New Customer Registration Form

Full Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

E-mail*

example@example.com

I acknowledge that the color service I have requested could have unintended results including but not limited to possible side effects which may add a greater risk of damage to my hair and possible allergic reaction to hair products, irritation, burning, redness, or soreness of the scalp and any other exposed skin. Additionally Color Bar Hair Salon/ Jackie Ferguson is not liable for lost or damaged items including but not limited to color damaged clothing, stains etc, that may have occurred before, during or after any color service.

I further acknowledge that I am aware that certain medications over the counter hair dye and various medical conditions can significantly increase the possibility of unfavorable results. I acknowledge that I now understand the risk that may occur from color correction services I have requested and I have been provided with an opportunity to ask my stylist questions about the possible adverse results and risks associated with my intended service appointment. I have decided to proceed with the requested color services.

I understand the risk and I agree that I will NOT hold my stylist, Color Bar Hair Salon, any other persons accountable or responsible if the results are now what I intended or if I suffer from an allergic reaction, irritation or any other condition.

I hereby release and forever discharge Color Bar Hair Salon, its owners, employees, and contractors including my stylist of and from all matter of actions, suits, claims, demands or damage of any kind or nature which I may otherwise have due to unintended or unfavorable results or skin irritation or other medical conditions that may occur from provision of the color correction services by any of the releases.

I confirm that I had an opportunity to consider the document and to obtain independent legal advice if I so desire with respect to the details of this acknowledgement and release and I confirm that I am accepting this acknowledgement and release freely voluntarily and without dureuss. I understand that it limits legal actions I could otherwise take against the releases.

I understand that following a consultation and by signing of the consent form, there will be absolutely NO REFUNDS for the professional services performed.

I understand Color Bar Hair Salon has a cancellation policy of 48 hours notice. If proper notice is not given I know I am held responsible for 50% of the services booked and my card on file will be charged. If I do not show for my appointment 100% of the services booked will be charged with the card on file with no refunds.

By signing below I am agreeing to all terms in this document.

Date*

Date

Signature*

Color Consultation Form