Revolution Salon COVID-19 Liability Release Waiver

Revolution Salon COVID-19 Liability Release Waiver

**Signature Required Prior to Scheduled Appointment and will be valid for one year from the date signed**
Due to the 2019-2020 outbreak of the novel Coronavirus (COVID-19), Revolution Salon is taking extra precautions with the care of every client to include health history review and enhanced sanitation/disinfection procedures.

Symptoms of COVID-19 include:
- Fever or chills
- Cough
- Shortness of breath or difficulty breathing
- Fatigue
- Muscle or body aches
- Headache
- New loss of taste or smell
  Sore throat
- Congestion or runny nose
- Nausea or vomiting
- Diarrhea
I agree to the following:

I understand that this waiver applies to any time I am at Revolution Salon for up to a year from the date of signing this form. I will self assess every time prior to entering Revolution Salon and affirm the statements below to be true. 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. I affirm that I, as well as all household members, have not been diagnosed with COVID-19 WITHIN THE PAST 30 DAYS. I affirm that I, as well as all household members, have not knowingly been exposed to anyone diagnosed with COVID-19 WITHIN THE PAST 30 DAYS or I/ someone in my household is a healthcare worker that is taking the necessary safety precautions to prevent contracting Covid-19 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. I am following all CDC recommended guidelines as much as possible and limiting my exposure to the Coronavirus/COVID-19. I understand that Revolution Salon cannot be held liable for any exposure to the COVID-19 virus caused by misinformation on this form or the health history provided by each client. By signing below you agree to accept all responsibility for the risk that you may contract COVID-19. While we are taking your safety and that of our staff very serious, by employing new safety and sanitation initiatives, we cannot guarantee that any of these measures will completely protect you from contracting COVID-19. I hereby release and agree to hold Revolution Salon harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of the salon, or that may otherwise arise in any way in connection with any services received from Revolution Salon. I understand that this release discharges Revolution Salon from any liability or claim that I, my heirs, or any personal representatives may have against the salon with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any services received from Revolution Salon. This liability waiver and release extends to the salon together with all owners, partners, and employees.
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