Aviv Jewelry LLC Consent form and waiver of liability for permanent jewelry.

Please read this form carefully and sign it to indicate that you understand and agree to the

terms and conditions outlined below.

I have voluntarily elected to undergo this appointment and the nature and purpose has been explained to me, along with the risks and hazards involved by AVIV JEWELRY LLC. By signing this form, I acknowledge that there are inherent risks involved with welding permanent jewelry. These risks include but are not limited to: burns, discomfort, allergic reactions, and potential scarring, and I accept any such risks. / HEREBY ASSUME ALL OF

THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES ASSOCIATED WITH THIS EVENT,

including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault.

- I acknowledge that I have received and understand the aftercare instructions for the permanent jewelry and agree to follow them as directed. - I acknowledge that the permanent jewelry I selected is dainty in nature, therefore it is NOT INDESTRUCTIBLE, and it needs to be treated with care. It may break, get stuck, pulled or snagged by other objects during daily activities. - I acknowledge that my permanent jewelry piece may stretch if it gets pulled or snagged by something (I.e. door handles - I acknowledge that ALL SALES ON PERMANENT JEWELRY ARE FINAL AS IT HAS BEEN

MEASURED, SIZED AND CUT ACCORDING TO MY SPECIFICATIONS AND ONLY AFTER I

GAVE PERMISSION TO GO AHEAD WITH THE SIZE and CHAIN I CHOSE. I understand

that my piece of permanent jewelry may come undone due to wear and tear, and I can contact the shop for a re-weld or an adjustment to the length of the bracelet/anklet/necklace should they stretch. I acknowledge that I CANNOT request a refund, should I change my mind, due to the custom nature of the process and the fact that permanent jewelry cannot be resold as it has been worn daily/nightly and in the shower.

- I agree to provide accurate and complete information about my health history, including any medical conditions, allergies, or medications that may affect my ability to undergo the

By signing this form, I release AVIV JEWELRY LLC and its employees from any liability for any harm, discomfort, or injury that may occur during the welding process. I also acknowledge that any injury or harm that results from the welding process is solely my

responsibility. I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of the activity in which I may participate, and that it will govern my actions and responsibilities at said activity. I understand while participating in this activity, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the activity holders, producers, sponsors, organizers, and assigns. I agree to be sent notifications via email about new products/services offered by Aviv Jewelry LLC and I understand that I can unsubscribe at any time. The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

/ CERTIFY THAT / HAVE READ THIS DOCUMENT AND / FULLY UNDERSTAND ITS CONTENT. / AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND / SIGN IT OF MY OWN FREE WILL.