UNCONVENTIONAL BEAUTY SPA & RETREAT

Disclaimer: Welcome & thank you for your interest in being a client of Unconventional Beauty Spa & Retreat. This form is used to collect information about new clients and used for internal purposes only. The information you provide is confidential and will be treated accordingly.

I have read and understand this waiver and have been fully informed of all  Unconventional Beauty Spa & Retreat terms and conditions as well as benefits and limitations. I certify that I have disclosed all medical conditions that might affect my treatments as well as previous products and services used and their side effects, if any. Esthetician Ponjola Thomas or authorized staff of Unconventional Beauty Spa & Retreat disclaims liability for any loss, injury, claim or damage related to your use of its products and services, including without limitation, those resulting from errors or omissions, a site or application being down, data loss, and unsatisfactory aesthetic outcomes Unconventional Beauty Spa & Retreat will not be liable to you for any indirect, incidental, consequential, reliance or special damages, including without limitation damages arising from any court action or legal dispute. In no event shall the aggregate liability Unconventional Beauty Spa & Retreat, whether in contract, warranty, tort (including negligence, whether active, passive or imputed), product liability, strict liability or other theory, arising out of or relating to the use of Unconventional Beauty Spa & Retreat products or services, exceed any compensation paid by you for treatment by Unconventional Beauty Spa & Retreat during the three months prior to the date of any claim. I release my providers from any injury or complication resulting from undiagnosed medical conditions present during my treatment. I assume all responsibility for updating changes in physical and mental condition.

I acknowledge that l am aware of and understand the risks that are associated with receiving a facial and makeover, and that I have had the opportunity to ask questions to my esthetician, which have been answered to my full satisfaction.

I confirm that I am voluntarily choosing to receiving a facial/ makeup treatments:

I confirm that I do not have any open skin lesions or an outbreak of herpes in the area of receive the facial/ makeup.

I confirm that I am not currently under the influence of alcohol or recreational drugs.

I confirm that I have given an accurate and truthful account of my medical and skin history, including all allergies, current medications and topicals that I am using to my esthetician before receiving my facial/ makeover.

I agree to release and indemnify and forever hold harmless my esthetician from any and all claims, damages, and legal actions arising from or connected in any way with my facial procedure.

By signing below I confirm that I am at least 18 years of age, or that a parent/guardian is signing on my behalf. I also confirm by signing below that I have read and fully understand and accept the provisions of this document and that I consent to receive the facial procedure.

I hereby grant permission to the rights of my image, likeness and sound of my voice as audio or video tape without payment or any other consideration. I understand that my image may be edited, copied, exhibited, published or distributed.

Additionally, I waive any right to royalties or other compensation arising or related to the use of image or recording.

I also understand that this material may be used in diverse educational settings within an unrestricted geographic area.

Photographic, audio or video recordings may be used for the following purposes:

conference presentations
educational presentations or courses
informational presentations
on-line educational courses
educational videos
social media and any other outlet for promotional purposes

By signing this release I understand this permission signifies that photographic or video recordings of me may be electronically displayed

CONSULTATION & DEPOSITS: All clients must receive a free consultation from me BEFORE booking services. This will help you and I understand the availability you need, the desired look, time & day, travel needs, etc.

All deposits must be submitted 3-5 days in advance DURING business hours. After hour bookings for a next day appointment will be considered a same day appointment (additional $20).

LATE FEE: Because I value every clients time; due to the booking process I may not be able to accept late clients or squeeze in appointments.

Unfortunately any appointment 10mins late will have to be cancelled.

RESCHEDULING: All clients are allowed to reschedule appointments 24hrs before the appointment date. The deposit paid for the appointment will be credited towards the rebooked appointment. I do understand that unforeseen circumstances occur in our everyday lives.

Any appointment rescheduled the same day of service will not be applicable for the credit to rebook. You must book a new appointment.

PAYMENT METHOD: All deposits and ending balances are collected via booking app. This is so that I can keep track of accurate number for business reasons. Cash app & Apple Pay are not accepted ( contactless Apple Pay is accepted)

NO SHOW APPOINTMENTS:Unfortunately no call no show appointments will be charged the same amount owed. Based upon reasoning for the mishap, client maybe banned from future bookings.

INSUFFICIENT FUNDS/ REFUSAL TO PAY CANCELLATION FEE

INSUFFICIENT FUNDS: Any client that refuse to pay the cancellation fee or no show fee, or does not update their card information so that their payment can be processed will be banned from booking.

GROUP BOOKINGS: All prices are final. Group sessions are priced on the amount of people being serviced. If one person cancels you can either reschedule within 24hr of the appointment or cancel. The price remains the same if you booked a 4 person session and only 3 shows.

TRAVEL FEES: Our travel fee starts at $85 then this is added to your location miles so ($85+ miles X $0.70 X 2 (round trip). For business use in Virginia in 2025, the mileage reimbursement rate is the standard IRS rate of $0.70 per mile. This rate, effective January 1, 2025.

To ensure a relaxing and professional experience for everyone, please take note of the following guidelines:

    •    Respectful Conversations: We kindly ask that you refrain from engaging in gossip during your visit. Our focus is on providing you with a serene and professional environment.

    •    Sober and Smoke-Free Appointments: Please arrive for your appointment sober. Smoking and alcohol consumption are not permitted during your session.

    •    Chewing Gum: You’re welcome to enjoy gum; however, during eyebrow and eye makeup services, please avoid chewing or talking. This helps us maintain precision as we brace our hands on your face for detailed work. Once the eye portion is complete, feel free to resume chewing and chatting.

    •    Cell Phones: For a smooth and uninterrupted session, we kindly ask that you refrain from using your phone during your appointment.

    •    Punctuality: Please plan your time accordingly and arrive promptly for your appointment. This allows us to provide your service without rushing and ensures a timely experience for all clients.

    •    Snack Area: You’re welcome to enjoy refreshments from our snack area. Please be mindful of others and leave enough for clients scheduled after you.

    •    No Additional Guests: To maintain a tranquil atmosphere, only clients receiving services should be present. We kindly ask that children or additional companions remain at home unless they are scheduled for an appointment.

Thank you for your understanding and cooperation. We look forward to providing you with an exceptional experience.

By signing this form, the client agrees to the following:

I understand, have read and completed this questionnaire truthfully and agree to inform the technician of any changes in the above information. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I understand that withholding information or providing misinformation may result in contraindications and/or irritation to the skin from treatments received. The treatments I receive here are voluntary and I release this institution and/or skin care professional from liability and assume full responsibility thereof.