Loading...

Our standard liablility waiver must be signed prior to participating in any activities at Big Island Climbing Indoor Adventure Center including the use of the equipment at Pā'ani VR (virtual reality).


BIG ISLAND CLIMBING INDOOR ADVENTURE CENTER

RELEASE OF LIABILITY AND ASSUMPTION OF RISK

BY SIGNING THIS DOCUMENT I WILL WAIVE OR GIVE UP CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE OR CLAIM COMPENSATION FOLLOWING AN ACCIDENT. PLEASE READ CAREFULLY!

I, the undersigned, understand that in consideration of using the facilities, climbing walls, equipment and/or participating in activities of Big Island Climbing – Indoor Adventure Center, including Pa'ani VR (“BIC”), I must obey all rules and regulations of BIC regarding indoor rock climbing and its programs. I acknowledge that indoor rock climbing entails inherent risks such as death, injury, paralysis, and damage to myself, to property, or to third parties, including but not limited to: equipment failure, falling climbers, broken and/or falling holds, loose holds, the negligence of BIC or its agents, the negligence of guests or visitors of BIC, the negligence of the designers, manufacturers, or installers of the indoor rock climbing wall or its equipment, the negligence of the belayers, slips, falls, or collisions or other such actions occurring while using the indoor rock climbing wall or the virtual reality equipment. 

I hereby voluntarily release and forever discharge BIC from any and all liability, and agree to indemnify and forever hold harmless BIC from any and all claims, liabilities, demands, or causes of action, including any claims which I, my heirs, next of kin, assigns, estate, or personal representatives have or may have, which are in any way connected with my participation in indoor rock climbing, or any activities of BIC, or use of its equipment or facilities (collectively the “Activities”).

I expressly agree and promise to accept and assume all of the risks existing in these Activities, both known and unknown, whether caused or alleged to be caused by the ordinary negligence or omissions of BIC. I realize that by voluntarily assuming the risks involved, I will be solely responsible for my death or any injury or damage that I may sustain.

I certify that I am at least eighteen (18) years of age or older, physically and mentally capable of safely participating in indoor rock climbing and that any personal equipment that I use as part of my climb are appropriate and properly qualified for my climb. I further certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating in these Activities and I am willing to assume and bear the costs of all risks that may arise from these Activities. 

Terms and Conditions Waiver – Big Island Climbing and Pā’ani VR Virtual Reality Arcade

To: Donalea Partners, LLC, dba Big Island Climbing Indoor Adventure Center and Pā’ani VR Virtual Reality Arcade, a corporation incorporated under the laws of The United States of America, its agents, owners, officers, affiliates, volunteers, participants, employees, and all other persons or entities acting in any capacity on their behalf (hereinafter collectively referred to as “BIC”): This Assumption of Risks, Release of Liability, Waiver of Claims and Indemnity Agreement (the “Agreement”), together with any documents referred to herein, governs the User’s (described below) use of Pā’ani VR’s virtual reality equipment with various virtual reality content and/or software (the “Services”), at 126 Keawe Street, Hilo, HI (the “Premises”). In this Release Agreement, the term “Virtual Reality Arcade Activities” shall include but is not limited to: utilization of a Virtual Reality headset, observation of the use of a virtual reality headset, and all activities, services and use of facilities and equipment either provided by or arranged by Pā’ani VR including competitions.

By using the Services I confirm that I accept the terms of this Agreement and that I agree to abide by them. The words “I” and “me” in this Agreement refers to the User. Should I access the Services on the behalf of another legal entity, I hereby warrant that I have the authority, actual or implied, to bind that entity to the Agreement. In using the Services, I represent and warrant that I have the capacity to enter into a legal agreement in the state of Indiana. If I do not have the capacity to enter into a legal agreement in the state of Hawaii, I may not use the Services unless a parent or legal guardian agrees and consents to this Agreement on my behalf. By permitting a person who lacks capacity to utilize the Services, the parent or legal guardian is hereby bound by this Agreement

IN CONSIDERATION OF Pā’ani VR Virtual Reality Arcade allowing the User to use the Services, the User agrees as follows on behalf of themselves, their spouse, children, parents, heirs, assigns, personal representatives and estate:

