MINOR Consent Form 2025 Logo

  • SHARKBITE PIERCINGS PIERCING CONSENT FORM

    620 N Rose Dr Ste 110 Placentia CA 92870

  • PARENT'S INFORMATION

    PARENT, PLEASE PUT YOUR INFORMATION HERE - YOU WILL NEED TO FILL OUT THE ENTIRETY OF THE FORM INCLUDING ALL SIGNATURES.
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  • CHILD'S INFORMATION

    PARENT, PLEASE PUT YOUR CHILD'S INFORMATION HERE.
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  • IDENTIFICATION INFORMATION

    Please upload 1-2 photos of BOTH PARENT AND CHILD ID to prove relationship. If last names do not match, we require a copy of the original birth certificate to prove the parent and child are related.

  • Please submit 1-2 photos with the following:

    1 PARENT ID, 1 CHILD ID

    Parent ID: Driver's License, State ID, Passport, Military ID, Tribal ID


    Child ID: School ID (ONLY IF LAST NAMES MATCH), Original Birth Certificate, Current Passport (No more than 3 years old, must be current and non-expired)

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  • Please select if you are a natural parent, or a legal guardian. Legal guardian includes adoptive parent, step parent, or any form of guardianship that is a result of anything court ordered or if relationship is not established via a birth certificate.


    If you are a legal guardian, if you are not on the original birth certificate, please include any forms that establish guardianship over the minor being signed for. POWER OF ATTOURNEY IS NOT PROOF OF GUARDIANSHIP. Siblings cannot sign for other siblings without formal proof of Guardianship.

  • PROOF OF GUARDIANSHIP

    IF YOU ARE NOT A BIOLOGICAL PARENT (EX: ADOPTED CHILD OR LEGALLY OBTAINED GUARDIANSHIP) THEN YOU MUST SUPPLY PROOF OF GUARDIANSHIP. THIS WOULD BE A FORM FILED INTO THE COURT STATING YOUR ABILITY TO GOVERN FOR THE CHILD. POWER OF ATTOURNEY ALONE IS NOT SUFFICIENT PROOF OF GUARDIANSHIP.
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  • Please keep in mind this person is to be contacted should any emergencies occur. Please be sure to list someone who can help you in case of an emergency. Incidents are very rare, but we want to be sure you can be taken care of should anything happen.

    Assuming you wish to be the emergency contact, nothing needs to be input unless you would like someone else names in the event of an emergency.

  • I,         (CLIENT'S PARENT), agree to all of the following statements on behalf of my child: The PRACTIONER refers to both the piercer and the business.

    Piercing is a cosmetic and elective procedure. I understand that piercing may cause permanent modification. I, being of sound mind and body, acknowledge that by signing this agreement that I have been fully informed of the inherent risks associated with getting a piercing (a procedure in which jewelry is inserted into the body by way of needle).

    I fully understand these risks, known and unknown, can lead to injury, including but not limited to: infection, scarring, keloids, allergic reactions to jewelry, or any items associated with the procedure. With full understanding of these risks, I still wish to proceed with the piercing and I freely accept and expressly assume any and all risks that may arise from the piercing.

    I have been given the full opportunity to ask any and all questions that I might have about the obtaining of a piercing from the staff at SHARKBITE PIERCINGS and that all of my questions have been answered to my full and total satisfaction. I specifically acknowledge here that I have READ this document and fully accept all risk involved.

    I acknowledge the the artist and piercing studio have given me instructions on the care of my piercing while it is healing, and I understand and will follow them. I understand that it is possible for the piercing to become infected, particularly if I do not follow the instructions given to me.

    I understand that there is a chance of cosmetic defect, or that I may not like the placement. Placement will be marked prior to piercing, but movement or non-cooperation may affect final placement. I understand that if I cannot follow instructions for the piercing procedure, or put either client or practitioner at risk, that the procedure may be stopped prior to completion. I understand that piercing charges will not be refunded. I understand that the practitioner will not restrain anyone for a piercing procedure.

    I acknowledge that the obtaining of my piercing is my choice alone and I consent to application of the piercing to allow any actions or conduct by the artist that is reasonably necessary to perform the piercing procedure.

    I am NOT under the influence of alcohol, drugs, or any substances that may otherwise impede my judgement.

    I acknowledge that it is not reasonably possible for the artist to determine whether I may have an allergic reaction to the metal, antiseptics, or anything involved in the process of the piercing.
     
    After entering designated working area, I agree to release SHARKBITE PIERCINGS, its owner, or any involved parties from ANY and ALL claims, damage claims, damages or legal actions arising from or connected in any way with my piercing or the procedures and conduct used to apply my piercing, or from any negligence from clumsiness by accident or otherwise while in the designated working area including but not limited to: slip and fall, muscle cramp, cuts, bruises, etc.

    No jewelry is infallible, and breakage or loss are possible with any jewelry, especially if I am not careful. Care of jewelry, including keeping it inserted, and occasional tightening, is the responsibility of the client once the studio is left. There are absolutely NO REFUNDS once the jewelry is used/contaminated. I understand and acknowledge this statement.

    I acknowledge that I have truthfully represented myself with a valid photo ID, which may or may not have been photocopied for filing purposes, to the representatives of SHARKBITE PIERCINGS and that I am eighteen (18) years or older and that this information presented on the form in its entirety is true and correct. This information is held for 3 years and then destroyed to comply with health department regulation.

    The jewelry used that is provided from the studio is generally any of the following material(s): ASTM F-138 IMPLANT GRADE STEEL, ASTM-F136 IMPLANT GRADE TITANIUM, 14K GOLD, 18K GOLD, NIOBIUM, PLATINUM, GLASS. All jewelry except for implant grade steel and some gold is nickel free; some items may contain trace amounts of nickel. If such, PRACTIONER will inform CLIENT of presence of nickel if known and advise accordingly if CLIENT has any known metal allergies. Almost all items are completely nickel-free for ease of the client.

    All materials are highly biocompatible. Jewelry sold is threadless, threaded, hinge, or seamed, depending on item(s) chosen and piercing(s) performed.

    All jewelry is sold as individual parts (ex: 14k star top and implant grade titanium post are two separate items) - it is considered STANDARD to receive a TITANIUM post with your purchase of gold top ends.

    Mill certificates are available on request.

    By completing your form, you are acknowledging these terms.

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