I hereby grant and authorize Lancaster’s Luxe Lashes the right to take, edit, alter, copy, exhibit. publish, distribute and make use of any and all pictures. video, and/or audio is taken of me to be used in and/or for any lawful promotional materials including, but not limited to, newsletters, flyers, posters, brochures, advertisements, press kits, websites, social networking sites, and other print or digital communications without payment or any other consideration. This authorization extends to all languages, media, formats, and markets now known or later discovered. I waive the right to inspect or approve the finished product wherein my likeness appears, including a written or electronic copy. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image or recording. I hereby hold harmless and release Lancaster’s Luxe Lashes from all liability, petitions. and causes of action which I. my heirs. representatives. executors. or any other persons may make while acting on my behalf or on behalf of my estate.

This agreement will remain in effect for this procedure and all future follow-ups conducted by the certified eyelash extension professional. I understand that this consent agreement 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 the eyelash extension application procedure.
 
By signing below I knowingly and willingly consent to release any and all liability for the unintentional exposure or harm due to COVID- I9.
 
By signing below, I agree to the following:
I have completed this form to the best of my ability and knowledge. I agree to inform the technician of any changes in the above information. I agree that I do not have any condition(s) that would make the requested treatment unsuitable. I will inform the technician of any discomfort I may experience at any time during my treatment to allow them to adjust accordingly. I agree to waive all liability toward my technician and the salon for any injury or damages incurred due to any misrepresentation of my health.

By signing below, I acknowledge there is a no-refund policy in place. By paying for my service at the completion, I am acknowledging that I am satisfied with my services provided.

I, certify that this Informed consent, and waiver form was completed by me and that I understand all the questions, terms and conditions, and all entries in it and information are true and complete to the best of my knowledge. I agree to observe and obey all posted, written and oral rules and warnings, including on those materials provided by Lancasters Luxe Lashes.

I agree to waive and release to the fullest extent permitted by applicable state law each of the Tooth Gem service provider and the management of Lancasters Luxe Lashes from all liability whatsoever, from any and all claims or causes of action that I, my estate, heirs, executors or assigns may have for personal injury or otherwise, including any direct or consequential damages, which may result or arise from the application of, or my accidental swallowing of tooth gems, weather caused by the negligence or fault of the Tooth Gem service provider.


I understand that the application of tooth gems and products does not include any drilling into the tooth or breaking skin and may cause marks or discoloration of my teeth.


I understand that the application process of tooth gems may affect my tooth enamel, and I have been given the opportunity to talk about the risks associated with my Tooth Gem products with my Tooth Gem service provider.

I understand that the bonding agent used to apply my tooth gem may affect my teeth, and that I have been given the opportunity to talk about the risks associated with the bonding agent with my Tooth Gem service provider.


I understand and agree that the tooth gem application procedure is semi-permanent and there is no guaranteed amount of time the products will remain on my tooth.


I understand that certain tooth gems may fall off for any or no reason after applying the gems to my teeth. I understand and agree that Lancasters Luxe Lashes is not responsible for replacing or substituting any products, including any gems, white gold, crystal or gold charms, if my tooth gem falls off.
 
I understand that I should continue to see a dentist regularly to maintain proper oral health and hygiene for my teeth.
 
I have been advised that I should contact a dentist to remove all residue from the bonding agent from my tooth if my tooth gem falls off or if I wish to remove it.
 
I understand and will follow the aftercare instructions given to me by the Tooth Gem service provider to ensure the longevity of my tooth gem. 


I have been advised to not bleach or perform blue light whitening procedures on my teeth because such procedures may affect the bonding agent used to apply my tooth gem and the tooth gem itself.
 
I agree to indemnify and defend Lancasters Luxe Lashes and its representatives, employees, contractors, and agents, against all claims, causes of action, damages, judgements, costs or expenses, including attorney fees and other litigation costs, which may in any way arise from my use of, or presence upon the facilities of Lancasters Luxe Lashes.
 
I hereby authorize my Tooth Gem service provider and Lancasters Luxe Lashes permission to take photographs and use my likeness in a photograph or video for its promotional materials and publications, print and digital. I understand and agree that all rights to any photograph of me belong to Lancasters Luxe Lashes . If you do not authorize permission to take and use your photos, you must speak to our first impressions before the service is rendered.
 
The invalidity or unenforceability of any provision of this Release of Liability shall not have any effect on any other provision of this Release of Liability or of any other applications of such provision, and such unenforceable provision shall be deemed not to be a part of this Release of Liability.
 
The parties will attempt to resolve any dispute arising out of or relating to this Release of Liability through friendly negotiations. If the matter is not resolved, the parties agree to using mediation.