Corban Academy Admissions Application Form

I hereby authorize and consent to the use of images or videos, and their content, of me, with or without my name, by Corban Academy and Kona Faith Center, Inc. of Captain Cook, Hawaii for purposes including but not limited to: promotional materials, printed publications, internet posts, including social media, television, and other media sources. I do this with full knowledge and consent and waive all claims for compensation for use or for damages. I release Kona Faith Center, Inc., its officers, directors, employees, and agents from liability for any claims by me or any third party in connection with the use of my image.

I, the legal parent/guardian of the child/children listed below, hereby authorize and consent to the use of images or videos, and their content, of my child/children listed above, with or without their names, by Corban Academy and Kona Faith Center, Inc. of Captain Cook, Hawaii for purposes including but not limited to: promotional materials, printed publications, internet posts, including social media, television, and other media sources. I do this with full knowledge and consent and waive all claims for compensation for use or for damages. I release Kona Faith Center, Inc., its officers, directors, employees, and agents from liability for any claims by me or any third party in connection with the use of the image of my children listed below.

1. I (or my parent/legal guardian) sign this waiver voluntarily with the understanding that I (student) cannot participate in being part of the Corban Academy community (to be known as "event") without agreement to the terms and conditions that follow.
2. I shall conform to all applicable policies, rules, regulations, and standards of conduct established by the State/County of Hawaii, and Corban Academy, Kona Faith Center, Inc., Faith Center Property, Inc. (to be known as Non-profit Entity) and will not participate in any illegal activity.
3. I shall accept termination of my participation in this event if I fail to maintain acceptable standards of conduct as established by Nonprofit Entity and the State/County of Hawaii and United States of America.
4. I hereby release, waive, discharge and covenant not to sue (Nonprofit Entity, their directors, officers, employees, volunteers, and agents (hereinafter referred to as “Releasees”) from all liability to me, my personal representatives, assigns, heirs, next of kin or anyone else for any loss or damage in any claim or demands therefore, on account of property damage, personal injury or death, whether caused by the negligence of the Releasees or otherwise, arising out of any activity related to this event, including travel to and from this event.  

5. I agree to indemnify, save and hold harmless the Releasees and each of them from any loss, liability, damage or cost that they may incur due to my participation in this event, including travel to and from this event.

6. I hereby assume full responsibility and risk of bodily injury, death or property damage arising out of participation in this event as named above.  I understand that there are certain risks that may occur, including but not limited to: exposure to personal injury; accident or illness; forces of nature.

7. I further agree that the foregoing Release, Waiver, Indemnity Agreement, and Assumption of Risk is intended to be as broad and inclusive as possible, yet there may be unforeseen risks and will not hold the Releasees responsible in any manner.
8. I hereby grant permission for the performance of any first aid and/or emergency medical treatment that may be required in the case of an accident wherein I am rendered unconscious or unable to approve of the required medical treatment. In the event that I become the victim of an accident I will hold harmless from any liability or negligent actions which may arise in connection with the search and rescue, stabilization, evacuation, transportation, and emergency care I receive while secondary aid resources are being sought.

9. I hereby agree to permit Nonprofit Entity, agents, employees, volunteers, directors, officers, and other guests to take photographs (still or live) and make film records of this event without further recourse.  I understand such photographs and/or film may be used for commercial and/or promotional purposes.
10. I have read and voluntarily signed the Release, Waiver, Indemnity Agreement, and Assumption of Risk.

11. It is understood that Nonprofit Entity is not responsible and will not provide any medical or liability coverage, Workman’s Compensation, Temporary Disability Insurance, Auto Insurance or ANY other liability or other insurance of any kind and Non-profit entity is not responsible to you or any other person or insurance company in the event of illness, accident, injury or death traveling to and from and while at our premises.

12. I hereby acknowledge and state that my participation in this activity is entered into as a free and voluntary act with full and complete knowledge of the risks involved.

13. In addition, in case of accident or need for medical attention, I give permission to the Nonprofit Entity representatives to take named participant to a doctor and/or emergency facility.  It is understood that all expenses for treatment provided will be borne by the parent, guardian or the participant with no cost to Corban Academy, Kona Faith Center, Inc., or Faith Center Properties, Inc.

Check the boxes below to note you have read the above sections and agree to their contents. (Checking each box equates to initialing the section.)

This event as named above includes activities involving risks or injury.  I understand that activities will involve participation in exercises that are, by their nature, physically demanding and will subject the participant to stress, anxiety and possible hazards, not all of which can be foreseen.

Notice Of Nondiscriminatory Policy As To Students:
Corban Academy admits students of any race, color, national, and ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the academy. It does not discriminate on the basis of race, color, national and ethnic origin in administration of its educational policies, admissions policies, scholarship programs, and athletic and other academy-administered programs.