Photo & Media Release

Completion is optional. This release is opt-in and may be withdrawn at any time.

Guest Information

Full Legal Name

Date of Service

Phone

Service(s) Received

What You Are Consenting To

By initialing and signing below, I grant Lumi Nails & MedSpa ("Lumi") permission to capture and use photographs, video, and audio of me and/or my treatment for the purposes I have selected. I understand this consent is voluntary and applies only to the service(s) listed above unless I indicate otherwise.

Before / after & treatment photos — close-ups of my nails, brows, lashes, skin, or hair, with no recognizable face or identifying features. initials

Photos or video that show my face or make me identifiable. initials

Behind-the-scenes / ambient footage in which I may appear in the background of studio content. initials

Audio (voice, quotes, or testimonial). initials

Where the Content May Appear

I authorize Lumi to publish the selected content on the following channels (initial any I approve):

Lumi website and email newsletters.

Instagram, TikTok, Facebook, and other Lumi-owned social media accounts.

Printed marketing, in-studio displays, and press materials.

Paid advertising (social ads, Google, print, out-of-home).

Your Rights & Withdrawal

This release is opt-in. Declining does not affect your service, pricing, or standing as a guest.
You may withdraw consent at any time by emailing info@luminailsandmedspa.com. On request, Lumi will remove the content from channels it controls within a reasonable time. Content previously shared, re-posted, or downloaded by third parties may persist outside Lumi's control.
Lumi will not sell your images, license them to third parties, or use them in a way that is defamatory, sexually suggestive, or otherwise contrary to your reasonable expectations as a guest.
You are not entitled to compensation for any use authorized by this release, and you waive the right to inspect or approve the finished materials.
This release is governed by the laws of the State of Illinois.

If the guest is under 18: a parent or legal guardian must complete the guardian section below. Consent for a minor cannot be given by the minor themselves, and Lumi will not publish identifiable images of a minor without a guardian's signature.

Guest Signature

Date

Printed Name

Date of Birth

Parent or Legal Guardian (if guest is under 18)

Guardian Signature

Date

Guardian Printed Name & Relationship

Guardian Phone

Lumi Use Only

Received By (Staff)

Filed On