Please review the following information, as you will be asked to select a photo consent agreement in the next question that you are most comfortable with.

This authorization grants permission to use your image (still or moving) and/or your spoken words in perpetuity for educational and/or marketing purposes on social media.

By signing this document, you agree:

1. To allow the recording of your image and voice (e.g., photographs, audio, or video).
2. To distribute your image or recording in any medium, be it print or electronic form.
3. To grant permission to other entities to reproduce the image or recording for educational/marketing purposes.
4. That there is no reimbursement for the right to take, or to use your photograph or video or recording.

Acknowledgement and Waiver

I hereby agree to have this treatment be performed on me. I am aware that products used in facials and homecare can contain tree nuts, dairy and gluten. I acknowledge that at Robles Esthetics they may use products that contain these ingredients or are manufactured in a plant with these ingredients. I am aware that even with natural ingredients there is a remote chance of an allergic reaction and there is a possibility of an adverse reaction to product used in facials. 

I am also aware that certain services should not be performed with certain medical conditions. I have disclosed all my known medical conditions, allergies, medications and answered all questions honestly on the above form and agree to update Robles Esthetics as to any changes. I also am aware that individual results are dependent upon my age, skin condition, and lifestyle. I will inform my esthetician of any discomfort I may experience at any time during my treatment to allow them to adjust accordingly.

I acknowledge that at Robles Esthetics they do not provide medical advice and I accept full responsibility to seek out such advice before receiving any services or products from Robles Esthetics. I hereby release, discharge and waive any and all claims against Robles Esthetics and of my esthetician performing services or applying any products at Robles Esthetics, including from liability and responsibility for any and all illness, injuries, damages, claims, rights and causes of action of any kind or nature, that may occur during or arising out of any services or products received on this and any future dates. I expressly assume and accept the risk for any injuries sustained. I have read this entire document and agree to its terms.