(4) Following December 31, 1977, if a customer voluntarily requests services or parts for the repair of a motor vehicle without delay, due to an emergency, from a repair facility in a repair category for which that facility does not have a master or specialty mechanic, that facility may obtain from the customer a waiver of the customer's rights to have the repair work performed by a master or specialty mechanic. The waiver shall be executed in duplicate with 1 copy to be given to the customer requesting the repairs and shall read as follows: "______________________(customer) has voluntarily requested
_______________(repair person) of ________________(facility) to provide services
or parts in the repair of the below described motor vehicle because of an emergency and thereby waives any claim or cause of action he may have against either
____________(repair person) or _______________(facility) as a result.
Motor vehicle description:
Customer signature ____________
Dated __________
Time ____________ ."