Circle the product(s) you intend to
purchase. Sodium Hydroxide Potassium
Hydroxide
Please list intended usage of this/these product(s). _______________________________________________
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Initial
each item.
______ I understand any and all hazards associated with usage of these products.
______ I agree to be completely
and solely responsible for any and all injuries or damage to myself, others and
property associated with usage of above product(s)
and I take full responsibility for proper storage and safety
precautions for myself and any person who may come in contact with the
above product(s).
______ I agree not to hold Texas Herbal Body Solutions, Texas Natural Supply, their employees or owners
responsible
for any injuries, damage or misuse that results from the usage of above product(s).
______ I am a legal adult above the age of 18.
______ I am not procuring any of the above product(s) for the manufacturing of any illegal drugs, explosives or other
illegal
activities. Nor will I provide or make available to anyone these product(s) so that they can be used in manner
that would be illegal,
explosive or considered a dangerous activity.
_____ I understand that the above listed seller reserves the right to discontinue
sale of these product(s) to me for any reason.
Legal Signature _________________________________________________________________________
Date_____________________ Time______________________