Policies Agreement & Waiver

ATTENTION: COVID-19 policies have been updated as of March 19, 2021.

Please read all of our new policies and guidelines below before coming to your appointment. You must use the form below to agree to our new policies and submit a waiver prior to coming into the salon for your next appointment.

We are consistently reviewing the Connecticut state guidelines for safety, sanitation, and social distancing. We have become a Barbicide certified safe service establishment and we have our CT COVID-19 prevention badge.

Please make sure you submit the policy agreement and waiver at the bottom of this page before coming in for your next appointment. We will not be able to service you until we have received your waiver. If you do not have the ability to fill out the policy agreement and waiver located on this page then we will have you sign the waiver in the salon before your appointment.

Policy Agreement & Waiver

Before completing the form below, please review our new policies if you have not done so already.


    Yes, I have read and understand all new policies.*

    Salon Le Rae Waiver

    Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19 The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.

    Salon Le Rae has put in place preventative measures to reduce the spread of COVID-19; however, Salon Le Rae cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending appointments could increase your risk and your child(ren)’s risk of contracting COVID-19.

    By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I or my child(ren) may be exposed to or infected by COVID-19 by attending salon appointments and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at Salon Le Rae may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Salon Le Rae employees, volunteers, and program participants and their families.

    I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with salon appointments . On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless Salon Le Rae, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the salon, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in Salon Le Rae.


    I agree*


    I agree*


    I agree*


    I agree*


    I agree*

    Please select who will be participating

    AdultMinor(s)

    Please select only 1 option.

    1 minor2 minors3 minors4 minors5 minors

    This waiver is just for you.



    Please type your name in lieu of a physical signature.


    This waiver is for minor(s).



    This waiver is for the second minor.



    This waiver is for the third minor.



    This waiver is for the fourth minor.



    This waiver is for the fourth minor.



    Parent/Guardian Information



    Please type your name in lieu of a physical signature.


    Electronic Signature Consent


    I agree*

    We appreciate your cooperation and your continued support during these challenging times. Thank you for your understanding!

    We can all do our part to prevent the spread of illness in our community. You can help by staying home or rescheduling your appointment if you’re feeling sick. Symptoms may appear 2–14 days after exposure and include fever, cough, and shortness of breath. If you are healthy, we look forward to seeing you!

    By clicking 'Submit Agreement & Waiver' you are agreeing to all updated Salon Le Rae guidelines.

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