RELEASE, WAIVER, AND INDEMNITY AGREEMENT

RELEASE AND WAIVER: As consideration for allowing the undersigned to use Seabury
Hall’s gym, facilities and grounds, the undersigned do(es) hereby RELEASE, WAIVE, AND
FOREVER DISCHARGE SEABURY HALL, its officers, directors, trustees, faculty, coaches
and other employees, agents, successors and assigns, (hereinafter “SEABURY”), of and from any
and all: claims, causes of action (whether presently known or unknown), damages, expenses, and
legal liabilities, arising out of, to arise out of, or otherwise relating in any way to any actual or
threatened injury occurring in connection with participation in these activities or the program
described below (hereinafter “CLAIM”).

INDEMNITY: The undersigned do(es) hereby agree to INDEMNIFY AND HOLD SEABURY
HARMLESS from any CLAIM made against SEABURY and arising from any club member,
club leader, family member on the premises, or other participant (hereinafter collectively
“PARTICIPANT”) while s/he is participating in, observing, or traveling to or from any Seabury
Hall practice, scrimmage, game, tournament, or other PARTICIPANT activity on campus.

This Release, Waiver, and Indemnity Agreement is to be interpreted as broadly as permitted by

Hawaii law.

I/we confirm that I/we have read this Release and agree to its terms knowingly and voluntarily.
I/we confirm that I/we am/are the parent(s) or legal guardian(s) of PARTICIPANT if
PARTICIPANT is a minor; or are executing on my own behalf if of legal age. By signing below,
I/we agree to this Release, Waiver, and Indemnity Agreement on behalf of myself/ourselves
and of PARTICIPANT, if a minor.

Club, Group, or Organization Name:

________________________________________________________Date: ___________

Club, Group, or Organization Leader’s Name and Signature:

_________________________________________________________________________

Participant’s Name and Signature:

__________________________________________________________________________

If Participant is a minor:

______________________________________________________________________________
Parent or Guardian Name(s) (Please Print, Sign and Date)

REV. 7/2019
Participant’s Name and Signature: _________________________________________

Parent or Guardian Name(s) and Signature (if a minor):

______________________________________________________ Date: ____________

Participant’s Name and Signature: _________________________________________

Parent or Guardian Name(s) and Signature (if a minor):

______________________________________________________ Date: ____________

Participant’s Name and Signature: _________________________________________

Parent or Guardian Name(s) and Signature (if a minor):

______________________________________________________ Date: ____________

Participant’s Name and Signature: _________________________________________

Parent or Guardian Name(s) and Signature (if a minor):

______________________________________________________ Date: ____________

Participant’s Name and Signature: _________________________________________

Parent or Guardian Name(s) and Signature (if a minor):

______________________________________________________ Date: ____________

Participant’s Name and Signature: _________________________________________

Parent or Guardian Name(s) and Signature (if a minor):

______________________________________________________ Date: ____________

Participant’s Name and Signature: _________________________________________

Parent or Guardian Name(s) and Signature (if a minor):

______________________________________________________ Date: ____________

REV. 7/2019