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COVID-19 PANDEMIC LASER HAIR REMOVAL SERVICE WAIVER FORM

We at Infinity Laser Spa are doing everything we can to protect you, our clients, as well as our laser technicians. To this extent, we will be following the Center of Disease Control (CDC) with regard to social distancing practices as well as the cleaning and disinfection of our laser spa in order to reduce the spread of Novel Coronavirus, or COVID-19. This will require our staff to maintain six (6) feet of distance between ourselves and you, the client, as much as possible unless performing your service. We will also be requiring this same procedure for client-to-client contact in order to limit the exposure to all individuals.

 

We will require all individuals (staff and clients) to utilize either surgical masks or cloth masks that cover both your mouth and nose at all times to reduce the risk of exposure to yourself and others at all times while in the establishment. Patients undergoing laser hair removal for the face are exempt during the procedure only. It is also required of everyone to either wash or sanitize their hands upon entry, after using the restroom or touching their face or mask. 

 

By signing this waiver, you attest that you are clear of the following symptoms and situations within the last 14 days leading up to your appointment:

  • Fever of 99 degrees or above/chills
  • Cough
  • Trouble breathing or shortness of breath
  • Muscle aches
  • Sore throat
  • Diarrhea
  • Loss of smell or taste, or a change in taste
  • Headache  
  • Have had contact with an individual who has shown signs of the above symptom within the past 14 days
  • Have been around anyone with confirmed COVID within the past 14 days

Upon entering the building Infinity Laser Spa reserves the right to take your temperature using our touchless thermometer. If you have a temperature of 99 degrees or above, we reserve the right to refuse service and ask you to leave immediately. You can rebook your appointment after 14 days or by providing proof of a negative COVID test.  

 

At any time during our contact with you, if we feel you are not complying with the rules stated above, show signs of illness or are in any way combative we reserve the right to refuse service and will ask you to leave immediately.

 

By signing this waiver, you understand that by entering a business open to the public, you are susceptible to the risk of exposure to any illness including but not limited to, the Coronavirus also known as COVID-19, and will not hold Infinity Laser Spa Inc liable for any symptoms of illness following your contact with us and will contact us if you do develop symptoms within 14 days after your visit.

 

If we all work together, we can overcome the spread of this virus as well as other infectious diseases. We are happy to welcome our clients back!

 

By signing below, you agree to comply with the written instructions above. Failure to comply with these written instructions or verbal instructions from staff may result in your removal from the premises.

First Participant's Name

First Name*

Middle Name

Last Name*

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle 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.
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.
Parent or Guardian's Name

First Name*

Middle 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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