Eyelash Extension Consent Form

I {input7:firstname-3} agree to have eyelash extentions applied to my natural eyelashes and/or removed and retouched. By signing this agreement, i consent to the placement and removal of eyelash extentions by the certified eyelash extention professional.

I understand there are risks associated with having artificial eyelash and lash extensions applied to, or removed from my natural eyelashes. I further understand that as a part of the procedure, irritation, pain, itching, discomfort, and in rare cases, infection or blindness can occur. I agree that if I experience any of these medical conditions with my lashes I will contact the certified lash extension professional and have the eyelashes removed immediately and consult a physician at my own expense. I understand that even though the certified eyelash extension professional applies or removes the eyelash extensions using the proper technique, the instruments, tape, cleansers, gel pads, adhesive, and remover is used may irritate my eyes or require a physician follow up care and subsequent removal of the eyelash extensions.*

I understand and agree to the care instructions provided by the certified eyelash extension professional for the use and care of my eyelash extensions. I realize and accept the consequences of failure to adhere to these instructions may cause my eyelash extensions to fall out, damage the extensions and/or decrease the time the lashes will last.*

I am informing my certified eyelash extension professional of the following conditions.*

I agree to the following eyelash extensions post op and maintenance instructions:

This agreement will remain in effect for the procedure and all future procedures conducted by the certified eyelash extension professional. I read English to understand that this consent form is legal and binding. I have read and fully understand all information in this agreement. I am over 18 years of age and consent to the agreement and to treatment.

I agree to my eyelash extension professional using my photo and/or video in any online communities or forums ( including but not limited to Facebook, Instagram and other online social media). My eyelash extension professionals right of use shall include the right to publish, adapt, exhibit, reproduce, edit, distribute and display my images or likeliness in connection with any product or service for any purpose ( including, promotional advertising and trade) in all markets, media or technology known or hereafter developed, I shall not have any entitlement to compensation for any contact used.

I release my technician or Glam & Glō Squad from all liability associated with this procedure, which is performed with the utmost attention to safety and proper application using tools and products for the technician has been professionally trained to use. There is no guarantee for the bonding time of the eyelash extensions. Glam & Glō Squad , Michelle Quady, is not responsible for any technician errors. I understand the aftercare instructions and will do my part in maintaining my eyelash extensions. I understand that there are many factors they may affect the life of the eyelash extensions such as water and moisture contact, weather conditions, and activities involving exposure to high temperatures.

By signing below, I verify that I have read and understand the above statements and agree to them. By signing this form below I also grant permission to take before and after photos of my eyes/face which may be used for marketing purposes on a website, social media or class.*

Signature*