TRAVEL WAIVER

Name *

First Name

Last Name

Phone

(###)

###

####

Date

MM

DD

YYYY

Are you currently on any medication? *

Yes

No

Are you pregnant? *

Yes

No

Do you have any allergies? *

Yes

No

Do you have any skin conditions? *

Yes

No

I hold harmless & indemnify The Dollhouse Airbrush LLC for all liability services performed in my home. *

Agree

I approve the use of my photo on social media.

Agree