I am aware that participation in Virtual Reality Arcade Activities as defined in this agreement, involves certain risks, dangers and hazards. These may include, but are not limited to: seizures, loss of awareness, eye strain, eye or muscle twitching, involuntary movements, altered, blurred, or double vision or other visual abnormalities, dizziness, disorientation, impaired balance, impaired hand-eye coordination, excessive sweating, increased salivation, nausea, light-headedness, discomfort in the head, discomfort in the eyes, drowsiness, decreased ability to multi-task, fatigue, symptoms similar to motion sickness of which can persist and become more apparent hours after use and which may lead to an increased risk of injury when engaging in normal activities after leaving the Premises. Falls to the ground, impacts with other people, impacts with the wall, the ground or other structures or equipment, entanglement, other injuries resulting from participation or observation, equipment failure, the negligence of other persons or negligence on the part of Pā’ani VR including the failure by Pā’ani VR to safeguard or protect me from the risks, along with other dangers and hazards of Virtual Reality Arcade Activities.

I AM AWARE OF THE RISKS, DANGERS AND HAZARDS ASSOCIATED WITH VIRTUAL REALITY ARCADE ACTIVITIES AND I FREELY ACCEPT AND FULLY ASSUME ALL SUCH RISKS, DANGERS AND HAZARDS AND THE POSSIBILITY OF PERSONAL INJURY, DEATH, PROPERTY DAMAGE OR LOSS RESULTING THEREFROM.

IN CONSIDERATION OF Pā’ani VR agreeing to my participation in Virtual Reality Arcade Activities and permitting my use of their services, equipment and other facilities, and for other good and valuable consideration, the receipt and sufficiency of which is acknowledged, I hereby agree as follows:

To waive any and all claims that I have or may in the future have against Pā’ani VR and to release Pā’ani VR from any and all liabilities of any loss, damage, expense or injury, including death, that I may suffer or that my next of kin may suffer, as a result of my participation in Virtual Reality Arcade Activities, due to any cause whatsoever on the part of Pā’ani VR, further including the failure of Pā’ani VR to safeguard or protect me from the risks of participation in Virtual Reality Arcade Activities;

To hold harmless and indemnify Pā’ani VR for any and all liability for any property damage, loss or personal injury to any third party resulting from my participation in Virtual Reality Arcade Activities;

This Release Agreement shall be effective and binding upon my heirs, next of kin, executors, administrators, assigns and representatives, in the event of my death or incapacity;

Any litigation involving the parties to this Release Agreement shall be brought solely within the state of Hawaii and shall be within the exclusive jurisdiction of Hawaii.

I CONFIRM THAT I HAVE READ AND UNDERSTOOD THIS RELEASE AGREEMENT PRIOR TO SIGNING IT, AND I AM AWARE THAT BY SIGNING THIS RELEASE AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS, ASSIGNS AND REPRESENTATIVES MAY HAVE AGAINST PĀ’ANI VR.

I CONFIRM THAT I HAVE READ AND UNDERSTOOD THE RULES GOVERNING MY PARTICIPATION AND/OR MY CHILD/WARD’S PARTICIPATION IN ANY ACTIVITY AT PĀ’ANI VR (the “Pā’ani VR Virtual Reality Arcade Rules”). I CERTIFY THAT I UNDERSTAND AND HAVE EXPLAINED THE PĀ’ANI VR RULES TO MY CHILD/WARD. I ACKNOWLEDGE THAT FAILURE TO FOLLOW THE RULES COULD RESULT IN THE EXPULSION OF MYSELF AND/OR MY CHILD/WARD FROM THE PREMISE.

IF I DO NOT AGREE TO THE TERMS OF THIS AGREEMENT I UNDERSTAND THAT I MUST DISCONTINUE MY ACCESS TO THE SERVICES. ANY CONTINUED USE OF THE SERVICES SHALL BE CONSIDERED AS ACCEPTANCE AND CONSENT TO THE TERMS OF THIS AGREEMENT BY THE USER OR THEIR PARENT OR LEGAL GUARDIAN.

 

I HAVE HAD SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT.

I HAVE READ AND UNDERSTOOD IT, AND I AGREE TO BE BOUND BY ITS TERMS.

 

SPECIAL WAIVER REGARDING COVID-19

To ensure the health and safety of our guests and our employees, until further notice, BIC has implemented the following policies to address the COVID-19 pandemic:

  • The amount of people in each area may be restricted.
  • Climbers and guardians agree to abide by the rules set by BIC regarding the COVID-19 pandemic.

(please review and initial below)

I do not have any symptoms of COVID-19, nor do I have any symptoms of any respiratory illness (i.e., cough, shortness of breath, fever, loss of smell/taste).

