←
Skye Body Piercing Adults
Let us do this part
Today's Date:
Fri May 9 2025 08:28
Practitioner:
*
-- Select --
Bree Soderquist
Body Piercing Location(s):
*
Special Circumstances, Considerations; previous scarring, medical procedures in or around the area, etc:
Body Piercing Release Form Adults
Please answer the following below for your service(s).
Please read and answer
Age
*
I am 18 years of age or older.
Duress
*
I affirm that I am not under the influence of alcohol or drugs, and I am voluntarily getting a piercing without duress.
Eaten
*
I have eaten sufficiently in the last 4 hours.
It is important to be nourished before putting the body through stress to prevent passing out and encourage an optimal healing response.
Risks
*
I agree that there is a risk involved with any and all piercings.
These can include but not limited to:
infection, scarring, keloids, migration of the piercing, and rejection of the piercing.
The piercer will be going over information with you before/during/after the piercing, depending on what the piercing is.
By checking this box, I am acknowledging that I will be going home with a written copy of care information, will have the opportunity to ask my piercer questions, and accept any risks associated with the piercing.
Questions
*
By checking this box, I agree to ask any questions that come up about my piercing/piercing experience, and I know that I have the option to reach out to the artist as well if any future questions come up
Aftercare
*
I acknowledge that I will be going over aftercare instructions with my piercer once the piercing is completed. I acknowledge that I will be going home with a written copy of care instruction for my reference at home in case I forget anything.
I agree to follow them to the best of my ability.
I acknowledge that it is possible that the piercing can become infected, particularly if I do not follow the instructions. I understand the Piercer's suggestions are not to be confused with medical advice.
Pregnancy
*
I confirm that I am not pregnant or nursing.
Getting a piercing/body modification during any stage of pregnancy puts your unborn child(ren) at risk, and your own healing process is substantially slowed, which can cause the body to reject piercings, unusual scarring, etc.
Permanent change
*
I acknowledge that the piercing will result in a permanent change to my appearance. My skin may not be restored to its pre-piercing condition even after its removal.
Jewelry and Procedure
*
I understand that the piercer or ISTARI LLC DBA SKYE TATTOO cannot be held responsible if my body reacts negatively to the metal of the jewelry.
We only pierce with Implant Certified Titanium (ASTM F-136) milled on CNC (Computer Numerical Control) machines out of solid implant-grade titanium (ASTM F136 6AI-4V ELI) that is sourced in the United States. There are options for 14k + 18k gold as well.
Only approximately 0.6% of the population is allergic to titanium. If you are or suspect you are, please advise your artist immediately and seek testing from you primary care provider.
I understand that sterilized jewelry and equipment and/or single use disposables will be used for my piercing.
Symptomatic Allergies/Signs of Sickness
*
Do you agree that symptoms of illness or severe allergies will require rescheduling of your appointment? Due to health concerns, concerns for our clients, the shop environment and artists, all allergy symptoms or symptoms of being sick ie: coughing, sneezing, runny nose, sore throat etc will require the appointment to be rescheduled or stopped. Even with just having allergy symptoms this still applies because coughing and sneezing can still transmit an asymptomatic Covid-19 infection. This applies for the artist as well and may require your artists to reschedule.
Jewelry Switch-outs
*
I understand that I may need longer or larger jewelry inserted initially to account for swelling. I may need a smaller size or a piece of jewelry with a shorter post inserted after my piercing has healed for a healthier and more comfortable fit. This piece of jewelry will still be charged for as well as an insertion fee.
Photography
*
I acknowledge that there is the chance of having a picture taken with my consent ONLY.
I release all rights for any photographs or videos taken of me and the piercing. I give consent in advance to their reproduction in print or electronic form. This does NOT mean that every encounter will be filmed or photographed, your artist will ask for verbal consent during the time of the appointment.
This Document
*
I acknowledge that I have been given adequate opportunity to read and understand this document, that it was not presented to me at the last minute, and I understand that I am signing a legal contract.
Y
N
Medical Conditions
*
I agree to let my artist know that if I have diabetes, epilepsy, hemophilia, heart condition, take blood thinning medications or have any ailments that could effect this procedure or healing.
I am not the recipient of an organ or bone marrow transplant or, if I am, I have taken the prescribed preventive regimen of antibiotics that is required by my doctor in advance of any invasive procedure such as piercing.
