HPU MCA Student Production Waiver Form

This is the online HPU Media and Cinematic Arts Student Production Waiver Form. Please fill in all required categories below, including your name, email address, phone number(s), and other information for your production course. Students will receive specific production deliverable assignments from your instructor or a Media and Cinematic Arts Representative. While taking part in course productions, you will be representing your program, department and Hawai'i Pacific University. Please conduct yourself appropriately, and respect your fellow collaborators. Please read the below Student Production Waiver in full, and complete the e-signature requirement.
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Student Production Waiver

I am aware that engaging in student production activities and being present in film or video production areas and sets involves inherent risks and dangers and may constitute being "in harm's way" due to the presence and very nature of heavy equipment, high voltage electricity, unmarked obstacles, sharp objects, and other materials and people. I hereby certify that I will have experience and knowledge of the safe usage of equipment I am using, or ask a faculty member or staff or help, before using any equipment, whether that equipment is for shooting film or video, or for the construction of sets (including the use of dangerous power tools). I certify that I will not use school tools and equipment in any way that might endanger myself, fellow students, faculty, or staff, or harm the equipment itself. I will also use appropriate safety measures when using such equipment and when present in film or video production areas, including but not limited to wearing safety glasses when using power tools, wearing rubber-soled shoes when using high-voltage electricity, and wearing work gloves when using lights and other hot materials and equipment. I further certify that I will intervene, or seek out faculty or staff of Hawai'i Pacific University to intervene, if I witness any unsafe practices that might harm any individual or the equipment itself, whether on campus or on locations. I hereby release, discharge and agree to hold harmless any individual, facility, school, or organization connected to or associated with the Department of Communication, the Multimedia Program or Hawai'i Pacific University for any and all damages, injuries or other harm that my befall me during any time I may work in or outside the school's studios, classrooms, media labs, and/or equipment stock rooms in connection with student production activities; this includes, but is not limited to, on-campus or off-campus location sites, whether with or without an instructor present, i.e., on self-directed location shoots.

















Electronic Signature

The Electronic Signature eliminates paper use and expedites the overall application process.To submit an electronic signature, simply type your name into the "Enter Electronic Signature" text field and click "Submit". This Production Waiver covers the semester term for the corresponding course that you are enrolled in.


Information for Minors

If the subject is a minor under the laws of the state where modeling, acting or performing is done, then additional Guardian information and signature is required. In that case, please see an instructor for further directions, and a hard copy of this form with signature lines for your Guardian.

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