MINOR WAIVER, RELEASE & CONSENT TO PIERCING

Child's Legal Name

First NameLast Name

Parent/Guardian Legal Name

First NameLast Name

Today's Date

Date

Appointment Date

Date

Child's Preferred Name/Nickname

Phone #

Format: (000) 000-0000.

Email Address

My Piercer(s) Name

I, blanks* the parent/guardian of blank , induce the piercer(s) to pierce my son and/or daughter. In consideration of doing so, I fully understand THE PIERCER DOES NOT ACT AS A MEDICAL PROFESSIONAL. Any suggestions made to me are not to be constructed as/or substituted for advice from a medical professional. I acknowledge by signing this release I have been given the full opportunity to ask any and all questions which I might have about obtaining a piercing and all my questions have been answered to my full and total satisfaction. I acknowledge I have been advised of the matters set forth below and I agree as follows:

I consent that my child is not pregnant or nursing. They do not have epilepsy or hemophilia. They do not suffer from any heart conditions or take medication which thins the blood. I have informed the piercer of any condition such as diabetes that might hamper healing of thepiercing.

I consent that they do not suffer from hepatitis, or any other communicable disease, I have informed the piercer of this fact and I have been advised of any procedures necessary to promote the satisfactory healing of their piercing.

I consent that they do not suffer from any medical or skin conditions such as, but not limited to: keloid or hypertrophic scarring, psoriasis at the site of the piercing or any open wounds or lesions at the site of the piercing.

I have advised the piercer of any allergies to metals, latex gloves, soaps and medications. I acknowledge it is not reasonably posside for te piercer to determine wheter tney mign nave an allergic redction to te piercing or processes involved in the piercing and further acknowledge that a reaction is possible.

My child is not under the influence of drugs or alcohol. To my knowledge, they do not have any physical, mental or medical impairment or disability which might affect their well-being as a direct or indirect result of my decision to have a piercing done at this time.

I acknowledge that obtaining this piercing is my child's choice alone and will result in permanent change to their appearance, and that no representation has been made to me as to the ability to later restore the skin involved in this piercing to its pre-piercing condition.

I acknowledge infection is always possible as a result of obtaining a piercing. My child and I have received aftercare instructions andwe agree to follow all of them while the piercing is healing.

I understand they will be pierced using appropriate instruments and sterilization.

Therefore, I request the piercer to pierce my child's blank* . I understand how long this piercing usually takes to heal. I agree to release and forever discharge and hold harmless the piercer(s) and all employees from any and all claims, damages or legal actions arising from or connected in any way with my piercing, or the procedures and conduct used in his/her piercing.
By my signature below, I certify that I am the parent/legal guardian of blank* , who is willingly submitting to these procedures.

Parent/Guardian Signature

Today's Date

Date

Child's Signature

Today's Date

Date

We love capturing and sharing the beautiful jewelry and moments created here at Opalescent Studios. With your permission, we’d like to take photos and/or videos of your permanent jewelry for use on our social media, website, and promotional materials.By signing below, you agree that:• Opalescent Studios may use photos/videos of you and your jewelry for marketing and promotional purposes (such as Instagram, Facebook, TikTok, or our website).• You will not receive compensation for the use of these images.• You may request at any time that we stop using your image in future posts.Your comfort and privacy matter to us! If you’d prefer not to have your photo shared, just let us know — it won’t affect your appointment or experience in any way.

Child's Birth Certificate

Parents' Driver's License OR Court Documentation of Guardianship AND Guardians' Driver's License

Child's DOB

Date