Pamper Palace Kid’s Spa, Parties & Accessories LLC

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Name* This field is required.
First Name
Last Name
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Address* This field is required.
Street Address
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Phone Number* This field is required.
Area Code
Phone Number
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Email* This field is required.
example@example.com
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Event Name* This field is required.
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Event Date* This field is required.
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In consideration of being allowed to enter into the spa and/or participate in any parties or programs at Pamper Palace Kid’sSpa, Parties & Accessories, the undersigned, on his or her own behalf and on behalf of the minor identified acknowledges, appreciates and agrees that: * This field is required.
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I, the undersigned, parent/ guardian assume all risks and hazards incidental to participating in the activity and hereby waive, release, absolve, indemnify and agree to protect, defend and hold harmless Pamper Palace Kid’s Spa, Parties & Accessories , owners, staff and participants for any claim arising out of any injury to myself/ child to the fullest extent allowed by law. * This field is required.
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I, the undersigned parent/ guardian of the participant, am fully aware of the potential dangers and risk inherent in this activity, including physical injury, death or other consequences that may arise or result directly or indirectly from participation in all salon and spa services and activities. “If any provision of this clause is held unlawful, void, or for any reason unenforceable by a court of competent jurisdiction, then any such provision shall be deemed severable from this clause and shall not after the validity and enforceability of the remaining provisions.” * This field is required.
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Minor (Child) Photo Release Form: I, the parent or legal guardian of the child/children mentioned above grant all and any dba Pamper Palace Kid’s Spa, Parties &Accessories my permission to use photographs taken during this event for any legal use, including but not limited to: publicity, copyright purposes, illustrations, advertising and web content. Furthermore, I understand that no royalty, fee or other compensation shall become payable tome by reason of such use.* This field is required.
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Due to the 2019-2020 outbreak of the novel COVID-19 (Coronavirus), Pamper Palace Kid’s Spa, Parties & Accessories is taking extra precaution with the intake of each client, health history review, as well as sanitations and disinfecting practices. Symptoms of COVID-19Coronavirus)include: Common symptoms: Fever, tiredness, dry cough, Some people may experience: aches and pains, nasal congestion, runny nose, sore throat and diarrhea.* This field is required.
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I understand the above symptoms and I affirm that I and/ or child, as well as all households’ members, do not currently have, nor have experienced the symptoms listed above within the last 30 days. I affirm that I and/or the child, as well as all households’ members, have not been diagnosed with COVID-19 (Coronavirus)within the last 30 days. I affirm that I and/or child, as well as house hold members, have not knowingly been exposed to anyone diagnosed with COVID-19(Coronavirus) within the last 30 days.* This field is required.
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I affirm that I and/or child, as well as all household members, have not traveled outside of the country, or to any other city outside of our own that is or has been considered a “hot spot” for COVID-19 (Coronavirus) infections within the last 30 days. * This field is required.
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I understand that Pamper Palace Kid’s Spa, Parties & Accessories and its owners, agents, employees, officers, directors, trustees, binding heirs, executors, administrators, assignees, and all other persons or entities acting on its behalf cannot be held liable for any exposure to the COVID- 19 (Coronavirus) or any other contagion caused by misinformation on this form or the health history provided by each client. * This field is required.
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I understand that Pamper Palace Kid’s Spa, Parties & Accessories will NOT be liable if I and/or child fall ill with the COVID-19 (Coronavirus); either before, during or after coming to Pamper Palace Kid’s Spa, Parties & Accessories facilities. By signing below, I agree to each above statement and release the employees and Pamper Palace Kid’s Spa, Parties & Accessories from any and all liability for the unintentional exposures or harm due to COVID-19 (Coronavirus). * This field is required.
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Signature* This field is required.
Clear
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Date* This field is required.
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Minor Information for all of those that are participating in services:* This field is required.
First Name
Last Name
Age
Date of Birth
KNOWN ALLERGIES OR HEALTH CONDITIONS
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