Visitor Waiver

VISITOR RELEASE INDEMNITY AND ASSUMPTION OF RISK STATEMENT

Full Release Details must be carefully reviewed before submitting this waiver

In consideration of the permissions for me to enter the property and facility known as East Maui Animal Refuge, bearing Tax Map Key No. (11) 2-8-009-017, and located at 25 Malu Aina Pl. Haiku, Maui, HI.

I agree to release indemnity and hold blameless the East Maui Animal Refuge from any and all claims of damages, losses, and/or injuries to me which may result from my entry onto such property.

I agree to assume the risk of any damages, losses, and/or injuries that may result from my entry onto such property.

I understand that I may only visit after a date and time for my visit are confirmed by a representative of the Boo Boo Zoo.

Each person18 years or older planning to visit must complete the following form.

First Name

Last Name

Preferred Date of Visit required

Phone

Street Address

City

State

Postal / Zip code

If you are under the age of 18, a Legal Guardian must sign for you:

I am the legal guardian of the above applicant and I have read, understand and agree to all of the above and legally sign for the above minor by entering my name below:

Guardian Name:

Please list the full names of all individuals under the age of 18 whom you are bringing to the visit/tour. If you are not bringing individuals under the age of 18, please indicate "none."

I and have read, understand and agree to all of the above and legally sign by marking each checkbox below:

I agree to release indemnity and hold blameless the property and facility known as East Maui Animal Refuge, bearing Tax Map Key No. (11) 2-8-009-017, and located at 25 Malu Aina Pl., Haiku, Maui, HI, from any and all claims of damages, losses, and/or injuries to me which may result from my entry onto such property.

I agree to assume the risk of any damages, losses, and/or injuries that may result from my entry onto such property.

I hereby grant the East Maui Animal Refuge (EMAR) permission to use my likeness, and the likenesses of any or all individuals accompanying me on an EMAR tour or visit who are under the age of 18, in a photograph and/or video in any and all of its print and online publications, website and social media without payment and any other consideration. I understand that these materials will become the property of EMAR and will not be returned. I hereby irrevocably authorize EMAR to edit, alter, copy, exhibit, publish and/or distribute this photo or video for purposes of publicizing EMAR programs or for another lawful purpose. I also waive any right to inspect or approve the finished product, including written or electronic copy wherein my likeness appears. Additionally, I waive any rights to royalties or other compensation arising from, or related to, the use of the photograph or video. I hereby hold harmless and release and forever discharge EMAR from all claims, demands and causes of action which I, my heirs, representatives, executors, administrators or any other person acting on my behalf or on behalf of my estate have or may have by reason of this authorization. I have read this release before authorizing it and fully understand the contents, meaning and impact of this release.

I declare that the information I’ve provided is accurate and complete.

Thanks for submitting!

​Visitor Waiver

VISITOR RELEASE INDEMNITY AND ASSUMPTION OF RISK STATEMENT

Visitor Waiver