Entry Form

Sunday, August 30, 2015
QUEENS SURF, WAIKIKI
Makai of Duke Statue & Kuhio Beach
ENTRY FEE: $35
Entries must be received by Friday, August 28, 2015.
Maximum 1 surfing division per competitor. All entries may also
enter SUP Race. Entry fee includes t-shirt, lunch and prizes.
BEACH ENTRY FEE: $50
No refunds. No t-shirt for beach entries.
All NSSA participants & HASA top 10 participants
are not eligible to enter the contest in any division.
PRESENTED BY
— SPACES ARE LIMITED —
CLIP & MAIL
NAME OF KEIKI (Last Name)
(First Name)
Home Phone
Mailing Address
City
Emergency Phone Contact (Person to Notify in Case of Emergency)
Emergency Phone Number
State
E-Mail
DIVISIONS No parental assistance in the lineup except Kokua Division
Boys Shortboard:
6 - 9 years old
10 - 13 years old
6 - 9 years old
10 - 13 years old
Girls Shortboard:
6 - 9 years old
10 - 13 years old
Boys Longboard:
6 - 9 years old
10 - 13 years old
Girls Longboard:
Boys & Girls Kokua Division:
3 - 6 years old
parent assist, short or long board
6 - 9 years old
10 - 13 years old
Boys & Girls SUP Race:
CHOOSE
SHIRT
SIZE:
Age (as of 08.30.15):
Zip
S M L
S M
Youth Shirt Size
Adult Shirt Size
DOB:
Returned Checks: $25.00 charge
Mail Entries with Payment to: Na Kama Kai
PO Box 240039
Honolulu, HI 96824
Checks made payable to: Na Kama Kai
For more information: info@nakamakai.org or nakamakai.org
Duke’s OceanFest – Release, Waiver of Liability, Assumption of Risk and Indemnity Agreement
I acknowlege that surfing and related activities are hazardous and that I have made a voluntary choice to participate in these activities despite the risk that they present. In consideration of my being permitted to participate
in the Na Kama Kai (NKK) 3rd Annual Menehune Surfing Contest/Duke’s Ocean Fest, I agree to assume any and all risks of death which might be associated with or result from my participation in the event. I understand that
this waiver holds harmless the State of Hawaii, the City and County of Honolulu, Matson Navigation, Na Kama Kai, Aloha Surf Academy LLC, Outrigger Duke Kahanamoku Foundation, Duke’s OceanFest and sponsors of all
the events listed as well as memebers, administrators, officials, and officers of the above mentioned parties from all/any liability for injuries and damages what so ever arising from my presence or participation in the events.
I, the undersigned, have carefully read and understand this agreement and all its itmes. I understand that this release of liability which will legally prevent me or any other persons from filing suit or making any other legal
claim for damages in the event of my death or any injury to me. I also agree to conduct myself in professional sportsman-like manner before, during and after, and while I am in the vicinity of all NKK/Duke’s Ocean Fest
related events. I understand that any unprofessional or unsportsman-like conduct will be cuase for immediate disqualification from the event at the discretion of the Founder/CEO.
PARENT’S NAME
PARENT’S SIGNATURE
DATE
KEIKI’S NAME
KEIKI’S SIGNATURE
DATE