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Name of Parent/Guardian


Name of Advisor/Chaperone

EMERGENCY CONTACT NAME AND PHONE NUMBER(s): <><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><>

I, the undersigned in full recognition and appreciation of the dangers and hazards inherent in the Conservation Awareness Program, do hereby agree to assume all the risks and responsibilities surrounding my and/or my childâ&#x20AC;&#x2122;s participation in the activities; and further hold harmless, indemnify, and release and forever discharge the Hawaii Association of Conservation Districts, West Oahu SWCD, South Oahu SWCD, Windward Oahu SWCD, USDA Natural Resources Conservation Service, University of Hawaii, City and County of Oahu, and the private landowner and/or company at which this contest is held, and all of its officers, agents, leaders, employees, and volunteers from and against all claims, demands, and actions, or causes of action, on account of damage to personal property, or personal injury, which may result from his/her participation, and which result from causes beyond the control of, and without the fault or negligence of the above mentioned agencies, private landowner and/or company, its officers, agents, leaders, employees, or volunteers during the period of participation as aforesaid. IN WITNESS WHEREOF, I have caused this release to be executed this of

, 2015.

Signature of Student/Participant

Signature of Parent/Guardian


CONSENT/RELEASE FORM I consent to the reproduction and use, royalty-free, of motion picture films, videotapes, recorded sounds, and still photographs of my child by the Soil & Water Conservation Districts (SWCD) and United States Department of Agriculture (USDA) for all purposes including, but not limited to, education, training, trade, display, editorial, advertising, promotion, art, and exhibits. In giving this consent, I release the Soil & Water Conservation Districts and United States, its officers, employees, nominees, and designees from liability for any violation of any personal or proprietary right I may have in connection with such reproduction and/or use. I hereby waive any right of inspection or approval of the photograph(s) or of the use that may be made of the photograph(s), my childâ&#x20AC;&#x2122;s name, and their comment(s). (Name of Child)


Consent of Guardian I am the parent and/or guardian of the minor named above, and have the legal authority to execute consent and release. I approve the foregoing and waive any rights to the above. _____________________________________ (Signature)

___________________________________________________________________________ (Address) __________________________________________________________________________ (City) (State) (Zip Code) _____________________________________ (Date)

Profile for Oahu SWCD

Registration and permission form oahu  

Registration and permission form oahu  

Profile for oahuswcd