Waiver for Take Home Kit *

I will/have purchased from The Colour Bar, A Cynthia Diersen Salon LLC (hereby referred to as “The Colour Bar” for sake of brevity), take home hair coloring kit. I understand that I (i) will be solely responsible for applying this at home based on the instructions produced to me, (ii) there are inherent risks in using hair color, including allergic reactions or irritation and I have disclosed all known medical issues and allergies to The Colour Bar, and (iii) The Colour Bar is not responsible for any unexpected or undesired results or reactions. I release and discharge The Colour Bar and all its officers, owners, directors and employees from any and all liability for personal injuries to myself or others, and any other claims including claims that are known or unknown, foreseen or unforeseen, past, future, or contingent or third party claims arising from or in connection with this take home hair color. I have been made aware that my desired outcome may vary. I am aware of all the process and procedures I have used on my hair in the past few months and they may alter the process that I need to achieve my desired results. I realize this is very important information and that any information withheld regarding my previous process will increase my chance of damage and the potential for unpredictable chemical reactions. Further more, chemical exposure to eyes can be harmful. I understand that these are extraordinary times and this is a limited offer as an extraordinary measure. I am agreeing to apply my own color because of this. I understand that the sale of this take home kit is final. The results are my own. Any corrections needed are at my own expense. By signing this waiver, I agree to the terms and conditions discussed with me and my stylist and The Colour Bar is not responsible for the results. This take home kit is as customized as possible for my use however I understand that results may vary.

Agree

Name *

First Name

Last Name

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Electronic Form Signature *

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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