Purpose:
The purpose of the procedure is to weld jewelry around various parts of my body, typically in areas such as wrists, ankles, neck or other body parts as agreed upon.
Understanding of Risks and Procedure:
I acknowledge that I have discussed the procedure and its potential risks with the practitioner at The Zapped Cat. I understand that the procedure may involve the following risks and complications:
- Pain, swelling, and/or discomfort during and after the procedure
- Eye pain, discomfort, temporary or permanent blindness (protective eyewear will be provided)
- Infection, scarring, and/or allergic reactions
- Migration or rejection of the jewelry
- Need for further medical intervention or removal
I have been provided with aftercare instructions, and I understand the importance of following them to minimize complications. I understand that there is long-term care and maintenance requirements for the jewelry and I am responsible for this care. Neglecting maintenance may increase the risk of complications and decrease the lifespan of the jewelry.
I understand that tarnishing of the chains may occur for a variety of reasons including, but not limited to:
- Changes in skin pH and body chemistry
- Prolonged exposure to water, including hot tubs, pools, lakes, and oceans
- Lotions, perfumes, soaps, and chemicals
- Hard water
Personal Responsibility:
I take full responsibility for the jewelry after it is placed, including any potential damage, loss, or theft. I understand that the studio or practitioner will not be liable for any such incidents.
Consent and Release:
I voluntarily and willingly consent to the custom welded jewelry procedure and assume any risks associated with it. I release The Zapped Cat, its practitioners, employees, and affiliates from any liability for complications, injuries, or damages resulting from the procedure. I acknowledge that the practitioner has explained the procedure, risks, and aftercare instructions to me. I have had the opportunity to ask questions and have received satisfactory answers.
Age Verification:
I confirm that I am at least 18 years of age, or if I am a minor (13-17 years old), I have obtained the consent of my parent or legal guardian for this procedure.
Photo & Video Release:
I give permission to capture and use photographs and/or videos of me in relation to the permanent jewelry placement procedure. I understand and acknowledge the following:
- The purpose of capturing these photographs and/or videos is to document and showcase the process and results of the permanent jewelry placement procedure.
- I grant permission for the organization or individual to use the photographs and/or videos in various promotional and educational materials, including but not limited to websites, social media platforms, printed materials, and presentations.
- I comprehend that once the photographs or videos are utilized, The Zapped Cat no longer has control over their use by third parties who may also employ the images for their own purposes.
- I understand that my personal information will be kept confidential and that the photographs and/or videos will be used solely for the purposes stated above.
- I acknowledge that I will not receive any financial compensation for the use of these photographs and/or videos.
- I understand and agree that the organization or individual capturing the photographs and/or videos shall retain all ownership rights to the media.
- I release the organization or individual, its representatives, employees, or any other parties involved, from any claims or liabilities arising from the use of the photographs and/or videos, including but not limited to any claims for defamation or invasion of privacy.
Financial Responsibility:
I understand that there will be a fee associated with the custom welded jewelry placement procedure, which will be discussed and agreed upon prior to the procedure. The fee must be paid prior to any chain being measured and cut. We accept cash, check (a return check charge of $30.00 will be applied for any returned checks, regardless of the reason), credit card (Visa, MasterCard, American Express, and Discover), Venmo, or PayPal. All sales are final.
We will re-weld any piece applied by a Zapped Cat practitioner within 15 days (if the weld breaks) for free. We are not responsible if the chain breaks. I understand there is a $15 re-weld fee if needed beyond this 15 days.
Signature:
By signing below, I confirm that I have read and understood the information provided in this consent form, and I voluntarily give my informed consent for the custom welded jewelry placement procedure.