This agreement releases Beautiful Beastie from all liability relating to injuries that may occur during teeth whitening. By signing this agreement, I agree to hold Beautiful Beastie entirely free from any liability, including financial responsibility for injuries incurred, regardless of whether injuries are caused by negligence. Peroxide-based teeth whitening gel is self-applied to your teeth and it activated by our accelerator light to speed up the bleaching process. During your treatment, you may experience a slight tingling or fizzing sensation against your teeth, which is normal, but your should not experience the discomfort of pain. If you do experience the discomfort of pain during use of this product, immediately notify your salesperson by raising your hand.
I also acknowledge the risks involved in teeth whitening. These include but are not limited to skin and gum irritation which might be described as burning, bleeding, or red and/or white blanching. I swear that I am participating voluntarily, and that all risks have been made clear to me. Teeth whitening products are NOT suitable for any persons that are currently pregnant or nursing, have unfilled holes/cavities on their teeth (intact fillings done by a dentist are fine), currently have any temporary crowns or veneers, have had oral surgery within the last 90 days, or currently have untreated gingivitis or gum disease. Furthermore, these products are NOT suitable for taking any medication that makes them sensitive to light, have oral piercings that cannot be removed, are under the age of 18, have allergies to latex, cannot breathe through their nose comfortably for 30 minutes or more, have a strong gag reflex, or have been advised against teeth whitening products from their dentist. Your signature below verifies that you state and agree that you do not have any of these contradictions or conditions.
By signing below I forfeit all right to bring a suit against Beautiful Beastie for any reason. In return, I will receive teeth whitening services. 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 have read the above, understand and certify that I, the Realeasor, have healthy teeth and gums. I, the Realeasor, understand that the Released Parties are NOT dental professionals. I understand that the Released Parties do not guarentee my results or how long my teeth will maintain their new shade of white. If I pay with credit card I authorize the Released Parties to charge my card. All sales are final.
