Your Waiver / Intake Form

This form records job details and site conditions prior to work commencing. It does not replace legal advice.

First name*

Last name*

Email*

Phone

Job Details (How many sqm and what epoxy do you want?)

Site Address

Areas to Be Coated

Preferred Start Date

Existing Surface Condition Please disclose any known conditions affecting the concrete. Tick all that apply or describe below.

Cracks

Stains or discoloration

Moisture issues

Uneven surface

Previous coatings or sealers

Oil or chemical exposure

Other known defects

Description of surface condition:

Access and Site Information. Please note any access restrictions, pets on site, vehicles, or hazards that may affect the work.

I acknowledge the existing condition of the concrete, including cracks, stains, moisture, and surface variations. I understand these conditions may affect the final appearance and performance of the coating.

I understand concrete coatings may show natural variation in colour, texture, and finish. I accept that results depend on surface condition, environment, and site factors.

I understand the recommended curing times provided by Luxcrete Coatings and agree not to use the coated surface before the advised curing period ends.

I acknowledge Luxcrete Coatings is not responsible for failures or defects caused by pre-existing conditions, moisture movement, substrate issues, structural movement, or factors outside reasonable control.

I confirm the information provided is accurate and complete. I agree to the above terms prior to work commencing.

How did you hear about us?

By signing this document, I acknowledge the inherent risks and voluntarily assume full responsibility for any injury, damage, or loss that may result from my participation. I hereby waive and release the business, its owners, and its staff from any and all liability, past, present, and future, relating to the services provided.

Signature*

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Luxcrete Coatings

Luxcrete Coatings delivers hard wearing concrete finishes built for Australian conditions. Garages, patios, sheds, driveways. Finished properly from the ground up. Every job starts with real prep. Every system meets trade standards. Every site gets left clean. This work lasts because shortcuts never enter the process.

Perth owned and operated.

Fully insured.

Real projects. Real results.

View our work. Read client feedback. See the difference in the finish.

Request a free quote today. Fast response. Clear pricing. No pressure.

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