Hawaiian Canoe Racing Association Insurance Program                                                          Canoe Club:
Adult and Minor Waiver and Release of Liability                                                                       Lanikai Canoe Club
January 1, 2023 to December 31, 2023

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.

Paddler Name

(Required)

First Last

Gender

(Required)

Street Address

(Required)

Birthdate

(Required)

MM slash DD slash YYYY

City

City(Required)

State(Required)

Zipcode(Required)

Phones: Home, Work, Cell/Pgr

home(Required)

work(Required)

cell/pager(Required)

Email Address:

Email(Required)

IN AN EMERGENCY CONTACT:

Firts(Required)

First

Last(Required)

Last

Emerg Phone(Required)

Phone

If a minor, Printed Name of Custodial Parent or Guardian

First Last

Adult Paddler Signature:

(Adult Paddler or Minor's Guardian)(Required)

(Adult Paddler or Minor's Guardian)

Date

(Required)

MM slash DD slash YYYY

Hidden

Max. file size: 4 MB.

Hidden

Max. file size: 4 MB.

Upload Identification Document (Drivers license, passport, military ID, birth certificate, etc.)(Required)

Upload digital picture of face (for paddling ID). No hats or sunglasses, like a passport photo.(Required)

Mandatory HCRA Waiver (downloadable .pdf file), you will need adobe reader to fill out and sign the waiver, then upload as a pdf. As your member club, LCC will handle the HRCA process for you. *If you can’t print out the HRCA waiver pdf you can pick up a print copy at the longhouse. Alternatively you can email the Waiver to desibill@lanikaicanoeclub.org.

Please upload here

Accepted file types: pdf, jpg, jpeg, Max. file size: 512 MB.

Membership Profile

If this membership is for an adult, please have the following ready: --- driver license or passport (or other official form of Identification) --- digital photo of face for Paddling ID. If the member is a child, please have a birth certificate or other official form of ID ready, as well as a current digital photo of the child's face for their HCRA registration card.

A New Member (1st time with LCC)

A Returning Member (renewing)

New or Experienced Paddler?

LCC welcomes new paddlers, but for your safety and the safety of all our members, you'll be required to participate in a series of training sessions in March, before you are allowed to paddle in a six person canoe with us. Mahalo nui for your kōkua to keep us all safe.

If you have paddled with ILH, OIA, Na'Oipo, or are transferring to LCC from another canoe club, please provide the name/organization and of the club and the most recent year you were active. You may also describe your paddling or coaching experience if you wish.

Paddle Shirt Size

XS

S

M

L

XL

XXL

XXXL

T-Shirt

Any medical problems we should be aware of?(Required)

Can You Swim?(Required)

Yes

No

Is there any additional Information you wish us to have?

Membership End Date

Month

Day

Year

Sign LCC Membership Agreement

Under 18 yrs of age, PARENT or LEGAL GUARDIAN must sign for the youth registrant.

I hereby grant Oahu Hawaiian Canoe Racing Association (OHCRA) and Lanikai Canoe Club (LCC) the right to use my minors picture, photograph, and/or voice recording in any and all forms of media and in all manners including, but not limited to, composite or edited forms, for OHCRA and LCC’s use. I hereby grant OHCRA and LCC the absolute right and permission to copyright and/or publish images captured through video, photo, or digital camera, of which I may be included in whole or part, for news release, art, advertising, trade, or any other lawful purpose whatsoever. I hereby waive any right that I may have to inspect and/or approve the finished product or the copy that may be used in connection therewith, or the use to which it may be applied. I hereby release, discharge, and agree to save OHCRA and LCC from any liability by virtue of any blurring, distortion, alteration, optical illusion, or use in composition form, whether intentional or otherwise, that may occur or be produced in the making of said images, or in any processing tending towards the completion of the finished product. Primary/intended use(s) of photo/video: Documentation of the perpetuation of the art of the sport of Hawaiian Outrigger Canoe training, rigging, paddling and racing.

Consent(Required)

I have read Photo-Media Release in it's entirety and agree to the terms(Required)

Membership dues and activity fees are non-refundable, non-transferable, and not prorated. If circumstances arise that are outside the LCC's control, activities may be suspended or rescheduled. I will adhere to all club rules.

Signature for LCC Waiver:(Required)

Name: Parent/Guardian Signing(if applicable)

First Last