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RELEASE FORM FOR SERVICES Makeup Mau Loa 241 East 10th st. #B Tracy, CA 95376 1 hereby release, acquit and forever discharge Makeup Mau Loa of all, and from all manner of action and actions,judgements, sums of money and demands whatsoever in law or in equity, which I ever had, now have, or may have against Makeup Mau Loa, upon, or by reason of, any matter or cause whatsoever from the beginning of this day, Today's Date I have opted out of getting my patch test 48 hours prior to the application of any semipermanent/permanent makeup, plasma/fibroplast treatment, lashlift/perm, spray tan, makeup, microneedling treatment, facials... I release Makeup Mau Loa from any and all damages that may result from this service. The undersigned acknowledges that Briana Sepulveda/Makeup Mau Loa has explained the nature of the above-noted treatment procedure herein. I hereby consent to Briana Sepulveda/ Makeup Mau Loa performing the above-noted treatment procedures on me and in consideration of their doing so, I hereby and forever discharge Makeup Mau Loa, its officers and employees of and from all claims, demands, damages, actions and cause of action arising out of the performance of the said treatment procedures, which I, my heirs, executors, administrators, or assigns can, shall or may have. Being of sound mind and body, I hereby release any and all persons representing Makeup Mau Loa from all responsibility. I accept all responsibility myself for any consequences that might stem from my decision to have semipermanent/permanent makeup work done. I agree that these waivers also pertain to and are designed to protect any and all establishments where Briana Sepulveda conducts business. In Witness Whereof; this day of 20 Client's Signature Technician's Signature I chose to have this service done without a patch test Yes or No Client's Signature Thank you for your business