COVID-19 LIABILITY WAIVER
Name
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First Name
Last Name
Date
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-
Month
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Day
Year
Date Picker Icon
Name of Tattooist for upcoming visit
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Please Select
Kane
Jamie
Noel
Lucio
Clay
I knowingly and willingly consent to having tattoo service(s) during the COVID-19 pandemic. I voluntarily seek services provided by FOR THE SINNERS LLC and acknowledge that I am increasing my risk to exposure to COVID-19.
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by checking this box I understand and accept this statement.
I acknowledge that I must comply with all set procedures to reduce the spread while attending my appointment. This includes coming alone to your appointment, agreeing to a temperature screening, wearing a mask that covers the nose and mouth during the entire session while inside the shop, washing your hands upon arrival, and practicing social distancing. If guidelines are not met, artist has the right to cancel/reschedule at any time.
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by checking this box I understand and accept this statement.
I acknowledge the contagious nature of the COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing. I further acknowledge that FOR THE SINNERS LLC has put in place preventative measures to reduce the spread of COVID-19.
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by checking this box I understand and accept this statement.
I further acknowledge that FOR THE SINNERS LLC can not guarantee that I will not become infected with COVID-19. I understand that the risk of becoming exposed to and/or infected by COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, salon staff, and other salon clients and their families.
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by checking this box I understand and accept this statement.
I understand that air travel significantly increases my risk of contracting and transmitting the COVID-19 virus. I know that the CDC and OSHA recommend social distancing of at least 6 feet.
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by checking this box I understand and accept this statement.
I understand that due to the frequency of visits of other clients, the characteristics of the virus, and the characteristics of tattoo services, that I have elevated the risk of contracting the virus by merely being in the salon company.
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by checking this box I understand and accept this statement.
I verify that I have not traveled outside the United States In the past 14 days to countries that have been affected by COVID-19.
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YES
NO
I confirm that I have not traveled domestically within the United States by commercial airline, bus or train within the past 14 days.
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YES
NO
I confirm that I have not been diagnosed with Covid-19, and do not believe I have been exposed to someone with a suspected and/or confirmed case of COVID-19.
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YES
NO
I confirm that I am not experiencing any symptoms of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell. I further acknowledge FOR THE SINNERS has the right to refuse entry to symptomatic customers or visitors.
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YES
NO
I agree to inform my artist/and or shop prior to my appointment or shortly thereafter if I begin to feel any symptoms related to COVID-19, become diagnosed with COVID-19, or exposed to someone diagnosed with COVID-19.
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YES
I understand, read, and completed this questionnaire truthfully. I agree that this constitutes full disclosure and that it supersedes any previous verbal or written disclosures. I understand that this document is to provide the best possible guest experience when visiting FOR THE SINNERS. I hereby release and agree to hold FOR THE SINNERS LLC 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 FOR THE SINNERS LLC. I understand that this release discharges FOR THE SINNERS LLC 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 FOR THE SINNERS LLC. This liability waiver and release extends to the salon together with all owners, partners, and employees.
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YES
Signature
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Submit
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