Name

First Name

Last Name

Phone

I am over 18

Yes

No (If no, this service cannot be performed)

Service you are inquiring about:

Are you taking any medications? If yes, please list:

5. Have you had lash lifts, eyelash extensions, or lash tinting before?

Yes

6. Did you experience a reaction to any of these treatments?

Yes

By participating as a client, I permit, authorize and license the technician(s) and Business (J3-Studio) to display, photograph, digitize, modify, license or use my image or likeness for advertising/marketing purposes, and for any purpose they deem reasonably appropriate, without further consent from or royalty, payment, or other compensation by J3-Studio.

E-Sign:

Agreement: I request and consent to the Lash Lift procedures being carried out today by a technician of J3-Studio without undergoing a sensitivity patch test. The sensitivity test, which if conducted, may indicate my sensitivity / allergy to the products. I understand the contents of this form and take full responsibility for my actions, thus absolving all other parties of their responsibilities (technician and J3-Studio), if any, associated with the supply of the products and services(s). Please note that there are no refunds given for any reason on voluntary cosmetic beauty services performed by technicians at J3-Studio. I agree to this refund policy.

E-Sign:

I recognize and acknowledge that there are certain risks of personal injury or property damage related to my participation as a client, and I voluntarily agree to fully assume all of these risks, regardless of severity, that I may sustain as a result of participating in any and all activities connected with or associated with the application by the technician of lash lifts and/or coloring to my eyebrows using the Brow Lamination technique, including, but not limited to, injuries, damages, and losses arising out of negligent supervision, tort, contract, products, or any other theory of recovery. I, for myself and my heirs, assigns, personal representatives, and next of kin, expressly waive and release any and all claims, now known or hereafter known, against the Business (J3-Studio) and their employees, officers, directors, and agents of each and all of them (collectively, “Releaseees”), on account of personal injury or property damage arising out of or attributable to my participation as a client, whether arising out of negligence of any Releasees or otherwise. I covenant not to make or bring any such claim against any Releasee, and forever release and discharge all Releasees from liability under such claims. I understand that this waiver and release is intended to be as broad and inclusive as permitted by law and that if any portion hereof is held invalid, I agree the balance shall continue in full legal force and effect. I further agree that if this waiver and release is not valid in the United States, it shall be construed as a covenant not to sue anytime, anywhere and for any reason. I have read the information in this waiver thoroughly. I understand that I have given up substantial rights by signing it. I have the capacity to provide informed consent and I am signing this waiver and release freely and voluntarily.

E-Sign:

For brow lamination clients: Brow Lamination is a chemical process that is applied to the brow hair in order to change the direction in which the hair lays. A brow tint is also applied to the hair. Your skin WILL come in contact with the chemicals used to process the hair and can be subject to allergic reaction, redness, itchiness, bumps, or swelling. Even though reactions are extremely rare, it is important that you are made aware of the possibility as well as taking the proper steps to contact a physician immediately upon recognizing a reaction. Failure to do so will be harmful. Following the procedure it is normal to feel slight irritation, pink color to the skin, or tingling. If these symptoms progress and worsen, please rinse the effected area with water and contact your physician. It is important to follow all aftercare in maintaining the health of your brow hair. 24 hours following the procedure, moisturize the brow hairs each night with approved balms in order to maintain the integrity and strength of the hair. Failure to do so will result in breakage.

E-Sign:

Today's Date

YYYY