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Waikiki Surf Club

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Make sure this is the form for your canoe club. This is the HCRA waiver, not a membership application.

Q. Can I use my nickname or Hawaiian name?
A. No.
HCRA requires your legal name as it appears on your government issued ID, passport, or driver license.


Military
Please check boxes that apply to the Paddler:
Native Hawaiian
Hawaiian Canoe Racing Association Insurance Program
Canoe Club:
Waikiki Surf Club
Adult and Minor Waiver and Release of Liability

January 1, 2024 to December 31, 2024

In consideration of being allowed to participate in any way in the Hawaiian Canoe Racing Association and its member organizations’ athletics/sports programs, and related events and activities, the undersigned:

  1. Agree that prior to participating, they each will inspect the facilities and equipment to be used, and if they believe anything is unsafe, they will immediately advise their coach or supervisor of such condition(s) and refuse to participate.

  2. Acknowledge and fully understand that each participant will be engaging in activities that involve risk of serious injury, including permanent disability and death, and severe social and economic losses which might result not only from their own actions, inactions or negligence, but the action, inaction or negligence of others, the rules of play, or the condition of the premises or of any equipment used. Further, that there may be other risks not known to us or not reasonably foreseeable at this time. 

  3. Assume all the foregoing risks and accept personal responsibility for the damages following such injury, permanent disability or death.

  4. Release, waive, discharge and covenant not to sue the Hawaiian Canoe Racing Association, its member associations, its affiliated clubs, their respective administrators, directors, agents, coaches, and other volunteers or employees of the organization, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and leasers of premises used to conduct the event, all of which are hereinafter referred to as “releasees”, from demands, losses or damages on account of injury, including death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the releasee or otherwise.

The undersigned custodial parent or legal guardian acknowledges that he/she is also signing this release on behalf of the minor participant, that he/she is waiving certain rights on behalf of the minor participant that the minor participant otherwise may have and that the minor participant shall be bound by all of the terms of this release. By signing this waiver and release without a parent’s or guardian’s signature, the participant represents he/she is at least 18 years of age, or, if signing as the parent or guardian of the participant, signer represents they are the custodial parent or legal guardian of the minor participant.


THE UNDERSIGNED HAVING READ THE ABOVE WAIVER AND RELEASE, UNDERSTAND THAT THEY HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND SIGN IT VOLUNTARILY.

Legal Name*
Exactly as it appears on your driver license or other official government-issued document.

Birthdate*

Gender*

Phones: Home, Work, Cell/Pgr

IN AN EMERGENCY CONTACT:

If a minor, Printed Name of Custodial Parent or Guardian

Date
Hidden
TODAY'S DATE*

Adult Paddler Signature:

(or Minor’s Legal Guardian)