top of page

ARRI BEAUTY ROOM CLIENT LIABILITY WAIVER + PHOTO CONSENT FORM

Please fill out the following form completely.

I UNDERSTAND THAT THERE ARE RISKS ASSOCIATED WITH HAVING ARTIFICIAL EYELASHES APPLIED TO AND/OR REMOVED FROM MY NATURAL LASHES.
I UNDERSTAND THAT THERE IS A POSSIBILITY OF EYE IRRITATION, PAIN, ITCHING DISCOMFORT AND IN RARE CASES EYE INFECTION MAY OCCUR IF ONE IS ALLERGIC OR HAVE SENSITIVE EYES
EYELASH EXTENSION APPLICATION REQUIRES EYEPADS OR TAPE USED ON THE SKIN. MEDICAL TAPE AND ADHESIVES MAY CONTAIN ACRYLIC OR LATEX. ARE YOU ALLERGIC?
PLEASE SELECT ALL WHICH APPLIES TO YOU?
HAVE YOU HAD EYE SURGERY AROUND YOUR EYE(S) IN THE LAST 6 MONTHS?
I UNDERSTAND & AGREE THAT IF I EXPERIENCE ANY ISSUES WITH MY LASHES I WILL CONTACT MY TECHNICIAN AND HAVE THE EYELASH EXTENSIONS REMOVED IMMEDIATELY AND CONSULT A PHYSICIAN AT MY OWN EXPENSE. IN THE EVENT OF AN EMERGENCY I WILL CONTACT 911.
I UNDERSTAND
I DO NOT UNDERSTAND
I UNDERSTAND THAT IN ORDER TO HAVE THE EYELASH EXTENSIONS APPLIED TO MY EYELASHES I WILL NEED TO KEEP MY EYES CLOSED FOR A DURATION OF 60-180 MINUTES DURING THE PROCEDURE. I ALSO UNDERSTAND THAT I WILL NEED TO BE LYING IN A FLAT POSITION.
I UNDERSTAND
I DO NOT UNDERSTAND
ANY MEDICAL CONDITIONS THAT MIGHT BE AGGRAVATED BY LYING STILL FOR A PROLONGED PERIOD OF TIME MAY MEAN THAT I WILL NOT BE ABLE TO HAVE THE PROCEDURE PERFORMED ON MY EYES.
THIS AGREEMENT WILL REMAIN IN EFFECT FOR THIS PROCEDURE AND ALL FUTURE PROCEDURES CONDUCTED BY MY TECHNICIAN. I UNDERSTAND THAT THIS AGREEMENT IS BINDING AND THAT I HAVE READ AND FULLY UNDERSTAND ALL INFORMATION ABOVE.
I AGREE
I DISAGREE
I RELEASE ARRI BEAUTY ROOM, LLC FROM ALL LIABILITY ASSOCIATED WITH THIS PROCEDURE. THERE ARE NO GUARANTEES FOR THE BONDING TIME LENGTH OF THE EYELASH EXTENSIONS. ARRI BEAUTY ROOM LLC IS NOT RESPONSIBLE FOR ANY REACTIONS/OR CONCERNS ONCE SERVICE IS DONE.
I AGREE
I DISAGREE
Permission to Use Photograph I, the undersigned, hereby grant Arri Beauty Room LLC the absolute right and permission to use my photograph(s) in any manner or media, including, but not limited to, the following purposes: Website or Social Media
Yes, I consent
No, I do not consent
Date
Month
Day
Year
Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.
bottom of page