I Agree

To the best of my knowledge, I have not been exposed to any persons (family members, friends, etc). who have exhibited symptoms of COVID-19.

I Agree

PLEASE HELP US FOLLOW THESE GUIDELINES – it is your kuleana as well as ours.

I hereby release BIC from any potential exposure to COVID-19 which I, or my minor children, may be exposed to. I agree and understand that by entering this facility, I am assuming the risk of potential exposure to COVID-19 or related viruses. My consent to this COVID-19 Special Notice applies to me and any minor children named in this Waiver form.

Today's Date: November 30, 2023




First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Medical History

Please list any and all medical conditions which may affect your ability to participate in the Activities (e.g. heart conditions, recent operations, physical injuries, etc.):

Despite the foregoing medical conditions, you are expressly agreeing to participate in the Activities and agree to the terms herein.


If you decline to list your medical history, please initial here:  

First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Medical History

Please list any and all medical conditions which may affect your ability to participate in the Activities (e.g. heart conditions, recent operations, physical injuries, etc.):

Despite the foregoing medical conditions, you are expressly agreeing to participate in the Activities and agree to the terms herein.


If you decline to list your medical history, please initial here:  

Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Medical History

Please list any and all medical conditions which may affect your ability to participate in the Activities (e.g. heart conditions, recent operations, physical injuries, etc.):

Despite the foregoing medical conditions, you are expressly agreeing to participate in the Activities and agree to the terms herein.


If you decline to list your medical history, please initial here:  

Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Medical History

Please list any and all medical conditions which may affect your ability to participate in the Activities (e.g. heart conditions, recent operations, physical injuries, etc.):

Despite the foregoing medical conditions, you are expressly agreeing to participate in the Activities and agree to the terms herein.


If you decline to list your medical history, please initial here:  

Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Medical History

Please list any and all medical conditions which may affect your ability to participate in the Activities (e.g. heart conditions, recent operations, physical injuries, etc.):

Despite the foregoing medical conditions, you are expressly agreeing to participate in the Activities and agree to the terms herein.


If you decline to list your medical history, please initial here:  

Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Medical History

Please list any and all medical conditions which may affect your ability to participate in the Activities (e.g. heart conditions, recent operations, physical injuries, etc.):

Despite the foregoing medical conditions, you are expressly agreeing to participate in the Activities and agree to the terms herein.


If you decline to list your medical history, please initial here:  

Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Medical History

Please list any and all medical conditions which may affect your ability to participate in the Activities (e.g. heart conditions, recent operations, physical injuries, etc.):

Despite the foregoing medical conditions, you are expressly agreeing to participate in the Activities and agree to the terms herein.


If you decline to list your medical history, please initial here:  

Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Medical History

Please list any and all medical conditions which may affect your ability to participate in the Activities (e.g. heart conditions, recent operations, physical injuries, etc.):

Despite the foregoing medical conditions, you are expressly agreeing to participate in the Activities and agree to the terms herein.


If you decline to list your medical history, please initial here:  

Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Medical History

Please list any and all medical conditions which may affect your ability to participate in the Activities (e.g. heart conditions, recent operations, physical injuries, etc.):

Despite the foregoing medical conditions, you are expressly agreeing to participate in the Activities and agree to the terms herein.


If you decline to list your medical history, please initial here:  

Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Medical History

Please list any and all medical conditions which may affect your ability to participate in the Activities (e.g. heart conditions, recent operations, physical injuries, etc.):

Despite the foregoing medical conditions, you are expressly agreeing to participate in the Activities and agree to the terms herein.


If you decline to list your medical history, please initial here:  

Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Instagram: #bigislandclimbing

What is your Instagram handle?

I am the parent or legal guardian of the listed participant(s) (“Minor”), and hereby execute this Release for and on behalf of Minor and agree to bind myself, Minor, and any heirs, next of kin, assigns or personal representatives to the terms of this Release. I represent that I have full legal authority to act for and on behalf of Minor and I agree to indemnify and forever hold harmless BIC for any expenses, claims, or liabilities which may arise as a result of any insufficiency of my full legal authority to execute this Release.




By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Medical History

Please list any and all medical conditions which may affect your ability to participate in the Activities (e.g. heart conditions, recent operations, physical injuries, etc.):

Despite the foregoing medical conditions, you are expressly agreeing to participate in the Activities and agree to the terms herein.


If you decline to list your medical history, please initial here:  

Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE! and  Rock Gym Pro