COVID-19 Liability Release Waiver
Due to the 2019-2020 outbreak of COVID-19, I am taking extra precautions with the intake of each client, health history review, as well as increased sanitation and disinfection practices. As a matter of transparency, I am requiring that you sign a COVID-19 waiver. I am following all Federal (CDC), and Colorado State (DORA, CDPHE) rules and regulations. If you do not wish to sign this form, you will not be offered services at this time.

SARS-CoV-2 causing COVID-19 is a new and potentially threatening disease. If acquired, you may have no symptoms or develop life or limb/organ threatening complications, disability, job loss, family loss, and death. The purpose of this COVID-19 waiver is to allow you informed consent regarding your voluntary wishes to receive makeup application, hair styling, and/or lash extension services. Such services are not risk free. In addition to usual aesthetic risks, you are now at risk for COVID-19, despite any and every best effort on our behalf to protect you. Due to your voluntary consent to receive such aesthetic services, even despite the CDC, DORA, CDPHE best intent, actions and our ability to follow those government orders, we cannot accurately predict whom would or would not acquire COVID-19, or whom transferred COVID-19 to whom. Therefore, as a client, you are fully agreeing to the terms below without exception:

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Email *
Full Name (First + Last) *
Date of Birth *
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Home Address *
Phone Number *
Bride's Name (if you're part of a bridal party)
Symptoms of COVID-19
Symptoms generally appear 2-14 days after exposure. Prior to symptoms, you are still contagious and transmitting to others. 60% of cases present no symptoms at all.

- Dry cough
- Shortness of breath or difficulty breathing
- Fever (defined as a temperature of 100.4 F, or above)
- New loss of taste or smell
- Extreme exhaustion
- Muscle pain / Body aches
- Sore throat
- Nasal congestion
- Diarrhea & vomiting

I agree to the following:
I understand the above symptoms and affirm that I, as well as all household members, do not currently have, nor have experienced the symptoms listed above within the last 14 days. *
Required
I affirm that I, as well as all household members, have not been diagnosed with COVID-19 within the last 14 days. *
Required
I affirm that I, as well as all household members, have not knowingly been exposed to anyone diagnosed with COVID-19 within the last 14 days. *
Required
I affirm that I, as well as all household members, have not traveled outside of the country, or to any city outside of our own that is or has been considered a "hot spot" for COVID-19 infections within the last 30 days. *
Required
I understand that this business (Liana Kathryn Makeup) and my esthetician/cosmetologist cannot be held liable for any exposure or harm due to the virus, or any other contagion, caused by misinformation on this form or the health history provided by each client. *
Required
By E-signing my name below I agree to each above statement. I fully release and hold harmless from any and all liability the business owner, the business, professional liability insurance companies, all associated parties, all assignees, its contractors and staff, the business landlord, and landlord insurance companies, from any and all complications of suspected or confirmed SARS-CoV-2 virus and COVID-19 disease, including but not limited to the following: doctor fees, hospital fees, surgery fees, medicines, resulting employment losses and claims, disability losses and claims, life insurance losses and claims.  

I, your esthetician, Liana Conway, also affirm that I have improved and expanded my sanitation protocols to more thoroughly fight the spread of COVID-19 and other communicable conditions.
Full Name (E-Signature) *
Date *
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