Welcome Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone*Email* Date of BirthDay12345678910111213141516171819202122232425262728293031Month123456789101112Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920How did you hear about Lash Cartel?*-- Select --FriendInstagramFacebookWebsiteGoogle SearchPromoOtherWe'd like to follow you on InstagramTheir Name*More Information*What prompted you to visit Lash Cartel?* Eyelash Extensions Lash Lift Brows Other Other...*What kind of look would you like to achieve from your service today?*What type of music would you like to listen to, whilst in your service?This field is hidden when viewing the formHow can we help you enjoy your service more?Allergies*Do you suffer allergies or known product sensitivity that may impact on your service in anyway way? Yes No Please provide details of allergies and sensitivities*Photographs*Do you consent to before/after images to be used by Lash Cartel online and print? Yes No Treatment / Service Terms & Conditions At Lash Cartel your safety and satisfaction are our priority and while we take every precaution, the service we provide you or the products we use may not always be to your satisfaction or may inadvertently result in damage or loss. Therefore as a condition of having any service at Lash Cartel, you hereby acknowledge and confirm that: 1. You have been fully informed as to the nature of the service you have requested and will assume any and all risk associated with that service 2. You have informed Lash Cartel of any pre existing conditions, allergies or known product sensitivity that may impact on your treatment in any way 3. Lash Cartel is not liable for any dissatisfaction, discomfort, damage, loss or injury you may incur arising directly or indirectly out of any service provided or any product used 4. You give your consent to Lash Cartel to use of your phone number, address and email for their appointment confirmations and in house promotions. Personal information given to Lash Cartel will not be disclosed to any third party or used for any other specific purpose than that listed above 5. You hereby agree that Lash Cartels liability is in all cases limited to the maximum allowed under the Trade Practices Act, which is resupply of the service, or responsible costs for having the services re-applied.Signature*Date* DD slash MM slash YYYY
