Parental Consent Form

I, the undersigned (insert full legal name below) *

I am the parent and/or legal guardian of the subject minor (insert name below) who was born on such date indicated below: *

I give permission to xlashout_ (lashedbybri) to place artificial eyelash extensions on the subject minor*

I AGREEI DO NOT AGREE

My child(ren) has the following conditions/sensitives that the eyelash technician should be aware of:*

If none, please insert “none”

I understand and consent to have my child(ren) eyes closed and covered for the duration of the procedure of approximately 3-4 hours. These may vary depending on the type and number of eyelashes applied.*

I AGREE & CONSENTI DISAGREE & DO NOT CONSENT

I give consent to my lash artist, xlashout_ to take photographs of my child(ren)'s lashes and use them as content for xlashout_'s use.*

I CONSENT TO THE FOREGOINGI DO NOT CONSENT

I agree to each statement above and release xlashout_ (Brianijean Camacho) from any and all liability. I accept and agree to the procedure indicated below ( and any further procedures) that will be conducted on my child(ren). Please indicate appointment date & time below:*

I AGREE & RELEASE ALL LIABILITY FROM xlashout_ (BRIANIJEAN CAMACHO)I DISAGREE & DO NOT CONSENT TO ANY OF THE FOREGOINGOther

I understand that in rare occasions there are risks associated with having artificial eyelash extensions and eyelash extensions applied to or removed from my natural eyelashes. I further understand that in rare cases as part of the procedure, eye irritation and discomfort may occur. I agree that if I experience any of these conditions with my lashes that I will contact the certified lash extension artist and it may be beneficial to have the eyelash extensions removed.*

I UNDERSTANDI DO NOT UNDERSTAND

I hereby release any and all persons representing this small business from all claims, demands, damages, actions, and cause of action arising out of the performance of the service.*

I AGREEI DISAGREE

This agreement/parental consent form will remain in effect for this procedure and all future services conducted by the Certified eyelash artist technician. I read english and understand that this parental consent/agreement is legal and binding. I have read carefully and efficently and fully understand all the information, terms, and conditions in this agreement. I acknowledge that my child(ren) is under the age of 18 years old. By sigining this parental consent form, I am agreeing to have xlashout_ (Brianijean Camacho) conduct this eyelash extension procedure on my minor child.

I declare under penalty of perjury that the foregoing is true and correct to the best of my knowledge and I consent to all the stated above.

I, the undersigned, who's name is stated above and the parent/legal guardian of the subject minor hereby release any and all persons representing this small business from all claims, demands, damages, actions, and cause of action arising out of the performance of the service.

Signature*

By signing, I agree to the foregoing indicated on this form.

Date*

Date

Time*

Hour Minutes

AM/PM Option

Parental Consent for Eyelash Extensions