Chemical Service Waiver and Release of Liability Form

I, confirm that I am at least eighteen (18) years of age and have received a hair analysis and or consultation with a Hair Bar NYC stylist. I have provided all the requested information regarding any previous chemical or color treatment(s) that have been performed on my hair.

I acknowledge that any of these prior treatments, including color treatments, may affect the outcome of my keratin, color and or other hair services. My stylist has explained to me the best available treatment he or she recommends for my hair type, texture and current condition, based on my desired results.

I understand that a Keratin Treatment is a hair smoothing treatment which significantly reduces frizz, volume and curl, but it’s NOT a substitute for a permanent straightening treatment. Results may vary from person to person and I acknowledge that I have been advised of the potential outcome I can expect from this keratin treatment.

Keratin Treatments, color treatments and other chemical treatments can produce fumes during the procedure, which may cause irritation for some individuals. I acknowledge that I have been offered the option of a facial mask or shield for my eyes and face should they become sensitive or irritated during the procedure.

**I also acknowledge that I am currently NOT pregnant or nursing and I have advised my stylist of any potential health concerns, allergies or medical conditions that I’m listing below.

Allergies/Medical Conditions:

I have read and understand the terms of this Liability Waiver Form. I confirm that by signing this form, I hereby waive and release Hair Bar NYC Inc. and its employee(s) from any and all claims for damages or any other liabilities of any kind arising from or in any way related to; keratin service(s), color service(s) or any other chemical treatment(s) being provided to me by Hair Bar NYC Inc. and or its affiliates. I also understand that Hair Bar NYC Inc., has a strict 5 days Service Satisfaction Policy. In the event you find yourself unhappy with your results, please contact the salon where you received your service(s) within 5 days of service, so that we can arrange for an analysis in order to determine the best course of action to rectify the situation. After the 5 days period no service satisfaction requests will be honored.

Client Signature:


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