Salon Chemical Waiver Form – Fill Out and Use This PDF

CLIENT CHEMICALRELEASE FORM

DATE: _____________________________

I, ___________________________________, release __________________, and

(client)(salon)

Stylist/Colorist _____________________________, from any responsibility and/or

(stylist)

liability concerning the application, processing and/or consequences of the permanent chemical procedure of my hair. I consent to have _________________________________, a permanent chemical process,

applied to my hair.(service)

I release __________________, its employees and its agents harmless against any and all liability,

damage, and/or expenses arising out of or in connection with actions, claims, and/or damages resulting in personal injuries and disabilities (physical and/or psychological) that I might incur as a result of the chemical altercation through permanent chemical processing of my hair. I understand that additional conditioning treatments may be recommended and/or necessary for my hair maintenance and that permanent damage to my hair is possible due to the chemical application.

______________ (client initials) I have not had any chemical process performed on my hair within the last

six weeks.

______________ (client initials) I have had _____________________ chemical process performed on my

hair within the last six weeks.

Explain: ______________________________________________________________________________

The approximate costs of the permanent chemical services that will be used on my hair are as follows:

Print name

Client Signature

Print name

Stylist Signature