Minor Release Form

Client Name (minor)

Client Birth Date (minor)

Parent or Legal Guardian information

Name of Parent or Legal Guardian of Client

Phone Number

Email

By signing below, I agree that I am the parent or legal guardian of the minor receiving treatment(s) at Skin Facial Bar LLC. I understand that I am required to remain at the facility for the entirety of the minor’s treatment(s). I will also be required, if needed, to assist the minor in preparing for his/her treatment(s). I may also be required to remain in the treatment room to supervise all interactions between the service provider and the minor.

I also agree that I have completed the applicable treatment form(s) for the above-mentioned minor and have informed the service provider of all medical diagnoses, symptoms, medications, and complaints associated with the minor receiving treatment(s).

I agree to supervise any home care procedures that are recommended as a result of the treatment.

I understand the scope of esthetician services and that it is not meant to diagnose, treat, or cure any conditions and is not a replacement for standard medical care. I give permission for my minor child to receive treatment(s) at Skin Facial Bar LLC and agree to all the above terms.

I confirm that I have read and understand all information on the applicable forms for this treatment or service, and accept responsibility on my child’s behalf for any disclosures or liability described on those forms.

Clear