Waiver + Media Release

 
 
 
 

WAIVER AND RELEASE OF LIABILITY 

Aloha and welcome to our farm!  We are happy to share the beautiful sights on the farm, but please bear in mind that it is primarily a farm.  We have farm equipment and farm animals as well as potentially dangerous topological features. By signing the form below, you are releasing us from liability should you have an unfortunate experience on our farm.

I, _______________________________, HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES in and on the premises of MAHILANI PARTNERS LLC dba Lavaloha and/or those activities ASSOCIATED WITH MAHILANI PARTNERS, LLC dba Lavaloha. These risks includes, but are not limited to, injury, death or damage caused by actions and/or inactions by guests, employees, agents, owners, partners of MAHILANI PARTNERS LLC, whether such damage or injury is due to negligence, carelessness or recklessness; and regardless of whether such actions were directly or indirectly caused by the guests, employees, agents, owners, or partners of MAHILANI PARTNERS LLC. 

I certify that I am physically fit, am sufficiently prepared for participation in this activity, and have not been advised to not participate by a qualified medical professional. I certify that there are no health related reasons or problems which preclude my participation in this activity, including any nut or pet allergies. 

I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: 

(A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability 

arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this activity, THE FOLLOWING ENTITIES OR PERSONS: Mahilani Partners LLC dba Lavaloha and/or their directors, officers, employees, volunteers, representatives, and agents, and the activity holders, sponsors, and volunteers; 

(B) I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise. I acknowledge that Mahilani Partners LLC dba Lavaloha and their directors, officers, volunteers, representatives, and agents are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf. 

I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity. 

This Waiver and Release of Liability form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. I acknowledge that this Waiver and Release of Liability form was not induced in any way by MAHILANI PARTNERS LLC dba Lavaloha, its agents, owners, directors, employees, partners or guests. 

I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL. 

Participant’s Name Print: ___________________________________

Name, Age, Date (Please print legibly) 

Participant’s Signature: __________________________________________________ ___________

Name, Date 

Parent/Guardian’s Signature ______________________________________________ ___________

Name, Date (If under 18 years old, Parent or Guardian must also sign.)

MEDIA RELEASE FORM

I, _______________________(print name), grant permission to Lavaloha to use my and/or my child’s image (photographs and/or video) for use in Media publications including: Advertisements, Brochures, Email Blasts, Magazines, Newsletters, Recruits, Signage, Social Media, Videos, Website and or Affiliate Businesses.

I hereby waive any right to review the photographic content and permit its use in current and future marketing material, whether known or unknown to me at the time of use. Furthermore, I waive any right to royalties or other compensation arising from or related to the use of the image.

Please initial applicable statement:
_____ - I am 18 years of age or older and I am competent to contract in my own name. I have read and understand the impact of this release.

_____ - I am the parent or legal guardian of the below named child. I have read this release before signing below, and I fully understand the impact of this release. 


Signature: ________________________________

Date: _______________________

Signature of parent or legal guardian: _______________________________________
(Please sign if participant is under 18 years of age.)


Name(s) of Individual(s) photographed in party (please print): ___________________________________________________________

Mailing Address: ____________________________________________________________


Contact Information:

Phone:_________________

E-mail:________________________