Online Waiver Form
Online Waiver Form
To save time, prior to your appointment, please fill out our online waiver form below. Thank you. If you prefer to download a copy and fill it out, please
Indicates required field
Date of Birth
Month and Day Only, Example May 28
9 years and younger - No Services permitted whatsoever.
10 years - 17 years - Selected services permitted in the presence of their legal guardian to sign the customers release form on their behalf.
18 years and older - Services permitted with the customer's release form signature.
Waxing, Sugaring, Lash Extension, Make-Up Application Customer's Release and Acknowledgment of Risk
This is a RELEASE for waxing, sugaring, lash extensions and make-up applications ("Services"). I release, discharge, hold harmless, and absolve Brows By Sholin Dass (the "Released Parties") from any and all actions, suits, demands of any kind whatsoever, and claims of liability of any nature, including claims of negligence, for any damages or injuries, which I, my heirs, executors, administrators and assigns had, now have by reason of any matter connected in any way with the Services. By signing this release, I understand that I am giving up my rights to sue the Released Parties for any claims, damages or injuries relating to the Services.
I understand that I should not have the Services if I am currently using (or have recently used) any of the following products or have recently had any of the procedures, and I confirm the following:
I am NOT currently using...
-Retinol, any form of vitamin A
-Benzoyl Peroxide (clinical grade)
I have NOT in the past month had a...
-Microdermabrasion (professional grade)
-Any other kind of peel
Within the last 6 months, I have not used...
I understand that if I am taking medications, have undergone other procedures, or if I have allergies, any / all of these factors may cause certain effects upon my receipt of the Services. I expressly acknowledge that it is my responsibility to consult my physician to determine if I should receive Services from Brows By Sholin Dass.
I understand that there is a risk that I may experience an adverse reaction, such as but not limited to, bruising, redness, swelling, scabbing, pimples, raw or peeling skin, and/or rash, from the Services that I have asked Brows By Sholin Dass to provide to me.
I acknowledge that Brows By Sholin Dass has made no particular representation or guarantee about the Services to me.
I understand it is my responsibility to follow the advice and direction of my service professional during the Services and after-care advice provided to me.
I voluntarily assume any and all risk of loss, damage or injury that I may sustain arising out of or as a result of the Services of any activity incidental thereto, however and whenever the same may occur.
I confirm that I was given the opportunity to read and review this Release prior to signing and that I was also given the option to receive a copy of its terms.
If any part of this Release and Acknowledgement of Risk Form shall be found invalid or unenforceable then such part shall be considered deleted from this Form, and this Form shall be construed and enforced to the maximum extent permitted by law.
Electronic Signature Consent
By checking here, I agree that I have read and understand the above, that the statements given by me are accurate and that I am voluntarily agreeing to services and to the release. If the client is a legal minor (See legal age definition in services policy, above), the client's parent or legal guardian must read and sign this release.
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