Permanent Jewelry Waiver & Release

PERMANENT JEWELRY WAIVER & RELEASE
Legal Name*

First NameLast Name
Preferred Name/Pronouns*
Today’s Date*

MonthDayYear
Date
Appointment Date*

MonthDayYear
Date
DOB*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Drivers License Number*
Phone Number*
Please enter a valid phone number.
Email Address*
example@example.com
I understand that permanent jewelry is custom-fitted and welded closed. While it is designed to be worn continuously, I acknowledge that it can be removed at any time by cutting at the weld site with sharp nail clippers, scissors, or small wire cutters.*

YesNo
I understand that if my jewelry needs to be removed for any reason (including but not limited to medical procedures, personal preferences, or safety), I understand that it must be cut at the weld site and that I MUST have my chain to qualify for rewelding. Opalescent Studio is NOT responsible for lost, stolen, or damaged jewelry, including damage caused by snagging, pulling, or normal wear and tear.*

YesNo
I understand that if my jewelry breaks at the weld site within 7 days of my appointment, Opalescent Studio will reweld it free of charge. I understand that standard rewelding fees will apply after 7 days and are as follows: $15 reweld fee for sterling silver and gold-filled pieces and $30 reweld fee for solid 14k gold pieces.*

YesNo
I understand that permanent jewelry application involves the use of pulse arc welding technology. This creates a quick spark to fuse the jewelry ends together. This procedure will not touch the skin and a protective barrier will be used to prevent accidental contact. The process is painless and always performed with safety in mind.*

YesNo
I understand that, although rare, reactions to metals can occur. I release Opalescent Studios and its staff from any liability for skin reactions, medical complications, or other issues related to wearing permanent jewelry.*

YesNo
I confirm that I am voluntarily receiving this service and understand the risks involved. I agree that Opalescent Studios, its owners, staff, and affiliates are not liable for any claims, damages, or expenses that may arise from this service.*

YesNo
I confirm that I am at least 16 years of age. If I am under 16, I confirm that I have signed permission from a parent or legal guardian.*

YesNo
We love capturing and sharing the beautiful jewelry and moments created here at Opalescent Studio. 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 marking the "Yes" box below, you agree that:
- Opalescent Studio 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 recieve 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!
Yes, I give Opalescent Studio permission to use my image in accordance with the terms listed above.No, I do not give Opalescent Studio permission to use my image in any form.
Participant Signature*

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Date*

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Date
Parent or Legal Guardian Signature (if participant is under 16 years of age)

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Date

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Please upload a photo of your drivers license*

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PERMANENT JEWELRY WAIVER & RELEASE