Details:
Y
N
Bloodbourne Pathogens
*
Do you have any blood borne pathogens, transmittable diseases or recent illnesses? This does not stop the service, it is just to inform your artist.
Details:
Y
N
Medication
*
Are you taking any medications that can thin the blood? If yes, it does not stop the piercing process. It just informs the piercer so they can set up to accommodate your needs as best as possible.
Y
N
Skin Conditions
*
I agree to let my artist know if I have any skin conditions, including but not limited to: psoriasis, eczema, rosacea, acne, or any other skin condition that could impact placement and healing of piercings.
Details:
Y
N
Recent Symptoms of Illness
*
Have you or any member of your household experienced symptoms of a viral infection? Any of the following: Fever, loss of taste or smell, dry cough, running nose, sore throat, or shortness of breath in the past 14 days?
Y
N
Recent Exposure of Covid-19
*
Have you or any family member of your household tested positive, or been exposed to someone who has tested positive, for a viral infection ie: Covid-19 in the last 14 days?
Release
*
TO WAIVE AND RELEASE to the fullest extent permitted by law each of the Piercer and ISTARI LLC DBA SKYE TATTOO from all liability whatsoever, for any and all claims or causes of action that I, my estate, heirs, executors or assigns may have for personal injury or otherwise, including any direct and/or consequential damages, which result or arise, whether caused by the negligence or fault of either the Piercer or ISTARI LLC DBA SKYE TATTOO, or otherwise.
Global Pandemic
*
I agree that there is a current Global Pandemic; Covid-19, AKA 2019 novel coronavirus, 2019-nCoV, SARS-CoV-2 declared by World Health Organization. Covid-19 is extremely contagious. The virus that causes COVID-19 is believed to spread via droplets via respiratory, Aerosolized transmission via living in the air up to 3 hours, Surface transmission via several days. Spread is more likely to occur during close contact with an infected person symptomatic or asymptomatic.
Attorney Fees
*
I agree to reimburse each of the Piercer and ISTARI LLC DBA SKYE TATTOO for any attorneys. fees and costs incurred in any legal action I bring against either the Artist or the Piercing Studio and in which either the Artist or the Piercing Studio is the prevailing party. I release Skye Tattoo and it’s agents from liability with regards to any circumstances beyond their control.
Full and Voluntary Assumption of Risk
*
ISTARI LLC DBA SKYE TATTOO has engaged and is enforcing preventive measures that follow the CDC and States guidelines to reduce the spread of Covid-19. These preventive measures however are not guaranteed as Covid-19 infection can happen to anyone anywhere. Being inside any business and partaking in services could increase your risk of infection.
I am voluntarily making assumption of risk and that I may be exposed to or infected by entering ISTARI LLC DBA SKYE TATTOO. That may result in personal injury, illness, permanent disability and death. I understand that the risk of becoming exposed to or infected by Covid-19 at ISTARI LLC DBA SKYE TATTOO may result from these actions, omissions, or negligence of myself and others including but not limited to ISTARI LLC DBA SKYE TATTOO's employees, contractors and / or representatives.
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.
Legal Name:
*
Pronoun:
-select-
He/Him
She/Her
They/Them
He/Them
She/Them
He/She
He/She/They
Chosen name:
Address:
*
Postcode:
Date of birth:
*
-Month-
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
-Day-
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
-Year-
1915
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
1916
You must be 18 or older
Phone #:
*
Email:
*
Signature:
*
Sign above or type signature:
Parent/Legal Guardian
I, as custodial parent or legal guardian of the above minor under -18 years of age, hereby consent to the terms and conditions set forth in this release form and I attest that all documentation I have provided is true and accurate.
For Parent or Legal Guardian of a Minor: If you are the parent or legal guardian providing consent for the piercing of anyone under the legal age of 18/ minor, please answer the following questions and acknowledgements below on their behalf as they pertain to that individual. All minors must have proper identification. Acceptable forms are as follows: State ID, birth certificate, copy of birth certificate, tribal ID, military ID. Physical copy ONLY *WE HAVE THE RIGHT TO REFUSE SERVICE TO ANYONE.
Guardian's Legal Name:
*
Signature:
*
Photo ID
*
Please take photo(s) of your government issued photo IDs and related paperwork.
Remove Photo