Waiver of Liability

For and in consideration of good and valuable consideration, including, but not limited to, the following instructions, certifications, products, programs, and services the receipt and sufficiency of which is acknowledged hereby, I hereby waive my rights to all claims for injuries, risks, adverse effects, and life-threatening medical and clinical conditions that I may sustain arising out of the ALLURE A MEDICALLY DIRECTED SPA, INC (ALLURE) instructions, certifications, products, programs, and services or any subsequent activities arising therefrom.

I further agree to hold harmless ALLURE for all injuries, be they physical, fiscal or otherwise, that I may inflict upon others as a result of the therapies, treatments, procedures, sessions, programs, and other wellness services in addition to the use of ALLURE’s other products and services.

I recognize and acknowledge that there are certain risks of physical and other injuries, risks, adverse effects, and life-threatening medical conditions involved in attending a ALLURE therapy, treatment, procedure, session, program, and other wellness service including the purchase and use of ALLURE products, and I agree to assume the full risk of injuries, including death, damages or losses that I may sustain as a result of attending an therapy, treatment, procedure, session, program, and other wellness service by ALLURE and the use of purchased products sold by ALLURE. I agree to waive and relinquish any and all claims I may have arising out of, or connected with, said course and products, whether they relate to injuries, risks, adverse effects, and life-threatening medical conditions to others or myself.

I do hereby fully release and discharge the ALLURE and its officers, agents and employees from any and all claims from injuries, including death damage or loss, which I may have as a result of this service and the products sold by ALLURE.

I have read and fully understand and agree to the above stated conditions of participation in this Program.

By indicating your acceptance, you understand, agree, warrant and covenant as follows:

REGISTRATION AGREEMENT AND LIABILITY WAIVER (the “Agreement and Waiver”)

Authority to Register and/or to Act as Agent. You represent and warrant to the ALLURE that you have full legal authority to complete this event registration by phone, email, in person, and/or through our website and Enrollware.com registration hyperlink on behalf of yourself and/or any party you are registering (the “Registered Parties”), including full authority to make use of the credit or debit card to which registration fees will be charged. As used in this Agreement and Waiver, the ALLURE refers to the ALLURE and any and all subsidiaries, affiliated entities, or entities that control or are controlled by the ALLURE singly or together and its officers, employees, contractors, subcontractors and agents.

If you are registering a child under the age of 18 or an incapacitated adult you represent and warrant that you are the parent or legal guardian of that party and have the legal authority to enter into this agreement on their behalf and by proceeding with this event registration, you agree that the terms of this Agreement and Waiver shall apply equally to all Registered Parties. By registering a child under 13, you agree and consent to the collection of that child’s information, which you provide for the purposes of registration.

Waiver

YOU UNDERSTAND THAT PARTICIPATION IN THE EVENT AND USE OF OUR PROGRAMS, PRODUCTS AND SERVICES ARE POTENTIALLY HAZARDOUS, AND THAT A REGISTERED PARTY SHOULD NOT PARTICIPATE UNLESS THEY ARE MEDICALLY ABLE AND PROPERLY TRAINED. YOU UNDERSTAND THAT EVENTS MAY BE HELD OVER PUBLIC ROADS AND FACILITES OPEN TO THE PUBLIC DURING THE EVENT AND UPON WHICH HAZARDS ARE TO BE EXPECTED. PARTICIPATION AND USE OF OUR PROGRAMS, PRODUCTS AND SERVICES CARRIES WITH IT CERTAIN INHERENT RISKS THAT CANNOT BE ELIMINATED COMPLETELY RANGING FROM MINOR INJURIES TO CATASTROPHIC INJURIES INCLUDING DEATH. YOU UNDERSTAND AND AGREE THAT IN CONSIDERATION OF BEING PERMITTED TO PARTICIPATE IN THE EVENT AND USE OF OUR PROGRAMS, PRODUCTS AND SERVICES, YOU AND ANY REGISTERED PARTY, THE HEIRS, PERSONAL REPRESENTATIVES OR ASSIGNS OF YOU OR THE REGISTERED PARTY DO HEREBY RELEASE, WAIVE, DISCHARGE AND CONVENANT NOT TO SUE ALLURE FOR ANY AND ALL LIABILITY FROM ANY AND ALL CLAIMS ARISING FROM PARTICIPATION IN THE EVENT AND THE USE OF OUR PROGRAMS, PRODUCTS AND SERVICES BY YOU OR ANY REGISTERED PARTY.

