Skip to Content
Honolulu Emergency Services Department
Ka ʻOihana Lawelawe Ulia Pōpilikia o Honolulu
Search for:
Home
Emergency Medical Services
Meet the Team
Join the Team
Calling 911
Resources
Prepare for a 911 Medical Emergency
Billing
EMS Unit Locations
Natural Disasters
Data and Statistics
History
In Memoriam
Awards
Community Outreach
Educational Resources
EMS Explorers (Junior Paramedics)
Ocean Safety
Meet the Team
Join the Team
Resources
Prepare for Ocean Emergencies
Beach Signs
Lifeguard Tower Locations
Natural Disasters
Data and Statistics
History
Awards
Community Outreach
Junior Lifeguards
Health Services
Meet the Team
Join the Team
Data and Statistics
C.O.R.E.
Meet the C.O.R.E. Team
Staying Safe
Contact Us
News
Calling 911
Home
Emergency Medical Services
Meet the Team
Join the Team
Calling 911
Resources
Prepare for a 911 Medical Emergency
Billing
EMS Unit Locations
Natural Disasters
Data and Statistics
History
In Memoriam
Awards
Community Outreach
Educational Resources
EMS Explorers (Junior Paramedics)
Ocean Safety
Meet the Team
Join the Team
Resources
Prepare for Ocean Emergencies
Beach Signs
Lifeguard Tower Locations
Natural Disasters
Data and Statistics
History
Awards
Community Outreach
Junior Lifeguards
Health Services
Meet the Team
Join the Team
Data and Statistics
C.O.R.E.
Meet the C.O.R.E. Team
Staying Safe
Contact Us
News
Calling 911
Temp Test Page
Lorem ipsum dolor sit amet, consectetur adipiscing elit. Maecenas vitae congue nibh. Suspendisse dictum lorem id sapien vehicula cursus. Praesent gravida, lectus at eleifend porta, velit sapien maximus.
Hero Button Text
2024 Summer Junior Lifeguard Registration
Junior Lifeguard Name
(Required)
First
Middle
Last
Location
(Required)
You may only register for one location per child.
Kokololio (July 22-26, 9 a.m. - 2 p.m.)
Age, as of June 1, 2024
(Required)
Gender
(Required)
Male
Female
T-Shirt Size
(Required)
Shirts will be provide courtesy of Florence Marine X.
Extra Small
Small
Medium
Large
Extra Large
Extra Extra Large
Name of Parent/Guardian or Emergency Contact
(Required)
First
Last
Address of Parent/Guardian or Emergency Contact
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Phone of Parent/Guardian or Emergency Contact
(Required)
Email of Parent/Guardian or Emergency Contact
(Required)
Please State Any Medical Conditions or Allergies
(Required)
Consent
(Required)
I Agree to the Release and Waiver.
I, the Parent/Guardian or Emergency Contact, release the Ocean Safety and Lifeguard Services Division, the Honolulu Emergency Services Department, and the City and County of Honolulu, and any or each of its officers, agents, employees, and sponsors from any liability for injuries or damages arising out of or related to my child’s participation in and instructions provided by the City’s summer Junior Lifeguard Program.
I understand and agree that open ocean activities are inherently dangerous activities and my child’s participation in the City’s Junior Lifeguard Program, while supervised by City personnel, is knowingly and voluntarily entered into. As the Parent/Guardian or Emergency Contact of the Junior Lifeguard, I assume all risk of bodily injury and/or damages that may arise out of or relate to participation in this program. Should emergency medical care be required for my child while in the Program, I certify that my child is a covered insured under an existing health insurance plan/program and that I agree to pay for all such costs and expenses incurred for such emergency medical services.
I release the City and County of Honolulu, its officers, agents, employees, and sponsors and waive any and all claims for injuries and damages that may arise out of or relate to my child’s participation in the Program.
I have read and understand this Release and Waiver agreement and enter into this agreement knowingly and voluntarily.
Signature
(Required)
Please use your mouse to sign your name in the box above.
CAPTCHA
search
close
chevron-down
facebook-square
facebook
bars
youtube-play
instagram
chevron-down