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Please Fill Out the Required Information Prior To Your Appointment

(This form is for our info only and does NOT book your appointment)

My Little Wax Bar
Wax Client Training Model Waiver
Personal and Confidential
MLWB assures you that providing a safe and healthy environment for our clients and staff is our top priority.


We take great pride in keeping our salon clean and safe, and we know this is more important than ever to continue in keeping everyone healthy. We are taking guidance from our governing agencies which recommends regular cleaning as one of the most important, preventive measures we can take. In addition to frequent hand washing and frequent sanitizing, we’ve enhanced our daily cleaning routines with more rigorous procedures and additional focus on high-touch and traffic areas.  All rooms (chairs, countertops, trays, doorknobs, etc) are sanitized with EPA approved sanitizers between clients.

COVID-19 Customer Waiver
I consent to inform My Little Wax Bar that I have not been exposed to COVID-19 or have had symptoms of COVID-19 within the last 14 days of my appointment.  I consent that I do not have any flu-like symptoms, body aches, diarrhea, cough, fever, runny nose, or a sore throat.
By submitting this form I agree that the above declaration is true and correct and that any dishonest answers may have Serious Health Implications.
During this COVID-19 pandemic, I understand that by visiting any public place that I may be exposed to COVID-19.  I agree that I am opting to receive services at My Little Wax Bar of my own choice and that I will not hold My Little Wax Bar or any of it's employees liable, should I contract COVID-19.
  • I have given an accurate account of the questions asked above including all known allergies or prescription drugs or products I am currently ingesting or using topically. I understand my esthetician will take every precaution to minimize or eliminate negative reactions as much as possible. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures.


  • I hereby elect to voluntarily receive todays waxing service as a TRAINING MODEL and at a Discounted Rate and with full knowledge that the service I receive today is to educate and train other professional estheticians.  I acknowledge that the esthetician  and MLWB will do her best to be as efficient as possible, but that she is training and may not be able to remove ALL hair in within the service time.


  • I am fully aware that as a training model there may be a some skin reactions such as but not limited to redness, irritation, ingrown hairs, small white bumps, bruising and/or sensitivity to the area and understand that cool ice packs are recommended for any type of these symptoms.


  • I give permission to my esthetician to perform the waxing procedure we have discussed and release MY LITTLE WAX BAR LLC, its employees and students from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or related to any adverse reactions that may be sustained by me.


  • I agree as well that I will not share my experience as a training model at My Little Wax Bar in any NEGATIVE form whatsoever thru any type whatsoever of Social Media platform.


  • By submitting this release, I acknowledge that I have read this foregoing waiver of Liability and Hold Harmless Agreement, understand, agree, and submit it voluntarily.


  • I am at least eighteen (18) years of age and fully competent.

Thank you for submitting this form and helping to reduce waste!

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