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Piercer Notes

Let us do this part
Today's Date:
Thu May 2 2024 05:48
Practitioner:*
Artist signature:*


Please read and answer
 
Date & Time of Piercing*
 
 
Piercing Location *
 
 
Jewelry *
 
 
Notes/Complications
 
If any provision, section, subsection, clause or phrase of this release is found to be unenforceable or invalid, that portion shall be severed from this contract. The remainder of this contract will then be construed as though the unenforceable portion had never been contained in this document.
Client Information
I hereby declare that I am of legal age (with valid proof of age) and am competent to sign this Agreement.
Name:*
Date of birth:*
Phone #:
Email:
Signature:*


Photo ID
Please take photo(s) of your government issued photo IDs and related paperwork.