Further, I grant Moda Bella Salon and Spa, its employees and representatives, permission to chemical services on my hair and not hold them responsible for any and all adverse health reactions from this service.
By signing this form, I assume all risk of injury and harm resulting from the treatment activity specified herein and I agree to release, defend, indemnify, and forever discharge the Salon from all liabilities, claims, damages, costs, and expenses, or any action due to loss, damage, injury, or death that might incur resulting from the chemical treatment.