PERMANENT JEWELRY CONSENT & LIABILITY WAIVER
Service Description
You are voluntarily electing to receive a soldered-on permanent jewelry application. This process includes welding a chain directly around your wrist, ankle, or neck to create a clasp-free piece of jewelry intended to be worn long-term.
PLEASE NOTE:
All participants under the age of 18 will require a parent/guardian signature.
Payment is due in full prior to service and is non-refundable.
Participant's Name
*
First Name
Last Name
Age Confirmation
*
I am 18+
I am under 18
Legal Guardian Consent (For Clients Under 18) - I confirm that I am the parent or legal guardian of the minor(s) named here. I have read and understand the information provided in this waiver, including the Health & Safety Disclosure. I give my full consent for the minor to receive permanent jewelry services and accept all associated risks on their behalf.
First Name
Last Name
Are you signing for additional minors?
*
Yes
No
List any additional minors receiving services today. By signing below, you confirm you are their parent or legal guardian and accept full responsibility for them under this waiver.
Parent/Guardian Signature
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Waiver & Release of Liability
I hereby release and hold harmless the business and technician from any and all claims, liabilities, damages, or legal actions resulting from or connected to the services performed today. This includes, but is not limited to, accidental injury, allergic reaction, infection, scarring, or damage to personal property. I understand that this waiver shall be binding upon me and my heirs, legal representatives, and assigns.
Health & Safety Disclosure
I acknowledge and agree to the following:
I am 18 years of age or older, or I have obtained parental or legal guardian consent.
I do not have any medical conditions (including but not limited to epilepsy, photosensitivity, metal allergies, or skin conditions) that could be aggravated by this service.
I understand that the permanent jewelry process involves the use of heat and electrical tools, and I agree to follow all safety instructions provided by the technician.
I accept the potential risks associated with the procedure, including but not limited to minor burns, irritation, or injury.
I understand that permanent jewelry is not guaranteed to last indefinitely. It may break, stretch, or require removal. I accept full responsibility for its care after placement—including any loss, damage, or needed maintenance. I acknowledge that the studio or technician is not liable for these outcomes.
I confirm that I have had the opportunity to ask questions, and that the technician has explained the procedure, risks, and aftercare instructions to my satisfaction.
Photo Release (Optional)
*
I give permission to be photographed/videoed during or after my service for marketing or promotional use, including social media.
I do not wish to have my photo taken or used publicly.
Client Affirmation
By entering my signature below, I confirm that I have read this waiver thoroughly and understand its content. I consent to the permanent jewelry service under the terms outlined above.
Date
*
-
Month
-
Day
Year
Date
Signature
*
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