Precautionary COVID-19 Liability Release Form and Disclosure of Health Status

EXAMPLE FORM: (A SIGNATURE OF THIS FORM WILL BE REQUIRED BY ALL GUESTS RECEIVING SERVICES ON LOCATION)

Due to the 2019-2020 outbreak of the novel Coronavirus (COVID-19), we are taking extra precautions with the intake of each client. You acknowledge that JAGGER JAMES SALON is not the only hair salon available to you and that, as consideration for the receipt of services from JAGGER JAMES SALON, you agree to accept all responsibility for the risks that you may be exposed to while in our building and facilities.

The risks of COVID-19 are not well understood and there is uncertainty as to how the virus can spread and difficultly in determining whether anyone has the virus at any moment in time.

While we are taking your safety and that of our staff very serious, by employing new safety and sanitation initiatives, we cannot guarantee that any of these measures will completely protect you from contracting COVID-19.

However, in order to help us understand and minimize to the extent possible the risks presented by each client, please review carefully and answer the following:

Symptoms of Covid-19 include, but are not necessarily limited to:

-Fever
-Fatigue
-Dry cough
-Difficulty breathing

I _________________________________________________ agree to the following:

☑ I understand the above symptoms and affirm that I, as well as all members of my household, do not currently have, and have not experienced the symptoms listed above within the last 14 days.

☑ I affirm that I, as well as all members of my household, have not been diagnosed with COVID-19 within the last 30 days.

☑ I affirm that I, as well as all members of my household, have not to the best of my knowledge been exposed to anyone diagnosed with COVID-19 within the last 14 days.

☑ I understand that neither JAGGER JAMES SALON nor any individual stylist shall be held liable for any exposure to COVID-19
(or any other contagion) caused by misinformation provided on this form by any client.

This form will need a REQUIRED signature, with this you agree to release JAGGER JAMES SALON, its owners, agents, employees, contractors and facility landlord from any and all liability for any injury, disease, illness or death arising out of your receipt of services from or your visit to JAGGER JAMES SALON facilities. You further agree that if any steps are taken to make a claim against JAGGER JAMES SALON, or any other released party, you shall be obligated to pay all attorneys’ fees and costs incurred as a result of such claim.

*Again, this is an example FORM. Actual FORM will be required to sign for all guest receiving services on premises of JAGGER | JAMES SALON.

WE kindly thank all of our guests for their patience and understanding during these challenging times…