New Client Form
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth
*
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Month
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Day
Year
Date
Glamour Ghoul Threading is currently home based, are you okay with that? If not please exit out and i'm sorry for the inconvenience.
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✔️
Is this your first time ever getting lash extensions?
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Yes
No
Do you wear glasses?
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Yes
No
I'm comfortable being photographed for the purpose of marketing, advertising and etc.
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✔️
Do you agree to reschedule if you are feeling sick or have symptoms of COVID-19(Tested positive for COVID-19)
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✔️
I understand that in rare occasions there are risks associated with having artificial eyelashes and eyelash extensions applied to or removed from my natural eyelashes. I further understand that in rare cases as part of the procedure eye irritation and discomfort could occur. I agree that if I experience any of these conditions with my lashes that I will contact the certified eyelash extension professional that performed this procedure and it may be beneficial to have the eyelashes removed.
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I understand and agree to the after-care instructions provided by the certified eyelash extension professional for the use and care of my eyelash extensions. I realize and accept the consequences of failure to adhere to these instructions may cause the eyelash extensions to fall out and/or decrease the time the lashes will last.
I understand and consent to have my eyes closed and covered for the duration of approximately 30-180 minute procedure. Times may vary depending on the type and number of eyelashes applied.
I am informing the certified eyelash extension professional of the following conditions by marking with a check: Current use of contact lenses which I may be asked to remove during the procedure Current use of anything such as oil-containing sunscreen or moisturizers around the eyes Current use of eye drops of any kind, prescription or over-the-counter Current allergies or sensitivities History of an allergic reaction to eyelash extension products History of recurrent eye or tear duct infections History of dry eyes or Sjorgen's Syndrome Recent history of Chemotherapy Other medical conditions which would prohibit or compromise placement and retention of eyelash extensions
I will inform the certified eyelash extension professional to the following conditions by marking with a check:
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Current use of contact lenses
Current use of eye drops of any kind
Current allergies or sensitivities
History of an allergic reaction to eyelash extension products
History of recurrent eye or tear duct infections
History of dry eyes or Sjorgen's syndrome
Recent history of Chemotherapy
Other medical conditions which would prohibit or compromise the placement and retention of eyelash extensions
Preferences, Comments, Concerns about the set
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đź–¤Consent Form đź–¤
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I, the undersigned client, hereby give Glamour ghoul threading the absolute right and unrestricted permission to take, use, and display photogenic images of me, through any form of media, print, digital, electronic, broadcast, or otherwise, at any location for art, advertising, media release news articles, marketing, publicity, archival, or any other lawful purpose. I waive any right to royalties or other compensation arising from or related to the use of photogenic images of me. I release and agree to hold harmless Monarch & Glamour Ghoul Threading and my artist from any liability in connection to taking or using said images. I, the undersigned client, certify that I have read, had explained to me and fully understand the above Waiver and Release form and am signing it voluntarily as my own free act and deed. I certify that I have consulted with an artist and have read all applicable literature given to me. I accept the explanation of potential complications and risks described herein. I certify I am of sound mind and I am fully capable of
executing this Waiver and Release form for myself. No oral representations, statements, or inducements apart from the foregoing agreement that has been reduced to writing have been made.I, the undersigned client, acknowledge that there will be no refund provided for any service rendered. At Monarch & Glamour Ghoul Threading , we work hard to provide the best service possible to our clients. We want our clients to be satisfied with the service that they paid for. We do NOT provide refunds for services, but if you are not satisfied, we will fix it free of charge within 3 days of the initial appointment. In rare cases, if you happen to have an allergic reaction to the glue, where there are visible signs of puffiness of discharge, that prevents you from wearing eyelash extensions, we will remove them for free within 3 days.I, THE UNDERSIGNED, HEREBY FULLY RELEASE, WAIVE, COVENANT NOT TO SUE,AGREE TO HOLD HARMLESS, AND FOREVER DISCHARGE my artist at Monarch & Glamour Ghoul Threading from any and all liabilities, demands, claims, losses, injuries, or damages, including court costs and attorneys fees and expenses, of any kind arising out of, or relating to, the application of semi permanent eyelash extension products, EVEN IF, THOUGHCAUSED IN WHOLE OR IN PART BY A PRE EXISTING DEFECT, THE NEGLIGENCE, WHETHER SOLE, JOINT, OR CONCURRENT, GROSS NEGLIGENCE, STRICT LIABILITY OR OTHER LEGAL FAULT OF MY ARTIST. IT IS MY EXPRESS INTENT THAT THE ABOVE RELEASE INCLUDES THE RELEASE OF MY ARTIST FROM THE CONSEQUENCES OF
THEIR OWN NEGLIGENCE. It is also my express intent that this Waiver and Release Form shall bind the members of my family and spouse, if I am alive, and my heirs, assigns and personal representatives, if I am deceased, and shall be governed by the laws of the State of Georgia. I further agree that, should I choose to seek the advice of an attorney regarding said release, I will be responsible for any and all costs of legal services that I incur. I agree that this release shall be in contemplation of any possible damages, either known or unknown at the signing of this Waiver and Release form, and said damages are specifically waived following the signing of this waiver and release form. I further agree that in the event that any dispute that arises out of, or relating to, the application of semi permanent eyelash extension products and or terms of this Waiver & Release between me, or anyone acting on my behalf, my artist and or anyone affiliated with my artist shall be resolved by binding arbitration before the American Arbitration Association. The exclusive venue for arbitration against my artist shall be the city and state in which the artist resides at the time the arbitration is initiated. I agree that I will be responsible for and will pay all court costs, arbitration costs, attorney fees and expenses, and other associated costs incurred by my artist, in seeking enforcement of this Waiver & Release. I further release my artist from any responsibility for pre existing conditions I have not revealed, or any consequential change to those conditions that arises subsequent to the procedure. I understand that I am responsible for any medical treatment I may need to receive as a result of getting this procedure. I accept full responsibility for these and any other complications, which may arise or result during or following the eyelash extension procedures, which are to be performed at my request.
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