideration of the Student being permitted to participate in the School, I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which the Student may suffer as a result of the Student’s participation in the School.
In further consideration of the Student being permitted to participate in the School, I knowingly and expressly waive and fully release any and all claims that I may have against the School, the property, Earth School Hawai‘i, and any faculty, staff, instructors, independent contractors, or volunteers, for any injury or damages that the Student may suffer, in whole or in part, as a result of the Student’s participation in the School.
On behalf of myself, my heirs and legal representatives, I specifically agree that the School, the property, Earth School Hawai‘i, and any faculty, staff, instructors, independent contractors, or volunteers shall not be held liable for any claim, demand, cause of action of any kind whatsoever for, or on account of injury, damage or loss of any kind resulting from or related to the Student’s participation in the School.
I give the Student permission to attend field trips and be driven by Earth School Hawai‘i faculty, staff, instructors, independent contractors, or volunteers.
This Release shall be governed by and construed in accordance with the laws of the State of Hawai‘i.

Student Name *

Date

Signature of Parent/Guardian *

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Enrollment Forms

Please complete this form in a single session and ensure you click “SUBMIT” at the end. The form typically takes 5-10 minutes to complete. Once submitted, you will receive a confirmation email at the address you provide in this application.