Let us do this part
Today's Date:
Mon Oct 2 2023 06:07
Please read and answer
What piercing did you come in for today?*

Check after reading all conditions*
I am not sick. If I have any conditions that might affect the healing of this piercing or my health, I will inform my piercer.

I have advised the piercer of any allergies to metals, latex gloves, soaps and medications. I acknowledge it is not reasonably possible for the piercer to determine whether I might have an allergic reaction to the piercing or processes involved in the piercing and further acknowledge that such a reaction is possible.

I have trustfully represented to the piercer and staff that I am over the age of 18 years. I am not under the influence of drugs or alcohol. To my knowledge, I do not have any physical, mental or medical impairment or disability which might affect my well-being as a direct or indirect result of my decision to have a piercing done at this time.

I acknowledge that obtaining this piercing is my choice alone and will result in a permanent change to my appearance, and that non representation has been made to me as to the ability to later restore the skin involved in this piercing to it's pre-pierced condition.

I acknowledge infection is always possible as a result of obtaining a piercing. I have received aftercare instructions and I agree to follow all of them while my piercing is healing. I understand I will be pierced using appropriately sterilized jewelry and instruments.
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.
Personal Info
I hereby declare that I am of legal age (with valid proof of age) and am competent to sign this Agreement or, if not, that my parent or legal guardian shall sign on my behalf, and that my parent or legal guardian is in complete understanding and concurrence with this agreement.
Date of birth:*
If you are under 18 your parent/guardian will be required
Phone #:*
Sign up for our newsletter

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