Eyelash Extensions Waiver and Release

I authorize Bella Lash & Beauty Bar lash extension artists, hereinafter collectively referred to as my artist, to perform semi permanent eyelash extension procedures.

I understand this procedure requires individual synthetic eyelashes to be glued to my own natural lashes. I understand it is my responsibility to remain still during the application and to keep my eyes closed during the entire process until otherwise advised. I acknowledge that my artist has explained to me the methods and procedures concerning the application of semi permanent eyelash extension application and that there are certain complications and risks inherent both in the application process and in wearing semi permanent lashes. These risks may include, but are not limited to, temporary eyelash loss as a result of improper post application care, transient eye redness and irritation, and or an allergic reaction to the adhesive, under eye gel patches and or other products used during the procedure.

I hereby consent to the procedure at my own risk. If at anytime I am uncomfortable with the eyelash extension procedure, I will inform my artist and she will use good faith efforts to rectify the problem, including ending the session if I or my artist wish. If my artist is uncomfortable applying lashes to me, she will discuss her concerns with me and may end the session if necessary. I acknowledge that I have received no guarantees, warranties, promises, and or commitments regarding the application process or the products used or applied therein or other statements as to the results of this service.

I have revealed and or disclosed to Bella Lash & Beauty Bar all conditions and circumstances regarding my health and health history, medications being taken and any past reactions to products used or medications taken. Additional conditions could occur or be discovered during or after the procedure, which could affect my ability to tolerate the procedure.

I understand that the duration of my eyelash extensions requires my careful maintenance. I understand that it takes 24 hours for the adhesive to cure thoroughly and avoiding contact with direct excessive moisture for longer than a minute within the initial 24 hours post application, i.e. water, sweat, steam or tears to eliminate the risk of interference with this curing process, which may result in a weaker bond, premature lash extension loss, and or irritation. I also understand after the first 24 hours post application, if I participate in any of the following or any other activities that may interfere with the lashes I may experience premature loss of the lash extensions, i.e. excessive swimming, sauna use, steam rooms, and or pulling on lashes, using oil based or waterproof cosmetics, and or using mechanical curlers or crimping lashes in any way. I understand that failure to follow these instructions may cause irritation, reaction, eyelash loss, and other side effects described in this form. I understand that the eyelash extension application risks and the post application care and maintenance described herein apply equally to initial eyelash and subsequent touch up applications.

I, THE UNDERSIGNED, HEREBY FULLY RELEASE, WAIVE, COVENANT NOT TO SUE, AGREE TO HOLD HARMLESS, AND FOREVER DISCHARGE my artist at Bella Lash & Beauty Bar 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, THOUGH CAUSED 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 California.

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.

Please read the following statements and sign and date on the line to indicate that you have read, understand, and accept the following statements:

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 and fully understand that there might be other known risks not reasonable foreseeable at this time. I, undersigned client, acknowledge that I have read and agree to the provisions, terms, and conditions provided in this Waiver and Release Form. I agree to assume all risks of injury associated with eyelash extension application, and agree to hold harmless the artist and Bella Lash & Beauty Bar.

I, the undersigned client, acknowledge that there will be no refund provided for any service rendered. At Bella Lash & Beauty Bar, 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 client, hereby give Bella Lash & Beauty Bar 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 Bella Lash & Beauty Bar and my artist from any liability in connection to taking or using said images.

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