Name *

First Name

Last Name

Birthday *

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CANCELLATION AND NO SHOW POLICY *

Your appointments are very important to us as it is time reserved especially for you. We understand that sometimes schedule adjustments need to be made. It is oftentimes difficult to fill cancelled appointment slots on such short notice. Therefore, we respectfully request at least a 24-hour notice for cancellations or adjustments made to your appointment. Cancellations made within 24-hours of appointment time are subject to a 100% charge of reserved service.

By checking this box, I understand and agree to all terms.

AGREEMENT *

I understand that if I no-show an appointment, I am subject to being fired as a client and will no longer be able to book appointments at Mauka + Makai Studio.

By checking this box, I understand and agree to all terms.

LATE POLICY *

If you arrive late to your appointment, it limits the amount of time available to complete your service. Spray tan appointments are short. If you arrive 5-10 minutes late to a 15 minute appointment, I have no time to complete the service. The appointment will be charged 100% of the reserved service and you will need to reschedule. Please arrive promptly to ensure you are receiving the full potential of your paid services.

By checking this box, I understand and agree to all terms.

REFUNDS *

Refunds are not offered on all services, retail products, and gift certificates.

By checking this box, I understand and agree to all terms.

WAIVER OF LIABILITY *

I understand there are risks associated with having Lash Lift, Lash Perm, Lash Tint, and Brow Tint procedures applied and that notwithstanding the utmost of care in the application or removal of these products, there still exist risks associated with the procedure and product itself, which include, without limitation, eye irritation, eye pain, discomfort, and, in rare cases, blindness when improperly handled. As part of this procedure, I understand that a multitude of certain amount of solutions/creams will be used to tint and perm my natural eyelashes and brows. Even though the Professional may apply or remove my tint or perm properly, I understand any solution may become dislodged during or after the procedure, which may irritate my eyes or require further follow-up care, at my own expense to prevent damage to my eyes. I also understand there is more than one technique for tints and perms to my eyelashes and brows, and I will not attribute any liability to Lena Bui or Mauka + Makai Studio LLC as a result of this procedure or the use and care of these lashes. I also agree to defend, indemnify and hold harmless Lena Bui and Mauka + Makai Studio, LLC from any and all claims, actions, expenses, damages and liabilities, including reasonable attorneys’ fees which might be asserted against them as a result of my having this procedure performed, or my purchase of any retail products. As used in this agreement, the terms “Professional” include all of their respective officers, directors, agents, employees, successors and assigns.

By checking this box, I understand and agree to all terms.

PERMISSION TO USE PICTURES *

I hereby grant to Lena Bui and Mauka + Makai Studio the full right to take, publish and reproduce photographs of me both before and after this procedure, for any advertising, education, or other purposes whatsoever, including the right to retouch these photographs as deemed necessary by Lena Bui and Mauka + Makai Studio, LLC. I further expressly assign any copyright in these photographs to Mauka + Makai Studio, LLC. I also grant my consent for Lena Bui and Mauka + Makai Studio, LLC to use my image and likeness as contained in these photographs for any advertising or other purposes, along with any comments I may provide.

By checking this box, I understand and agree to all terms.

