Statement of Health

Please read and 'sign' the following certification statement prior to the start of your service:

I, , have not been quarantined within the last 14 days due to COVID-19 symptoms or illness, and I am not showing symptoms today. Additionally,





COVID-19 RELEASE AND WAIVER OF CLAIMS ("Release")

I hereby acknowledge the health risks and dangers associated with the transmission of the COVID-19 virus, and other communicable diseases, and recognize that exposure to the COVID-19 virus, or other communicable diseases, could occur while making use of Sachi Salon and Sachi Studios.

I have read and fully understand and acknowledge the contents of the Release and agree that I am voluntarily waiving, releasing, indemnifying and discharging Sachi Salon and Sachi Studios and their officers, directors, employees, tenants, and volunteers from any and all liability, damages, and each and every action (collectively, "Claims") by participation in and/or associated with Sachi Salon and Sachi Studios including, but not limited to exposure or transmission of the COVID-19 virus.

My electronic signature below is confirmation that I have read and fully understand and acknowledge the contents of the Release and agree that I am voluntarily waiving, releasing, indemnifying and discharging Sachi Salon and Sachi Studios and their officers, directors, employees, tenants and volunteers from the Claims.

Electronic Signature - type your full name in ALL CAPS (required)

Date (required)

Your Email Address (required)

Your Phone Number (required)

This form will be emailed to the front desk.