Release Form

RELEASE FORM

Please list medications and allergies here: *

* Indicates required field

This agreement releases Cielo Ruiz from all liability relating to injuries that may occur during any facial, waxing, Reiki, Energy Healing, health or nutritional coaching, Access Bars, cupping, from at-home product recommendations or any injuries obtained in the Ruiz home or property. By signing this agreement, I agree to hold Cielo Ruiz entirely free from any liability, including financial responsibility for injuries incurred, regardless of whether injuries are caused by negligence. I attest that all statements I’ve made on the consultation are true. By signing below I forfeit all right to bring a suit against Cielo Ruiz for any reason. I will also make every effort to obey safety precautions as listed in writing and as explained to me verbally. I will ask for clarification when needed. I understand that none of these services are to diagnose or treat medical conditions or replace medical treatments and that results vary. I fully understand and agree to the above terms. *

I agree

E - Signed *

First

Last

Email *

Submit