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Eyelash & Eyebrow Tinting & Eyelash Perming Release Form

Lash & Brow Tinting & Lash Perming RELEASE FORM

YOUR COMPANY NAME & ADDRESS

 TINTING & PERMING RELEASE FORM

I hereby release, acquit and forever discharge Company Name of all, and from all manner of action and actions, judgements, sums of money and demands whatsoever in law or in equity, which I ever had, now have, or may have against Company Name for, upon, or by reason of, any matter or cause whatsoever from the beginning of this day, Today's Date.

I have received my patch test 48 hours prior to the application of tinting & perming and am not allergic. I release Company Name from any and all damages that may result from this service.

 The undersigned acknowledges that Technician’s Name has explained the nature of the above-noted treatment procedure herein.  I hereby consent to Technician’s Name performing the above-noted treatment procedures on  me and in consideration of their doing so, I hereby and forever discharge Company Name,  its officers and employees of and from all claims, demands, damages, actions and cause of action arising out of the performance of the said treatment procedures, which I, my heirs, executors, administrators, or assigns can, shall or may have.  Being of sound mind and body, I hereby release any and all persons representing Company Name  from all responsibility.  I accept all responsibility myself for any consequences that might stem from my decision to have tinting & perming work done.  I agree that these waivers also pertain to and are designed to protect any and all establishments where Technician’s Name conducts business. 

In Witness Whereof; this _________ day of _______________________  2010

____________________________________      _________________________________

            Client's Signature                                    Technician's Signature

You could also add:  I chose to have this service done without a patch test Yes or  No   ____________________________

                                                                                                                                                     Client's Signature

IMPORTANT:  If you choose to use this Release Form have your attorney review it and customize it for your state laws.

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