Permission to treat minor

The Waxing Co. requires permission of a parent/guardian prior to treating any clients under the age of 18. With the exception of facial waxing, parents are required to be present within the treatment room.

I grant permission to The Waxing Co. to treat:

Waxing Contraindictions

Warning: If you are currently using any of the following prescriptions medications, you cannot receive a waxing service. You must discontinue use of these medications for a minimum of three (3) months prior to waxing. The exception is Accutane; you must be of this medication treatment course a minimum of one (1) year prior to waxing.

I have been using the following prescriptions (check all that apply).

Accutane (Acne medication)Adapalene (Acne medication)Alustra (Retin A)Avage (See Tazorac—Acne medication)Avita (See Retin A)ClindamycinDiferin (Acne medication)DoxycyclineErythromycinIsotretinoin (See Accutane)MadifloxicineMetronidazoleMinocyclineRenova (See Retin A)Tazorac (Acne medication)Tazarotene (See Tazorac)TetracyclineTretinoin (See Retin A)

Caution: If you are currently using any of the following, please inform your esthetician. These products can make the skin more sensitive. Thin, sensitive skin is more vulnerable to lifting and sensitivity during waxing

I have been using the following prescriptions (check all that apply).

Alpha Hydroxy Acids (Glycolic, Lactic)Oral AntibioticsTopical AntibioticsRetinolSalicylic AcidExfoliantsOther Acne medications not listed above

If you choose to proceed with a waxing service, you acknowledge the risks associated with waxing under these conditions.

I have read and discussed the risks of waxing and am aware of the consequences. I choose to proceed with a waxing service and I release The Waxing Co. from any and all liability.

No show and cancellation policy

Cancellation/No Show Policy: 24-hour advance notice is required to cancel or reschedule appointments.

• If you are unable to provide at least 24 hours advance notice, you will be charged the full amount of your service. This amount must be paid prior to your next scheduled appointment.
• Anyone who either forgets or consciously chooses to forgo their appointment for any reason will be considered a "No Show", and will be charged the full amount for your missed appointment.
• If you arrive late, your session may need to be shortened in order to accommodate on-time clients. Your esthetician will determine if there is enough time remaining to start a treatment.
• If you reschedule your appointment less than 24-hours before your appointment, you will be charged $25 for late reschedule.

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Respect and Dignity Policy: The Waxing Co. is committed to maintaining a safe and respectful environment for everyone who walks into our salon. We pride ourselves on being a 'drama-free' workplace for our employees, and a safe place for our wonderful clients to be treated! As professional estheticians, it is our duty and pleasure to treat all people with dignity, respect, and kindness. We hold these values very high, and ask that our clients treat all others with the same respect, dignity, and kindness that they themselves expect. As a client, you have the right to find another salon to receive treatment if you are not being treated with the level of dignity, respect and professionalism that you expect, and we strive to provide. Likewise, we reserve the right to refuse service, at any time, to anyone not fulfilling this respect and dignity policy. If you feel that you are not being treated in an appropriate manner during your visit to The Waxing Co., please ask to speak to the manager on duty immediately.

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Payment Policy: It is The Waxing Co.'s policy that payment is the responsibility of the client at the time of service.
• The Waxing Co. is pleased to accept the following: The Waxing Co. gift certificate, client’s credit card with photo ID; Second party credit card with a copy of the cardholder's photo ID and signed note from cardholder authorizing charges to be made by The Waxing Co.
• Only one Waxing C.o promotion may be redeemed per visit.

Arbitration Agreement: Client consents that any controversy between The Waxing Co. and the client shall be settled by arbitration in accordance with the then-current commercial arbitration rules of the American Arbitration Association, and judgment on the award rendered by the arbitrator(s) may be rendered by any court having jurisdiction thereof. The Waxing Co. and client shall share the costs of the arbitrator equally but shall each bear their own costs and legal fees associated with the arbitration. The location of the arbitration shall be in Honolulu, Hawaii.

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I certify that all the above information I provided is correct to the best of my knowledge. I will not hold The Waxing Co., or any member of the clinical or administrative sta responsible for any errors or omissions that I may have made in the completion of this form. I certify that I have read and fully understand the above terms and conditions, and consent to the above policies and agreements as they have been explained to me above. This consent form supersedes all previous verbal or written communications given to me by The Waxing Co. This consent form is valid unless all or part is revoked by me in writing.