Adult clients will be asked to sign this upon arrival to the salon.

By signing this form, you, the client confirm that you have not experienced symptoms of COVID-19 (fever, chills, cough, shortness of breath, difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, diarrhea) not due to pre-existing conditions. You also agree to have your temperature monitored upon arrival. If you are not willing or able to confirm and accept these conditions, you will not be permitted to enter the salon, and may be charged in full for cancelation of the appointment.

Entry into Alex Provenzano Salon (“the Salon”) could increase your risk of contracting and transmitting COVID-19. For purposes of this release, waiver, and covenant, you must assume that whatever being done to protect you will not be sufficient. If you are not willing to assume the risk, release all claims, and promise not to sue, you are not permitted to enter the Salon or receive any services provided by the Salon, and you may be charged in full for cancelation of the appointment.

___________________     ____________________________

 Date                                    Signature of Client

ADDRESS

901 15th St. NW Suite 110

Washington, D. C 20005

Tel: (202) 785-0468

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