Site Usage Request Form Fields marked with a * are required Last Name * First Name * School / Organization * Address * City / State / Zip * Phone * Your Email * Requested Sites Hale Kanaka‘ole Hale o Lono Pā Hoaka Kaupō Waikahekahe Kamokuna Date of Visit * Time * Planned Activity * Total # of people * Age Range * Who will be in charge of the group? Do you agree to pay a site usage fee? Yes No (See Site Usage Fee Policy below. Fees are non-refundable and payable upon approval of Site Usage Request Form.) Additional Comments: Anyone that will be attending the excursion (students, teachers, and chaperones) must complete the Acceptance of Conditions and Release of Indemnity Form. These forms must be filled out and returned to the Edith Kanaka‘ole Foundation prior to the excursion. The Release form is a one-time form so once filled out it will last an entire school year, and covers all sites under the stewardship of the Edith Kanaka‘ole Foundation. Group leaders are responsible for their own safety and other equipment; i.e.: First aid kit, water cooler, etc. Submit class list of participants with these forms and update as necessary. EKF Site Usage Fee Policy Use of the Edith Kanaka‘ole Foundation sites are for cultural and educational purposes only. Effective June 1, 2004 a small fee will be charged for site usage at all EKF sites to help offset maintenance costs. While we do not want to discourage site usage by assessing this fee please understand that without your donations we would not be able to share these special places with you. Fee: A minimum fee of $60.00 or $3.00 per person, which ever is greater, will be charged. If the EKF facilitator is needed for more than one hour an additional fee will be assessed.