CARE AND MAINTENANCE *

PLEASE READ AND UNDERSTAND COMPLETELY. I agree to follow maintenance instructions provided by Lena Bui and Mauka + Makai Studio, LLC for the care customized spray tan, and that if any follow up care is required due to my own mistake or negligence, or failure to follow these instructions, this will be at my own expense and risk. If I experience any itching or irritation, I agree to contact Lena Bui and Mauka + Makai Studio, LLC immediately if any issues arise. DHA is listed in the Food, Drug and Cosmetic Act (FD&C Act) as a color additive for use in imparting color to the human body. However its use in cosmetics - including sunless “tanning” products - is restricted to external application. According to CFR, “externally applied” cosmetics are those “applied only to external parts of the body and not to the lips or any body surface covered by mucous membrane.” (21 CFR 70.3v) • DHA reacts with the skin’s amino acids resulting in a “tan” similar to that of the sun. The darker you can tan naturally, the darker you can tan with a spray tan. Like most cosmetics, avoid exposure to the eyes, lips, and other parts of the body covered with a mucous membrane. This should be accomplished by following the staff’s breathing instructions as to avoid inhaling or ingesting the sunless product and by applying the barrier cream. • Wearing deodorants, lotions or makeup will act as a barrier to the tanning solution causing an uneven tan or white spots, so we ask that you do not wear these before spray tanning. Completely exfoliating before applying and re-applying will enhance the results. Do not use any oil-based products, alpha hydroxy acids and mineral oils as they accelerate skin exfoliation. • Please refrain from any activities that will cause perspiration until after your first shower. • Your spray tan should last 5-10 days depending on your skin type and how well you take care of your sunless tan. It’s very important to keep your skin moisturized after your spray tan, avoiding long baths or showers or hot tubs. Salt water exposure or a chlorinated pool can also shorten your spray tan. • Following the spray tan session, please avoid: tight clothes, excessive perspiring, leather seats. Do not shower for 6-8 hours. Letting solution stay on overnight without showering is not recommended. Some fabrics may be stained by the spray tanning solution, so please use caution and care. • Be advised we do NOT advise being sprayed for photographic sessions, modeling assignments, weddings, etc. unless you have had a trial spray tan. • Exfoliating, shaving and showering 24 hours before spray tanning is recommended. Waxing 3 days before, Laser Hair Removal 2 weeks before or 5 days after spray tan.

By checking this box, I understand and agree to all terms.

NO KNOWN MEDICAL CONDITIONS / INFORMED CONSENT *

• Be advised there may be a small percentage of individuals whose skin does not react favorably to spray tanning. Some medications such as birth control pills, hormone replacement medications, or antibiotics may alter your spray tan. Please consult with your technician if you have any questions. • All the ingredients in the product used in this procedure are intended for cosmetic use and generally regarded as safe. There are, however, occasions where individuals may be allergic to one or more ingredients in the spray tan solution. If this occurs, shower and discontinue use. If severe reaction, contact a physician. You may ask to see the ingredients prior to application. • It is my responsibility to inform the tanning technician of any allergies, relevant medical history, or prior adverse reactions to spray tanning products and moisturizers. The FDA recommends that you take the following measures to protect against ingestion or inhalation during your sunless session by using: - Protective eyewear - Nose filters - Sealing lips with lip balm - Protective undergarments WARNING: This product does not contain a sunscreen and does not protect against sunburn. I have read the contents of this consent form carefully and state that I am not aware of any medical condition, allergies, or other reason that would prohibit me from sunless tanning. I have been given adequate instructions for the proper use of the sunless application, understand the risks involved, and use it at my own risk. In consideration of spray tanning services provided by Mauka + Makai Studio LLC, I hereby waive, release, hold harmless, and forever discharge Mauka + Makai Studio LLC of and from all claims, demands, debts, contracts, expenses, causes of action, lawsuits, damages, and liabilities, of every kind, whether known or unknown, from or related to my use of Mauka + Makai Studio LLC spray tanning services. I hereby assume any risks associated with the spray tanning services provided under this Agreement and Release. I hereby agree to release the owners, operators from any damages that I might incur from Spray Tanning. I acknowledge that I have been advised of the potential harmful or negative side effects that the spray tan can cause to those who have specific medical or skin conditions. I understand that the solutions are a skin, eye and mucus membrane irritant and that in rare cases persons may be allergic or have hypersensitivity to any ingredient within solutions. I further state that I have no known medical condition that might be aggravated by the procedure or any medical condition that would prevent me from complying with or heeding to the professional’s instructions or these warnings. If any action is brought to enforce the terms of this agreement, the prevailing party shall be entitled to its costs and reasonable attorneys’ fees. Any claims arising out of this agreement will be resolved through binding arbitration using the rules of the American Arbitration Association. This agreement will remain in effect for this procedure, and all future procedures conducted by Lena Bui and Mauka + Makai Studio, LLC or any other professional conducting business at the salon/spa establishment listed above. I agree that this Agreement is binding upon me, and my heirs, legal representatives and assigns. I represent that I am over 18 years of age and that I have the right to enter this agreement, or if I am under 18 years of age, I have had my parent or legal guardian consent to this agreement. By his or her signature below, he or she ratifies and consents to this procedure under these terms.

By checking this box, I understand and agree to all terms.

Today's Date *

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