The individual named below (referred to as "I" or "me") desires to participate in the fastening/securing of permanent jewelry onto my body (the "Activity") performed TESORI COLLECTIVE, LLC, with offices located in Oswego, NY (the "Company"). In consideration of the fastening/securing of permanent jewelry onto my body and in recognition of the Company's reliance hereon, I agree, on behalf of myself, my heirs, and my personal representatives, to all the terms and conditions set forth in this instrument (this "Release").
I am aware that the process of applying/fastening/securing permanent jewelry involves the use of welding equipment and related welding tools. Potential risks of the Activity include, but are not limited to burns, eye injuries that could result in permanent vision or sight loss or impairment, and other bodily harm. I have been instructed by the Company and am aware that I cannot look at the arc weld or watch any portion of the Activity unless I wear properly rated welding safety glasses as my duty and sole responsibility to avoid eye injuries.
I confirm that I am in good health and proper physical condition and do not have any medical or other conditions that would impair my ability to participate in the Activity. I will also follow all instructions, recommendations, and cautions of the Company at all times during the Activity. I hereby certify that I have disclosed all conditions regarding my health history and past reactions to jewelry metal and components in connection with the Confidential Client Profile and Consultation Form.
I understand that if I have a pacemaker or any other medical condition that could be adversely affected by welding activities, I must disclose this to my Permanent Jewelry Artist before proceeding with the application of permanent jewelry. Failure to disclose such information may result in serious health risks, including potential interference with medical devices like pacemakers.
I AM AWARE AND UNDERSTAND THAT THE ACTIVITY IS A POTENTIALLY DANGEROUS ACTIVITY AND INVOLVES THE RISK OF SERIOUS INJURY, DISABILITY AND/OR PROPERTY DAMAGE. I ACKNOWLEDGE THAT ANY INJURIES THAT I SUSTAIN MAY RESULT FROM OR BE COMPOUNDED BY THE ACTIONS, OMISSIONS, OR NEGLIGENCE OF THE COMPANY, INCLUDING NEGLIGENT EMERGENCY RESPONSE OR RESCUE OPERATIONS OF THE COMPANY. NOTWITHSTANDING THE RISK, I ACKNOWLEDGE THAT I AM KNOWINGLY AND VOLUNTARILY PARTICIPATING IN THE ACTIVITY WITH AN EXPRESS UNDERSTANDING OF THE DANGER INVOLVED AND HEREBY AGREE TO ACCEPT AND ASSUME ANY AND ALL RISKS OF INJURY, DISABILITY OR PROPERTY DAMAGE ARISING FROM THE ACTIVITY, WHETHER CAUSED BY THE ORDINARY NEGLIGENCE OF THE COMPANY OR OTHERWISE.
I hereby expressly waive and release any and all claims which I may have, or which I may hereafter have, whether known or unknown, against the Company, and its officers, directors, manager[s], employees, agents, affiliates, members, successors, and assigns (collectively, "Releasees"), on account of injury, disability, death, or property damage arising out of or attributable to the Activity, whether arising out of the ordinary negligence of the Company or any Releasees or otherwise. I covenant not to make or bring any such claim against the Company or any other Releasee, and forever release and discharge the Company and all other Releasees from liability under such claims. This waiver and release does not extend to claims for gross negligence, intentional or reckless misconduct, or any other liabilities that New York law does not permit to be released by agreement.
I understand that by signing this release, I am waiving any and all claims, of any kind arising out of or attributable to my participation in the Activity, and the Activity itself, including those claims that may be unknown to me, or which I do not suspect to exist at this time. WITH THE INTENTION OF WAIVING ALL UNKNOWN AND UNSUSPECTED CLAIMS, I HEREBY EXPRESSLY WAIVE ALL RIGHTS, BENEFITS, AND PROTECTIONS I MAY HAVE UNDER NEW YORK LAW, INCLUDING ANY CLAIMS THAT MAY EXIST BUT ARE NOT PRESENTLY KNOWN OR ANTICIPATED.
I further acknowledge that I may hereafter discover claims or facts in addition to, or different from, those which I now know or believe to exist with respect to the subject matter of this release, and it is my intention to fully, finally, and forever settle and release all such matters, whether known or unknown, suspected or unsuspected, to the fullest extent permitted by New York law.
I shall defend, indemnify, and hold harmless the Company and all other Releasees against any and all losses, damages, liabilities, deficiencies, claims, actions, judgments, settlements, interest, awards, penalties, fines, costs, or expenses of whatever kind, including reasonable attorney fees, fees, the costs of enforcing any right to indemnification under this Release, and the cost of pursuing any insurance providers, incurred by the Company or any other Releasees, arising out of or resulting from any claim of a third party related to my participation in the Activity, and the Activity itself, including any claims arising out of my own negligence or the ordinary negligence of the Company.
I hereby consent to receive from any licensed hospital, physician, or medical personnel any medical treatment deemed necessary if I am injured or require medical attention during my participation in the Activity. I understand and agree that I am solely responsible for all costs related to such medical treatment and any related medical transportation and/or evacuation and I release all parties from any type of liability for anything that may happen during my treatment.
I hereby consent to use, re-use, publishing of any photographic pictures of me. I hereby relinquish any right that I may have to examine or approve the completed product or products advertising copy or printed matter that may be used in conjunction therewith or the use to which it may be applied.
This Release constitutes the sole and entire agreement of the Company and me with respect to the subject matter contained herein and supersedes all prior and contemporaneous understandings, agreements, representations, and warranties, both written and oral, with respect to such subject matter. If any term or provision of this Release is held invalid, illegal, or unenforceable in any jurisdiction, such invalidity, illegality, or unenforceability shall not affect any other term or provision of this Release or invalidate or render unenforceable such term or provision in any other jurisdiction. This Release is binding on and shall inure to the benefit of the Company and me and their respective heirs, successors, and assigns. All matters arising out of or relating to this Release shall be governed by and construed in accordance with the internal laws of the State of New York without giving effect to any choice or conflict of law provision or rule (whether of the State of New York or any other jurisdiction). Any claim or cause of action arising under this Release may be brought only in the federal and state courts located in OSWEGO, NEW YORK and I hereby consent to the exclusive jurisdiction of such courts.
By initialing (physically or electronically) in the spaces provided by each statement I specifically acknowledge that: