24th Annual Quiksilver-Kamaaina Nissan Big Island Pro-Am Surfing Trials The following must be completed if the participant is younger than 18 years of age: I, ______________________________, the parent/legal guardian of ______________________________, a minor, have read this document and recognize and understand that participation in a surfing competition involves a risk of death, personal injury and/ or property damage inherent in such activity. With this knowledge, on behalf of said minor, I voluntarily choose to allow said minor to participate in said activity and approve and consent thereto. I further represent that said minor is in good physical and mental condition and that said minor can safely participate in such activity. I further agree to notify a contest official if there is any change in said minor’s physical and/or mental condition such that said minor cannot safely participate in said surfing competition. On behalf of myself, said minor, our legal successors and assigns, I hereby freely execute this document and release from liability Quiksilver Sportswear, Kamaaina Nissan, Orchid Land Surfboards Inc., 94.7 KWXX-FM, all sponsors and contributors, the State of Hawaii, the County of Hawaii, all contest officials, and its agents and employees as set forth above. DATED: _____________ ______________________________________________ DATED: _____________ ______________________________________________
STATE OF HAWAII COUNTY OF HAWAII ss.
On this ____________ day of ___________________, 2008, before me personally appeared_____________________________________, known to me to be the person described in and who executed the foregoing instrument, and acknowledge that he/she executed the same as his/her free act and deed. Witness my hand and seal. |