Namolokama Canoe Club

Form below contains your HCRA mandated waiver – please read and sign.
The club will send it on to HCRA for you. Continue on to Create Your Member Profile.

Please note that the board has discretion whether they accept your membership application.

Payment: This year the club is proud to offer a new online credit card payment option, or you may deliver a check instead.

"*" indicates required fields

Hawaiian Canoe Racing Association Insurance Program Canoe Club:
Adult and Minor Waiver and Release of Liability Namolokama Canoe Club
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:

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.

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.

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

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's Legal Name*

as it appears on driver license or government issued ID

Gender*

Female

Male

Non-binary / Other

Birthdate*

Hidden

Gender

Street Address*

City*

State*

Zipcode*

Phones: Home, Work, Cell/Pgr

Home*

Work

Cell/Mobile*

Email*

Emergency Contact:

First Name*

Last*

Phone*

If a minor, Printed Name of Custodial Parent or Guardian

First Last

Hidden

TODAY'S DATE*

Adult Paddler Signature*

(or Minor's Legal Guardian)

Membership Profile

My preferred name, what I'd like to be called, is:

nickname or Hawaiian name, if applicable

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. Driver License or Govt issued ID Photograph (head, no hat or sunglasses - like a passport photo). For a CHILD: birth certificate or other form of ID instead of driver license.

Age of the Paddler as of January 1, 2024.*

Please enter a number from 6 to 109.

Certified in CPR?*

Yes

First Aid Certified?*

Yes

Advanced Life Saving?*

Yes

Ability to Swim Well?*

Yes

Tread Water for 20 minutes*

Yes

Have you paddled before?*

Yes

How many years have you paddled?*

The last year I paddled was ????*

4 digits year please: 2023 2022, 2021 etc. If you paddled for another canoe club or association please file for a TRANSFER/RELEASE to Race with us.

Coached by:

For what Club(s)?

Last Division Paddled

Are you interested in paddling competitively and/or recreationally?

Competitive

Recreational

Please drag and drop, or select an image from your device. Upload government issued ID.*

This secure system is our club's protection for your information. Please, no texting or emailing pics of your ID to volunteer or coaches cell phones. It's far, far less secure! We appreciate your help keeping your data safe from unwanted intrusion!

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

Second Emergency Contact*

If we can't reach your designee above, who could we call second, in case of an emergency?

Second Emergency Contact's Phone*

Medical Conditions or Problems we should be aware of for your safety??*

Is there any additional Information you wish us to have?

Namolokama Canoe Club Membership Agreements

Assumption of Risk, and Photo/Media Release*

I acknowledge and fully understand that participation in club activities, events, races, practices, programs, or any activity (hereinafter "Activities") is an inherently dangerous activity which involves risk of serious injury, including permanent disability, death, or other losses. Risk may arise from any number of circumstances including, but not limited to, the actions or inactions of the participant or other persons, the rules of play, the condition of the premises or equipment. Risk, whether known or unknown, reasonably forseeable or not, are inherent in paddling and Activities. I understand and assume the risks.

I accept personal responsibility and assume the liability for any damages incurred associated with the risks of participation.

I release, waive, discharge and covenant not to sue the Canoe Club, 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 during participation, (hereinafter "Club").

I assume all risks associated with losses or damages arising from my participation in Activities, whether due to Club negligence or otherwise.

Photo/Media Release: Club hereby has my permission to photograph, film, or otherwise record and use images that may include myself and/or my child/children, voice, and/or likeness, for limited, educational/nonprofit purposes. Children's names are never used. Additionally, Club will reach out to get specific permission for any specific, planned use.

I understand that paddling is a public sport in a public place, and the club has no control over other Club members, members of the public, or volunteers who may take photos and use personally.
THE UNDERSIGNED HAVING READ THE ABOVE WAIVER AND RELEASE, UNDERSTANDS THAT THEY HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING, AND SIGN VOLUNTARILY.

I consent

Parent/Legal Guardian of the minor child*

By signing below, I am warranting that I am the legal parent or guardian of the minor child, authorized to enter into legal agreements regarding my child. I understand that I am waiving certain rights that my minor child may otherwise have, and that my child is bound by all terms of this release.

First Last

Signature*