Limitation of Liability; Disclaimer of Warranties

ALLURE SHALL NOT BE LIABLE FOR ANY DIRECT, INDIRECT, INCIDENTAL, SPECIAL OR CONSEQUENTIAL DAMAGES, RESULTING FROM (A) THE USE OR THE INABILITY TO USE THE ALLURE OR (B) FOR THE COST OF PROCUREMENT OF SUBSTITUTE GOODS AND SERVICES OR (C) RESULTING FROM ANY GOODS OR SERVICES PURCHASED OR OBTAINED OR TRANSACTIONS ENTERED INTO THROUGH THE ALLURE OR (D) RESULTING FROM UNAUTHORIZED ACCESS TO OR ALTERATION OF YOUR TRANSMISSIONS OR DATA, INCLUDING BUT NOT LIMITED TO, DAMAGES FOR LOSS OF PROFITS, USE, DATA OR OTHER INTANGIBLE, EVEN IF THE ALLURE HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. YOU EXPRESSLY AGREE THAT USE OF THE ALLURE IS AT YOUR SOLE RISK. THE ALLURE IS PROVIDED ON AN “AS IS” AND “AS AVAILABLE” BASIS. THE ALLURE EXPRESSLY DISCLAIMS ALL WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING WITHOUT LIMITATION ANY WARRANTY OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE OR NON-INFRINGEMENT.

The ALLURE makes no warranty that ALLURE sites’ services will be uninterrupted, secure or error free. The ALLURE does not guarantee the accuracy or completeness of any information in, or provided in connection with, the ALLURE site. The ALLURE is not responsible for any errors or omissions, or for the results obtained from the use of such information. You understand and agree that any material and/or data downloaded or otherwise obtained through the use of the ALLURE sites is at your own discretion and risk and that you will be solely responsible for any damage to your own computer system or loss of data that results from the download of such material and/or data.

Indemnification

You agree to indemnify and hold each of the ALLURE harmless from and against any and all damages, costs, claims or demands, including reasonable attorneys’ fees, made by any third party due to or arising from or relating to your use of the ALLURE’s services.

Applicable Law; Consent to Jurisdiction

ALLURE sites (excluding linked sites) are controlled by the ALLURE from its offices within the State of California, United States of America. By completing this event registration, both you and the ALLURE agree that the statutes and laws of the State of California, without regard to the conflict of laws principles thereof, will apply to all matters relating to this event registration, this Agreement and Waiver, the Terms of Use or other use of the ALLURE sites. You agree that exclusive jurisdiction for any dispute with the ALLURE resides in the courts of the Riverside County in the State of California (and subsequent courts of the other applicable states once our training site and affiliated training center is officially nationally recognized) and you further agree and expressly consent to the exercise of personal jurisdiction in the courts of the State of California in connection with any dispute including any claim involving the ALLURE or its affiliates, subsidiaries, employees, contractors, officers, directors, telecommunication providers and content providers.

Severability

You further expressly agree that this Agreement and Waiver is intended to be as broad and inclusive as is permitted by the law of the State of California and that if any provision of this Agreement and Waiver shall be found to be unlawful, void, or for any reason unenforceable, then that provision shall be deemed severable from this Agreement and Waiver and shall not affect the validity and enforceability of any remaining provisions.

BY INDICATING YOUR ACCEPTANCE OF THIS AGREEMENT AND WAIVER, YOU ARE AFFIRMING THAT YOU HAVE READ AND UNDERSTAND THIS AGREEMENT AND WAIVER AND FULLY UNDERSTAND ITS TERMS INCLUDING ALL OF ALLURE’S COPYRIGHT NOTICE, DISCLAIMERS, WAIVER OF LIABILITY, CANCELLATION POLICY, PRIVACY POLICY, ETHICS POLICY, CONFLICT OF INTEREST POLICY, AND LINKING POLICY THAT ARE STATED IN THIS AGREEMENT AND WAIVER AND/OR ALLURE’S WEBSITE. YOU UNDERSTAND THAT YOU ARE GIVING UP SUBSTANTIAL RIGHTS, INCLUDING THE RIGHT TO SUE. YOU ACKNOWLEDGE THAT YOU ARE SIGNING THE AGREEMENT AND WAIVER FREELY AND VOLUNTARILY, AND INTEND BY YOUR ACCEPTANCE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.

