The Powder Room Minor Consent Form for Facial Services

Minors (all clients under the age of 18) can only receive facial services with written parental/legal guardian consent.

A parent or legal guardian must be present to assist the minor in completing the New Client Information Form.

A parent or legal guardian is required to remain in the buidling while the minor receives services.

• By signing this form, I confirm that I am the parent or legal guardian of the minor who will be receiving facial services.

• By signing this form, I acknowledge that I understand the potential risks associated with facial services and skincare products the esthetician will use during services. I accept these risks and release The Powder Room and its licensed estheticians from liability for any claims arising from my child's participation in these services.

• By signing this form, I acknowledge that I have read and understand the Enzyme and Chemical Peel Prep Guidance and the Enzyme and Chemical Peel Aftercare Guidance posted to The Powder Room's website.

• By signing this form, I acknowledge that The Powder Room New Client Information Form for the minor receiving facial services has been completed accurately.

• By signing this form, I agree to inform The Powder Room of any changes in my child's medical history, current medication, and/or any changes relevant to future services/treatments.

Acknowledgements:

Parent/Legal Guardian Statement of Consent:

As parent or legal guardian of the above-named minor, I hereby consent to said minor's facial service(s). I have read/acknowledge all of the above.