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Piercing Deposit Consent Form
Let us do this part
Today's Date:
Tue Jun 9 2026 02:52
Practitioner:*
Date and time:*
Deposit Amount:*
Please read and answer
I have confirmed a date and time with my piercer for my appointment.
I understand that my deposit is non-refundable and will be forfeit if:

You are late to your appointment.

You no show your appointment.

You cancel your appointment.

You reschedule on the day of your appointment.

You appear to be under the influence of drugs or alcohol .

You do not have state or government issued ID (required by the state health regulations).

FOR MINORS ONLY

You do not have the notarized consent form.

You do not have proper ID for the minor (ID card, birth certificate, passport).
If you are uncertain about the details of your appointment please contact the studio directly for clarification.

You can Call or Email the studio directly. Please allow 1 business day for a response to your inquiry. We are a high volume studio and stay quite busy.

859-254-2174
tattoocharlieslex@gmail.com
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:*
Address:
Postcode:
Date of birth:*
 
Age: 
Phone #:*
Email:*
Signature:*