understand and acknowledge that I am of the full age of 18 years or older. If below 18 years of age a parent or guardian must also sign this form. I confirm that I am not under the influence of alcohol or any illicit or prescription drugs which would in any way impair my ability to agree to the terms of this agreeement or safely commence the procedures herein. This agreement will remain in effect for this procedure and all future procedures conducted by my stylist/artist or any other technician conducting business at Salty Roots Salon + Company, LLC. I understand that this agreement is binding and that I have read and fully understand all information above.

 

1. RISKS

I fully understand and accept the procedure and risks associated with Brow Lamination/Hybrid Stain/Tint and Lash Lift where my eyebrow/eyelash hairs will be semi-permanently restructured and styled and or tinted. I further hereby save harmless and indemnify Salty Roots Salon + Company, LLC. for any damages whatsoever resulting from me not complying with the request Salty Roots Salon + Company, LLC. has stated herein.

I understand and accept that it is my responsibility to remain still in a reclined position throughout the application or otherwise advised. Any medical conditions that might be aggravated by lying still for a prolonged period of time may mean that I will not be able to have the procedure performed on my eyebrows/lashes.

If at any time I am uncomfortable with the procedure, I will inform the stylist/artist and the stylist/artist will gladly rectify the problem, including ending the session if I (or the stylist) wish. If the stylist/artist is uncomfortable performing the service on me, the stylist/artist will discuss their concerns with me and may end the session if necessary. It has been represented to me that no guarantees, warranties, promises, commitments or other statement as to the results of this service have been made, and I acknowledge that I have received no particular representation or guarantees, and I am consenting to the procedure at my own risk. 

I have revealed or disclosed conditions and circumstances regarding my health and health history, medication being taken and any past reactions to products used or medication taken. I understand, additional conditions could occur to be discovered during or after the procedure, which could affect my ability to tolerate the procedure. I confirm that I do not have any medical, skin or hair conditions that may interfere with the procedure, application mentioned herein.  

I confirm I do not have any of the following skin conditions. If I have any of the following skin conditions, I understand I will not be suitable for the brow lamination and/or tint procedure.

• Psoriasis 

• Eczema 

• Alopecia 

• Sunburn 

• Ultra-Sensitive Skin 

• Wounds or Scar Tissue in the treatment area 

• Infection 

• Pimple in the treatment area

I confirm, I have not had any semi-permanent make-up procedure on my Brows for at least 8 weeks.

I confirm, I have not had any skin treatments on my face for at least 4 weeks and have not been on any medication that can affect the skin (such as Accutane) for at least 6 months. 

I confirm, I am not pregnant or breastfeeding (Brow Lamination, Brow Hybrid Stain, Lash Lift, and Lash Tint are not recommended). 

I understand and accept that Brow Lamination is an Alkaline based perm, so it is very strong. It is not suitable for clients with chemically damaged hair or extremely curly hair, as it can damage it further or cause unpredictable results. If the stylist/artist finds determines my brow hairs are damaged or is too curly, the stylist/artist may decide not to proceed with service.

I understand that if I wear contacts I must remove them before a Lash Lift or Last Tint service is performed.

 I understand and accept that some mild but normal symptoms may occur depending on the sensitivity of my skin during the procedure and will subside within 24 hours. These symptoms include:

(a) Mild tingling 

(b) Slight redness due to brushing brow hairs back and forth 

(c) Slightly warm in the area 

I acknowledge that I have been advised by Salty Roots Salon + Co. of the following potential health/medical risks associated with receiving brow lamination and/or tint and still wish to proceed with the procedures mentioned herein:

(a) Allergic reaction symptoms: itching, severe burning, skin flaking or peeling, inflammation, blisters  

I understand individual responses to product used for brow lamination/stain/tint and lash lift may vary - should a reaction occur, it is my responsibility to seek medical attention at my own expense. 

I will advise the stylist/artist of any discomfort, irritation, and/or discomfort immediately. 

I understand it is my responsibility to follow the aftercare instructions for best results.

I understand in order to maintain the effects of Brow Stain/Tint the service needs to be re-done every 4-6 weeks.

I understand in order to maintain the effects of Brow Lamination the service needs to be re-done every 6-8 weeks for maintenance.

I understand that brows may be come unruly if touch ups are not done.

I understand brow lamination will make styling the brows easier, but will not eliminate the need for styling. Brushing and/or use of a styling gel may still be required. 

