Permanent Jewelry Waiver, Release and Consent Form

Full Name

First NameLast Name

Date of Birth

Date

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Introduction

By signing this Waiver and Release Form, you (the "Guest") agree to release and hold harmless the jewelry provider, event organizers, and associated personnel from any claims related to the permanent jewelry procedure. You acknowledge that you are voluntarily participating in this process, and you understand the potential risks involved.

Understanding of Risks and Procedure

I understand that the permanent jewelry procedure involves the use of a welding tool and materials that may pose risks, including but not limited to:

Burns from the welding tool
Allergic reactions to metals, adhesives, or other materials
Skin irritation or infection
Accidental injury during the process
Long-term care and maintenance requirements for the jewelry

I release Electric Bonds LLC, its practitioners, employees, and affiliates from any liability for complications, injuries, or damages resulting from the procedure.

I acknowledge these risks and voluntarily choose to participate in the permanent jewelry procedure and assume any risks associated with it.

Liability Release

In consideration of receiving permanent jewelry, I, on behalf of myself, my heirs, executors, administrators, and assigns, do hereby release and forever discharge the jewelry provider, event organizers, and all associated personnel from any personal injury, property damage, loss, or other claims, demands, actions, causes of action, damages, or liabilities arising from my participation in the event or in connection with:

The permanent jewelry procedure
Injuries resulting from the use of welding tools or other materials
Any allergic reactions, injuries, or infections resulting from the jewelry or the procedure
Any loss, damage, or injury to myself or my property during or after the event
Any accidental injuries during the event
Any other adverse effects or incidents that may arise from wearing our jewelry

I agree to hold harmless and indemnify the event organizers and jewelry provider from any legal claims, damages, or costs associated with my participation.

I understand that the jewelry provider and event organizers are not liable for any medical costs, damages, or claims arising from my participation in the permanent jewelry service.

By accepting this agreement, you acknowledge and agree that Electric Bonds LLC will not be held liable for any claims, damages, or losses arising from the use of our jewelry. In no event shall Electric Bonds LLC be liable for any indirect, incidental, or consequential damages arising out of or in connection with the use of our products.

Consent for Permanent Jewelry

I understand that permanent jewelry involves creating a lasting piece that is welded or attached to my body. I consent to receiving this service and understand that the jewelry is intended to remain in place until removed or altered.

I understand that I will need to care for the jewelry to ensure longevity, I will follow all aftercare instructions provided to me, and I acknowledge that I am responsible for the ongoing care of the jewelry after it has been applied.

I acknowledge that I am fully aware of this and give my consent for the jewelry to be applied during the event.

Photography and Media Release

I consent to the taking of photographs, videos, or other media during the event or service. I understand that these images may be used for promotional, marketing, or social media purposes by the jewelry provider and event organizers.

I give permission for photographs or images of the procedure and the jewelry placement to be taken for documentation and educational purposes.

I agree that all photos and videos taken are subject to use on our social media, website, flyers, and/or other marketing as we see fit.

Returns

Please note that all purchases of our permanent jewelry are final. We do not offer refunds or exchanges under any circumstances.

It is my responsibility to care for my jewelry, and I accept any and all fault for any damage that may occur.

I understand that every piece of jewelry is custom fit and personalized to each guest, therefore, all purchases are final sale and no refunds or replacements are offered under any circumstance. NO REFUNDS will be given for lost, stolen, damaged or snagged pieces.

Do you understand the terms and conditions listed above?

GOVERNING LAW: This agreement shall be governed by and construed in accordance with the laws of FLORIDA STATE/USA, without regard to it's conflict of law principles.

Do you understand the terms and conditions listed above?

Age Verification

I confirm that I am at least 18 years of age, or if I am a minor, I have obtained the consent of my parent or legal guardian for this procedure.

Voluntary Participation

I understand that participation in the permanent jewelry procedure is entirely voluntary. I am free to choose not to participate at any time during the process without penalty or obligation. If I choose not to proceed with the service, I will not hold the jewelry provider or event organizers liable.

Acknowledgment and Agreement

By signing this form, I acknowledge that I have read and fully understand the contents of this Waiver and Release Form. I voluntarily consent to participate in the permanent jewelry procedure and accept the risks associated with the service.

Signature:

I have read and understood this Permanent Jewelry Consent Form, and I sign it of my own free will.

Date

Signature

Permanent Jewelry Waiver, Release and Consent Form

Client Information