Juvenile Waiver Form
Juvenile Waiver Form
6/15/2011 2:10:14 PM
6/15/2011 2:10:13 PM
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<br />WAIVER OF CONFIDENTIALITY <br />(complaints involving juveniles) <br />We, ______________________________________________, state and certify <br /> <br />(Type or print names) <br />that we are the parents/or legal guardians of: _________________________________ <br />) <br /> <br />(Type or print juvenile's name <br />Our address is: _________________________________________________________ <br />Our telephone number is: _______________________________ <br />Our social security numbers are: _______________ __________________________ <br />(Type or print SSN) (Type or print name) <br />______________ __________________________ <br />(Type or print SSN) (Type or print name) <br />As the parents and/or legal guardians of the above named juvenile, we are aware <br />that any police reports and/or records involving said juvenile's arrest are strictly <br />confidential by law. See Sec. 571-84(e), Hawaii Revised Statutes, Sec. 571-11(1) <br />H.R.S., and Sec. 92F-22(4), H.R.S. We agree to forever indemnify and hold harmless the <br />County of Hawaii, its agents, representatives, successors and assigns for any claim, <br />charge or lawsuit for releasing, and forever waive any claim of confidentiality in any <br />police records and/or reports involving said juvenile's arrest, to the Hawaii County Police <br />Commission. We also acknowledge and agree that we are not entitled to any police <br />reports and/or records involving said records if any criminal investigation and/or criminal <br />prosecution is pending in any of the Courts of the State of Hawaii. <br />____________________________________________________________ <br />) <br />(Signature of parent/guardian)(Signature of parent/guardian <br />DatedDated: _______________ <br />: _______________ <br />
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