I understand in order to maintain the effects of Lash Lift the service needs to be re-done every 6-8 weeks. These results may vary depending on several factors, including how well you look after them. It's important to use an oil-free makeup remover and avoid rubbing or sleeping with your face against a pillow when sleeping.

 

2. WAIVER, RELEASE OF LIABILITY AND INDEMNITY

 I, inconsideration of Leah Fenenbock and Salty Roots Salon + Company, LLC. completing the procedure(s) mentioned below, hereby release and further agree not to make any claim or demand, or commence legal action against Salty Roots Salon + Co., LLC for damages, compensation, loss or any relief whatsoever in respect of any cause or matter relating to the procedure(s). I further agree that this Agreement shall operate conclusively as an estoppel in the event any such claim, action or proceeding and may be pleaded accordingly.

I accept full responsibility for and indemnify and hold Salty Roots Salon + Company, LLC. and any of its employees and/or contractors, harmless and without liability of any kind whatsoever for the responses to products used for Brow Lamination/Stain/Tint and Lash Lift may vary - Salty Roots Salon + Company, LLC. and its employees will not be held responsponsible for any injury or damage that may occur.

I further agree to hold Salty Roots Salon + Company, LLC. nameless and harmless from any and all damages. I release Salty Roots Salon + Company, LLC. from any responsibility for pre-existing conditions I have not revealed, or any consequential change to those conditions that arises after the procedure. I understand I am responsible for any medical treatment I may need to receive because of getting this procedure. I accept full responsibility for these and any other complications, which may arise or resulting of getting this procedure(s), which are to be performed at my request.

Having read the above, I acknowledge that all of procedures contemplated and consented to herein have been fully explained and I fully understand the nature, scope and potential risks of the procedure(s) I am consenting to being performed and accept full responsibility for any and all results of the said procedure.

 

3. PRIVACY

I further acknowledge that any information provided by me to Salty Roots Salon + Company, LLC. is being provided solely for the purpose of Salty Roots Salon + Company, LLC. internal records and under no circumstances is it deemed to be given to Salty Roots Salon + Company, LLC. for the purpose of making or giving any medical advice, decisions, opinions, diagnosis, or representation to me or any other third party. 

 

 

4. CONSENT

I hereby consent Salty Roots Salon + Company, LLC. taking photographs of me both before and after the procedures being undertaken by Salty Roots Salon + Co and at the request of myself. It is further understood, acknowledged and herein authorized for Salty Roots Salon + Company, LLC. to use photographs for the purpose of compiling an album of its various current/past clients to show prospective clients, including but not limited to uploads to social media platforms such as Facebook, Instagram, Google, TikTok, etc. and to be included in Salty Roots Salon + Company, LLC. eyebrow tattoing course material, the procedures completed by Salty Roots Salon + Co. in its normal course of business. In the event that I do not wish for Salty Roots Salon + Company, LLC. to use said photographs in its prospective client photo album or on social media then I shall expressly state so by completing "Schedule A" attached to this Agreement and I thereafter acknowledge and consent to Salty Roots Salon + Company, LLC. retaining said photographs solely for its own files and internal use in development and monitoring of all services provided. 

I hereby warrant that I have read this Agreement carefully, understand its terms and conditions, acknowledge that I will be waiving certain legal rights by signing it (including the rights of the minor, my spouce, chidlren, parents, guardians, heirs, and next of kin, and any legal personal representatives, executors, administrators, successors, and assigns), acknowledge that I have signed this Agreement freely and voluntarily, without any inducement, assurance or guarantee, and intend for my signature to serve as confirmation of my complete and unconditional acceptance of the terms, conditions and provisions of this Agreement. This Agreement shall be deemed to have been made in accordance with the laws of the State of Florida. If any provision shall be deemed severable from this Agreement and shall not affect the validity and enforceability of any remaining provisions.

IN WITNESS WHEREOF  the parties hereto acknowledge and agree that they have read and understand the terms of this Agreement on

 

Per: Salty Roots Salon and Company, LLC.

expressly state I do not give permission to Salty Roots Salon + Company, LLC. to use photographs taken of me, both before and after the procedures being undertaken for use in its prospective client photo album or on any social media platforms. 

 

Per (company name): Salty Roots Salon and Company, LLC.

Artist name: Leah Fenenbock