ALLURE INFORMED CONSENT FOR BOTULINUM TOXIN TREATMENT

The purpose of the informed consent form is to provide written information regarding the risks, benefits, and alternative of the procedure named above. This material serves as a supplement to the discussion you have with your doctor/healthcare provider. It is important that you fully understand this information, so please read the document thoroughly. If you have any questions regarding the procedure, ask the doctor/healthcare professional prior to signing the consent form.

THE TREATMENT

Botulinum toxin (Botox and similar agents) is a neurotoxin produced by the bacterium Clostridium A. Botulinum toxin can relax the muscles on areas of the face and neck, which cause wrinkles associated with facial expressions or facial pain. Treatment with Botulinum toxin can cause your facial expression lines or wrinkles associated with facial expressions or facial pain. Treatment with Botulinum toxin can cause your facial expression lines or wrinkles to be less noticeable or essentially disappear.

Areas most frequently treated are:

Glabellar of frown lines, located between the eyes;
Crow’s feet (lateral areas of the eyes);
Forehead wrinkles;
Radial lip lines (smoker’s lines)
Head and neck muscles.

Botox is diluted to a very controlled solution and when injected into the muscles with a very thin needle, it is almost painless. Patients may feel a slight burning sensation while the solution is being injected. The procedure takes about 15-20 minutes and results can last up to 3 months. With repeated treatments, the results may ted to last longer.

RISKS AND COMPLICATIONS

Before undergoing this procedure, understanding the risks is essential. No procedure is completely risk-free. The following risks may occur, but there may be unforeseen risks and risks that are not included on this list. Some of these risks, if they occur may necessitate hospitalization, and or extended outpatient therapy to permit adequate treatment. It has been explained to me that there are certain inherent and potential risks and side effects in any invasive procedure and in this specific instance such risks include but are not limited to

Post treatment discomfort, swelling redness, and bruising;
Transient headache;
Double vision;
A weakened tear duct;
Flu like symptoms may occur;
Post treatment bacterial, and or fungal infection requiring, and or fungal infection requiring further treatment;
Minor temporary droop of eyelids in approximately 2% of injections, this usually lasts 23 weeks;
Occasional numbness of the forehead lasting up to 2 – 3 weeks; and
Allergic reaction

PREGNANCY, NEUROLOGIC DISEASE, & ALLERGIES

I am not aware that I am pregnant and I am not trying to get pregnant, I am not lactating (nursing). I do not have any significant neurologic disease including but not limited to Myasthenia Gravis, Multiple Sclerosis, Lambert Eaton Syndrome, Amyotrophic Lateral Sclerosis (ALS), and Parkinson’s Disease. I do not have any allergies to the toxin ingredients, or to human albumin.

ALTERNATIVE PROCEDURES

Alternatives to the procedure and options that I have volunteered for have been fully explained to me.

PAYMENT

I understand that this is an “elective” procedure and that payment is my responsibility and is expected at the time of treatment.

RIGHT TO DISCONTINUE TREATMENT

I understand that I have the right to discontinue the treatment at any time.

INDEMINIFICATION

I hereby indemnify “ALLURE A MEDICALLY DIRECTED SPA,” “REPLENISH 360 A DIVISION OF PDRE LLC,” “KARL VASQUEZ SALON & SPA,” and “PALM DESERT RESUSCITATION EDUCATION LLC” from any liability relating to the procedures that I have volunteered for. I also understand that any treatment performed is between my doctor/health care provider who is treating me and I. In addition, I will direct all post-operative questions or concerns to the treating clinician.

I herby indemnify the Facility/Meeting Room/Hotel where this treatment is being performed from any liability relating to the procedures that I have volunteered for.

PUBLICITY MATERIALS

I authorize the taking of clinical photographs and videos and their use for scientific and marketing purposes both in publications and presentation. I understand that photographs and video may be taken of me for educational and marketing purposes. I hold ALLURE and any of its affiliates harmless for any liability resulting from this production. I waive my rights to any royalties, fees and to inspect the finished production as well as advertising materials in conjunction with these photographs.

