DIE PRETTY LLC
TOOTH GEM APPLICATION WAIVER & RELEASE OF LIABILITY (EVENT)
By signing below, I acknowledge that I am voluntarily receiving a cosmetic tooth gem application from Die Pretty LLC at a temporary event location.
I understand that tooth gems are a cosmetic, non-medical procedure applied to the surface of a natural tooth using dental-grade adhesive. I acknowledge that this service is not performed by a licensed dentist and is strictly decorative.
1. ASSUMPTION OF RISK
I understand and accept the following risks may occur, including but not limited to:
Tooth sensitivity
Gum irritation
Allergic reaction
Chipping or damage to enamel (especially if pre-existing damage exists)
Swallowing or inhaling the gem if it becomes loose
Adhesive residue remaining on the tooth after gem loss
Discomfort during or after application
I understand results vary per individual and are dependent on natural tooth structure, hygiene, and aftercare compliance.
I voluntarily assume all risks associated with this procedure.
2. NO REMOVAL POLICY
I understand and agree that:
Die Pretty LLC does NOT remove tooth gems.
If I choose to remove the gem, it must be professionally removed by a licensed dentist.
Die Pretty LLC is NOT responsible for any adhesive residue left on the tooth.
Die Pretty LLC is NOT responsible for damage caused by improper removal attempts by myself or another party.
3. EVENT LIABILITY RELEASE
Because this service is being performed at a temporary event location, I understand that:
Die Pretty LLC is not responsible for any injuries, damages, or losses occurring at the event venue.
I release Die Pretty LLC, its owners, contractors, employees, assistants, and event hosts from any and all claims, liabilities, demands, damages, actions, or causes of action related to this procedure.
I agree not to pursue legal action against Die Pretty LLC for any outcome related to this service.
4. MEDICAL DISCLOSURE
I confirm that:
I do not have untreated cavities, gum disease, enamel erosion, braces, or dental work in the application area unless disclosed.
I am not aware of any condition that would make this procedure unsafe.
I have disclosed any allergies or sensitivities.
If I am pregnant, have dental concerns, or have medical conditions, I acknowledge I have consulted a dentist prior to receiving this service.
5. AFTERCARE AGREEMENT
I agree to follow all aftercare instructions provided by Die Pretty LLC, including:
Avoiding hard foods for 24 hours
Avoiding picking or playing with the gem
Maintaining proper oral hygiene
Avoiding excessive pressure on the gem
Failure to follow aftercare may result in premature loss, for which Die Pretty LLC is not responsible.
6. EXCHANGE POLICY
I understand:
If the gem falls off within 7 days due to natural bonding failure, I may contact Die Pretty LLC for one complimentary reapplication.
After 7 days, any reapplication will require a new service fee.
Loss due to picking, trauma, improper aftercare, or dental work is not eligible for replacement.
7. PHOTO, VIDEO & CONTENT RELEASE
I grant Die Pretty LLC permission to photograph and record before, during, and after images and video of the service for marketing, social media, educational, and promotional purposes.
I waive any right to compensation or ownership of such media.
8. AGE REQUIREMENT
I confirm that I am:
☐ 18 years or older
OR
☐ A minor with parent/legal guardian present and signing below.
9. ACKNOWLEDGMENT
By signing below, I confirm that:
I have read and fully understand this waiver.
I have had the opportunity to ask questions.
I understand the risks involved.
I voluntarily consent to the tooth gem application.
I release Die Pretty LLC from all liability to the fullest extent permitted by law.