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Metropolitan Day Spa

 

Eyelash Extension Agreement & Consent Form

CONSENT FOR EYELASH PROCEDURE: I have agreed to have eyelash extensions applied to and/or removed from my eyelashes. Before my qualified professional can perform this procedure, I understand I must complete this agreement and provide my informed consent by signing and dating where indicating below.

 

Terms and Conditions
 

  • I understand that this procedure requires single synthetic eyelashes to be glued to my own natural eyelashes

 

  • I understand that it is my responsibility to keep my eyes closed and be still during the entire procedure, until my eyelash technician addresses me to open my eyes

 

  • I understand that some risks of this procedure may be but not limited to eye redness and irritation. The fumes from the adhesive may cause my eyes to tear up if I open my eyes

 

  • I agree to disclose any allergies that I may have to latex, surgical tapes, cyanoacrylate, Vaseline, etc

 

  • I understand that I am required to follow the eyelash extension care sheet (attached hereto) in order to maintain the life of these extensions

 

  • I understand that I have a maximum of three days from the date of application to report any allergic reaction possibly pertaining to the procedure, to receive a removal free of charge

 

  • I understand that I have three days from the date of application for any fixes or adjustments free of charge

 

  • I understand that all sales are final and membership are non-refundable

 

  • I agree that by reading and signing this consent form, I release Metropolitan Day Spa from any claims or damages of any nature

 

  • I agree that I read and fully understand this entire consent form

 

  • I am of sound mind and fully capable of executing this waiver for myself

 

  • I have read and completed the Eyelash Extensions Agreement & Consent form in its entirety, and have answered everything to the best of my ability. I have been informed of potentially harmful or negative side effects that may be caused by the application and/or removal of Eyelash Extensions

 

Today's Date: February 5, 2025

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
I give Metropolitan Day Spa permission to show my before and after photos of eyelashes to other potential clients
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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