CDS Customer COVID-19 Liability Release Waiver

COVID-19 Release of Liability Waiver

*Signature Required Prior to Every Scheduled Appointment*
Name *

First Name Last Name
Phone Number
Please enter a valid phone number.
When is your appointment date?

Month Day Year
Date
Email
example@example.com
What best describes how you feel about your upcoming spa visit?

I am looking forward to "The Camilla Experience". I am excited, but I want to spend as little time in public as possible.
Some of our menu items have increased. For more information about our updated menu, please click here.

Due to the outbreak of the novel Coronavirus (COVID-19), Camilla Day Spa is taking extra precautions with the care of every client to include health history review and enhanced sanitation/disinfection procedures in accordance with the Center for Disease Control and the Florida Board of Cosmetology.

Symptoms of COVID-19 include:
- Fever
- Fatique
- Dry Cough
- Difficulty Breathing
SERVICE PRESCREENING I agree to the following: *

1) I understand the above symptoms and affirm that I, as well as all household members, do not currently have, nor have experienced the symptoms listed above WITHIN THE LAST 14 DAYS. 2) I affirm that I, as well as all household members, have not been diagnosed with COVID-19 or have not knowingly been exposed to anyone diagnosed with COVID-19 WITHIN THE PAST 30 DAYS. 3) I affirm that I, as well as all household members, have not traveled outside of the country, or to any city considered to be a "hot spot" for COVID-19 infections WITHIN THE PAST 30 DAYS. 4) I understand that I am REQUIRED to wear a face mask upon arrival. If I arrive without a mask, I understand that Camilla Day Spa has masks available for purchase. 5) I understand that if I must cancel my appointment, I must notify Camilla Day Spa within 48 HOURS of my appointment time. 6) I understand that if I fail to accept all of the above conditions, I will be unable to enter the spa until I test negative for COVID-19 and am symptom free.
RELEASE OF LIABILITY AND AGREEMENT NOT TO SUE, INDEMNIFICATION, HOLD HARMLESS, LIMITATION OF WARRANTY

In consideration for providing services, by signing below you agree to accept all responsibility for the risk that you may contract COVID-19. While Camilla Day Spa is taking your safety and that of its staff seriously, by employing new safety and sanitation initiatives, Camilla Day Spa cannot guarantee that any of these measures will completely protect you from contracting COVID-19.

I agree that if I take any steps to make a claim for damages against Camilla Day Spa, its agents, employees or any other released parties arising out of my receipt of services during my visit to Camilla Day Spa’s facilities, I shall be obligated to pay all attorneys’ fees and costs incurred as a result of such claim.

I acknowledge that I can go elsewhere to have my services, and I acknowledge that Camilla Day Spa is not the only salon where I can receive salon services. By signing this Agreement, I acknowledge that I am free to go to other salons who may not require my agreement to accept responsibility for contracting COVID-19 and I chose to have services.

By signing, I agree to receive communication from Camilla Day Spa and I agree to each statement above and release Nail City & Spa Inc, DBA Camilla Day Spa from any and all liability for the unintentional exposure or harm due to COVID-19.
Date *

Month Day Year
Date
Signature *
Should be Empty:

COVID-19 Release of Liability Waiver