Customer Informed Consent and Release – Covid-19 EmailThis field is for validation purposes and should be left unchanged.I understand and acknowledge the dangerous and contagious nature of the SARS-CoV-2 virus (“Coronavirus”) that can cause the disease known as COVID-19.*YesNoI have had sufficient opportunity to access and review available information regarding the Coronavirus and COVID-19, including information available from federal, state and local authorities.*YesNoI acknowledge that, while K Charles and Co Salons has put in place measures to prevent the existence and spread of the Coronavirus within any K Charles and Co. location, K Charles and Co cannot guarantee that I will not become infected with the Coronavirus while present at a K Charles and Co. location.*YesNoI further understand that my exposure to the Coronavirus may result from the actions, omissions, or negligence of myself and/or others, including, but not limited to, other K Charles and Co customers or even K Charles and Co. personnel.*YesNoUnderstanding these facts, I voluntarily seek services provided by K Charles and Co and acknowledge that I am increasing my risk of exposure to the Coronavirus by seeking such services.*YesNoI, ON BEHALF OF MYSELF, MY SUCCESORS, AND MY ASSIGNEE(S), HEREBY RELEASE AND DISCHARGE KCharles and Co, AND THEIR EMPLOYEES, REPRESENTATIVES, OWNERS AND AGENTS FROM ANY AND ALL CLAIMS, CAUSES OF ACTION, LEGAL PROCEEDINGS, DAMAGES, LOSSES, OR HARM OF ANY KIND, AT LAW OR IN EQUITY, ARISING FROM MY POTENTIAL EXPOSURE TO THE CORONAVIRUS AND THE ONSET OF COVID-19 BY REASON OF MY VOLUNTARY DECISION TO ENTER AND SPEND ANY AMOUNT OF TIME IN A KCharles and Co. LOCATION.*Signature
