Permanent Jewelry Waiver

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Name* This field is required.
First Name
Last Name
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Email* This field is required.
example@example.com
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Phone Number* This field is required.
Please enter a valid phone number.
4
Appointment Date* This field is required.Please use the following to indicate when you are scheduled for your permanent jewelry. ***This is not for scheduling new appointments, if you’d like to schedule, please message the artist first***
Date
Month
Day
Year
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Hour
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Minutes
PM
AM
PM
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Acknowledgment of Age* This field is required.Are you at least 18 years old? If NO, at the end of this waiver, you will be prompted through a section for the consenting parent or guardian of the minor.
YESNO
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Acknowledgment of Service* This field is required.I understand that permanent jewelry involves custom fitting a chain and welding it closed using a small, localized spark. This process does not involve soldering directly on the skin but does involve heat in close proximity to the body.
Yes
7
Assumption of Risk* This field is required.I acknowledge that while the process is generally safe, there are inherent risks, including but not limited to minor burns, skin irritation, allergic reactions, or discomfort. I voluntarily accept all risks associated with this service.
Yes
8
Medical Conditions* This field is required.Please disclose any medical conditions, implanted devices (e.g., pacemakers, defibrillators, metal implants), or recent surgeries that may be affected by the welding process (if none, out NONE). This includes, but is not limited to: Pacemakers, defibrillators, or other electronic implants - Metal implants or hardware from surgeries - Recent surgical sites or stitches - Any condition that could be impacted by localized heat or sparks
Huge
Large
Normal
Small
Ok
Ok
9
Surgical/Scan Consideration* This field is required.I understand that permanent jewelry may interfere with medical scans (e.g., MRIs, X-rays) or surgical procedures. Jewelry may need to be removed or discussed with my healthcare provider prior to such procedures. It is my responsibility to consult with my doctor if I have any questions or concerns about safety.
Yes
10
Materials Acknowledgment & Care Considerations* This field is required.I understand that the jewelry used is stainless steel or 14k PVD gold-coated stainless steel, which is hypoallergenic and nickel-free for most individuals. These materials are designed to be durable, tarnish-resistant, and suitable for everyday wear.I acknowledge that the longevity and appearance of the jewelry can vary depending on individual care, skin chemistry, and exposure to chemicals, including but not limited to: Lotions, perfumes, or cosmetics applied directly on the jewelry - Chlorine, hot tubs, or swimming pools - Harsh cleaning agents or household chemicals - Physical impact or high-friction activitiesI understand that individual results may vary, and the artist/business cannot guarantee that the jewelry will remain perfect indefinitely.
Yes
11
Proper Fit & Final Sale* This field is required.I acknowledge that my jewelry is custom fit at the time of my appointment. I will have approved the fit prior to any welding. All sales are final, and no refunds or exchanges will be provided.
Yes
12
Breakage, Loss & Care* This field is required.I understand that permanent jewelry, while durable, is still delicate and may break with force, tension, or normal wear over time. I agree that the artist/business is not responsible for lost, stretched, or damaged jewelry after my appointment. If my jewelry breaks specifically at the original weld point within 14 days of my appointment, I may return for one complimentary re-weld. This does not apply to stretched, bent, or otherwise damaged chains. After this period, or for any additional repairs, fees may apply.
Yes
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Removal* This field is required.I understand that my jewelry can be removed at any time by cutting the jump ring and that I assume responsibility for removal outside of the business. The artist can remove the jewelry upon request.
Yes
14
Release of Liability* This field is required.To the fullest extent permitted by Colorado law, I release, waive, discharge, and hold harmless Santiana Martinez DBA Inked by Banti Tattoos LLC, Fallen Desires Tattoos & Oddities, and their employees, agents, and contractors from any and all liability, claims, demands, damages, or causes of action, whether known or unknown, arising out of or related to this service, including but not limited to personal injury, allergic reaction, burns, property loss, or other damages, except in cases of gross negligence or willful misconduct.
Yes
15
Photo/Video Consent* This field is required.I consent / do not consent to photos or videos being taken of my jewelry for marketing and social media purposes.
I Consent
I Do Not Consent
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Date of Consent* This field is required.
Date
Year
Month
Day
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Government Issued ID Upload* This field is required.To confirm your age and identity, please upload a clear photo or scan of a government-issued ID(driver’s license, passport, or state ID). Your information will only be used for verification purposes and will be kept confidential. If you are under 18, a parent or legal guardian must provide their ID along with consent (there will be an upload portion in the parental consent section)
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Parent/Guardian Name* This field is required.
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Date of Consent
Date
Year
Month
Day
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Government Issued ID Upload* This field is required.To confirm your age and identity, please upload a clear photo or scan of a government-issued ID(driver’s license, passport, or state ID). Your information will only be used for verification purposes and will be kept confidential. By uploading your ID, you are confirming you are the legal parent or guardian of the listed minor.
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