RESULTS

I am aware that when small amounts of purified Botulinum toxin are injected into a muscle it causes weakness or paralysis of that muscle. This appears in 2-10 days and usually last up to 3 months but can be shorter or longer. In a very small number of individuals, the injection does not work, as satisfactorily or as long as usual and there are some individuals who do not respond to it at all. I understand that I will not be able to use the muscles injected as before while the injection is effective but that this will reverse after a period of months at which time re-treatment is appropriate. I understand that I must stay in the erect posture and that I must not manipulate the area(s) of the injections for the 2 hours post-injection period.

I understand this is an elective procedure and I voluntarily consent to treatment with Botulinum toxin injections for facial dynamic wrinkles, TMJ dysfunction, bruxism and types of orofacial pain, including headaches and migraines. The procedure has been fully explained to me. I also understand that any treatment performed is the doctor/healthcare provider who is treating me and I. Again, I will direct all post-operative question or concerns to the treating clinician. I have read the above and understand it. My questions have been answered satisfactorily. I accept the risks and complications of the procedure and I understand that no guarantee is implied as to the outcome of the procedure. I also certify that if I have any changes in my medical history I will notify the doctor/healthcare professional who treated me immediately. I also state that I read and write in English.

ALLURE INFORMED CONSENT FOR DERMAL FILLER TREATMENT

THE TREATMENT

Treatment with dermal fillers (such as Juvaderm®, Restylane®, Belotero Balance®, Radiesse® and other dermal fillers) can smooth out facial folds and winkles, add volume to the lips, and contour facial features that have lost their volume and fullness due to aging, sun exposure, illness, etc. Facial rejuvenation can be carried out with minimal complications. These dermal fillers are injected under the skin with a very fine needle. This produces natural appearing volume under wrinkles and folds, which are lifted up and smoothed out. The results can often be seen immediately.

RISKS AND COMPLICATIONS

Before undergoing this procedure, understanding the risks is essential. No procedure is completely risk-free. The following risks may occur, but there may be unforeseen risks and risk that are not included on this list. Some of these risks, if they occur, may necessitate hospitalization, and /or extended outpatient therapy to permit adequate treatment. It has explained to me the risks and side effects in any invasive procedure and in this specific instance such risks include but are not limited to

Post treatment discomfort, swelling, redness, bruising, and discoloration;
Lumpiness, visible yellow or white patches;
Localized necrosis and or sloughing, with scab and or with out scab if blood vessel occlusion occurs.
Post treatment infection associated with any transcutaneous injection;
Reactivation of Herpes (cold sores);
Granuloma formation; and
Allergic reaction;

PREGNANCY, NEUROLOGIC DISEASE, & ALLERGIES

ALTERNATIVE PROCEDURES

Alternatives to the procedure and options that I have volunteered for have been fully explained to me.

RIGHT TO DISCONTINUE TREATMENT

I understand that I have the right to discontinue the treatment at any time.

INDEMINIFICATION

I herby indemnify the Facility/Meeting Room/Hotel where this treatment is being performed from any liability relating to the procedures that I have volunteered for.

PUBLICITY MATERIALS

RESULTS

Dermal fillers have been shown to be safe and effective when collagen skin implants and related products fill in wrinkles, lines and folds in the skin on the face. Its effects can last up to 6 months. Most patients are pleased with the results of dermal fillers use. However, like any esthetic procedure, there is no guarantee that you will be completely satisfied. There is no guarantee that wrinkles, and folds will disappear completely, or that you will not require additional treatment to achieve the results you seek. The dermal filler procedure is temporary and additional treatments will be required periodically, generally within 4 to 6 months, involving additional injections for the effect to continue. I am aware that follow up treatments will be needed to maintain the full effects. I am aware the duration of treatment is I dependent on many factors including but not limited to: age, sex, tissue conditions, my general health and lifestyle conditions, and sun exposure. The correction depending, on these factors, may last up to 6 months and in some cases shorter and some cases longer. I have been instructed in and understand the post treatment instructions.

I understand this is an elective procedure and I hereby voluntarily consent to treatment with dermal fillers for facial rejuvenation, lip enhancement, establish proper lip and mile lines, and replacing facial volume. The procedure has been fully explained to me. I also understand that any treatment performed is the doctor/healthcare provider who is treating me and I. In addition, I will direct all postoperative questions or concerns to the treating clinician. I have read the above and understand that no guarantees are implied as to the outcome of the procedure. I also certify that if I have any changes in my medical history I will notify the doctor/healthcare professional who treated me immediately. I also state that I read and write English.