Waiver of Liability

I understand there are risks associated with having synthetic eyelash extensions applied to and/or removed from my existing natural eyelashes, and that notwithstanding the utmost of care in the application or removal of these products, there still exists risk associated with the procedure and product itself, which include, without limitation, 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, eye irritation, eye pain, discomfort, and in rare cases blindness when improperly handled. As part of this procedure, I understand that a certain amount of eyelash adhesive material will be used to attach the artificial eyelash extension to my existing eyelashes. 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 stylist 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. Even though the Professional may apply or remove my eyelash extension properly, I understand adhesive material may become dislodged during or after the procedure, which may irritate my eyes or require further follow-up care, at my own expense to prevent damage to my eyes. I also understand there is more than one technique for applying eyelash extension to my eyelashes, and I will not attribute any liability to Professional as a result of this procedure or the use and care of these lashes. I also agree to defend, indemnify and hold harmless Professional and Mia Adaliz Artistry from any and all claims, actions, expenses, damages and liabilities, including reasonable attorney’s fees which might be asserted against them as a result of my having this procedure performed, or my purchase of Mia Adaliz retail products. As used in this Agreement, the terms “Mia’s Mia Lashes” and “Mia Adaliz Artistry” include all their respective owners and employees.

 I hereby consent to the procedure at my own risk. If at any time I am uncomfortable with the eyelash extension procedure, I will inform my stylist and she will use good faith efforts to rectify the problem, including ending the session if I or my stylist wish. If my stylist 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 agree to assume all risks of injury associated with eyelash extension application, and agree to hold harmless the stylist and company. 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 a stylist and have read all applicable literature given to me.

 

Eye Lash Extension Care & Maintenance: 

I agree to follow the care and maintenance instructions provided by Lash Bar Beauty and/or Professional for the use and care of my eyelash extensions, and that if any follow up care is required due to my own mistake or negligence, or failure to follow these instructions, this will be at my own expense and risk. I understand that if I do any of the following, it may result in damage to my eyelash extensions or cause my lashes to fall off prematurely. Knowing this I agree to follow these tips for best results: I will avoid oil based eye products as these will loosen the bond of my eyelash extensions. I understand that it is best to avoid saunas or steam rooms. 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.  If I experience any itching or irritation, I agree to contact my direct lash artist immediately. I agree to refrain from using waterproof mascara or an eyelash curler. I agree to not pick, pull or rub my eyelash extensions. I understand that I should not attempt to remove my eyelash extensions on my own or with any product, but that the procedure requires that my eyelash extensions be professionally removed.

I have revealed and or disclosed on all medical 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, THE UNDERSIGNED, HEREBY FULLY RELEASE, WAIVE, COVENANT NOT TO SUE, AGREE TO HOLD HARMLESS, AND FOREVER DISCHARGE my stylist, Mia Adaliz Adames, 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 STYLIST. IT IS MY EXPRESS INTENT THAT THE ABOVE RELEASE INCLUDES THE RELEASE OF MY STYLIST 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 Florida.

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 sem- permanent eyelash extension products and or terms of this Waiver & Release between me, or anyone acting on my behalf, my stylist and or anyone affiliated with my stylist shall be resolved by binding arbitration before the American Arbitration Association. The exclusive venue for arbitration against my stylist shall be the city and state in which the stylist 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 stylist, in seeking enforcement of this Waiver & Release. I further release my stylist from any responsibility for preexisting 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.

 

Permission to Use Pictures: 

I, the undersigned client, hereby give Mia Adaliz Adames and her company 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 am allowing photographs to be taken of my face, eyes and/or eyelashes, both before and after this procedure, including the right to retouch these photographs as deemed necessary.

 

 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 Mia Adaliz Adames, her business and any affiliated stylist from any liability in connection to taking or using said images. Eyelash Extension Agreement & Consent Form.