BSAPPHIRE PERMANENT JEWELRY
Client Information
MINOR CLIENT CONSENT, RELEASE OF LIABILITY & ASSUMPTION OF RISK
Minor's Full Name:
*
Date of Birth:
*
Parent/Guardian Name:
*
Email:
*
example@example.com
Phone:
*
Format: (000) 000-0000.
Consent & Acknowledgement
I understand that all jewelry is final sale.
I understand that this jewelry can break and/or stretch if pulled or caught.
I understand that this jewelry can be safely removed at any time by cutting the jump ring with appropriate tools.
I understand not to look directly at the spark during the welding process. Doing so could severely affect eyesight.
I acknowledge that I have disclosed any known metal allergies or skin sensitivities prior to my appointment.
I acknowledge that the minor does not have a pacemaker, implanted medical device, known metal allergy, skin condition, or any other condition that may make this permanent jewelry experience unsafe.
I understand that the minor may be required to remove my jewelry for certain medical procedures (such as MRI scans or surgeries)
I understand that Bsapphire Permanent Jewelry is not responsible for lost jewelry or charms after my appointment.
Release of Liability
I HAVE CAREFULLY READ THIS "WAIVER AND RELEASE" AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. I EXPRESSLY AGREE TO RELEASE AND DISCHARGE BSAPPHIRE PERMANENT JEWELRY FROM ANY AND ALL CLAIMS OR CAUSES OF ACTION AND I AGREE TO VOLUNTARILY GIVE UP OR WAIVE ANY RIGHT THAT I OTHERWISE HAVE TO BRING A LEGAL ACTION AGAINST BSAPPHIRE PERMANENT JEWELRY FOR PERSONAL INJURY.
Photo Release (Optional)
I authorize photographs and videos of my jewelry to be used for marketing and social media purposes.
*
YES
NO
Parent/Guardian Certification
I certify that I am the parent or legal guardian of the minor listed above and have the authority to consent to this service on their behalf.
Parent/Guardian Signature:
*
Date:
*
-
Month
-
Day
Year
Date
Parent/Guardian must be present during the permanent jewelry service.
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