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To-Go Jewelry Purchase

Let us do this part
Today's Date:
Fri May 9 2025 04:26
I request BODY PIERCING BY BINK, LLC to assist me with my body piercing.
By completing and signing this form, I hereby release BODY PIERCING BY BINK, LLC, its employees, and agents from all manner of liabilities, claims, actions, or demands, in law or in equity, which I or my heirs might have now or hereafter, by complying with my request for said procedure.
Please read and answer
 
Which piercing(s) are we assisting with today?
 
Y
N
Would you like to be enrolled in our Loyalty Program? It's free and we won't spam you!
Choose "yes" if you would like to be enrolled, or if you believe you are already enrolled. You will receive a text when you enroll and when new rewards are available to you. Each dollar spent is a point earned; points are redeemable for a variety of rewards. Rewards may expire but points do not.
 
Understanding the Jewelry Return Policy. Please read and initial.*
All sales are final. We do not accept returns or exchanges on body jewelry for sanitary and safety reasons. If you are unsure of the jewelry sizing you need, we strongly suggest scheduling a jewelry change appointment.
 
 
Understanding the Jewelry Warranty. Please read and initial.*
Most of our manufacturers offer a lifetime guarantee against any manufacturer defects. This warranty pertains to issues such as stones coming loose from their settings or defective threads/threadless pins. This does not pertain to breakage caused by user error, mishandling of jewelry, normal wear and tear, or lost jewelry. This warranty is held between the manufacturer and the jewelry retailer (BODY PIERCING BY BINK, LLC.) When buying jewelry, you are not purchasing a warranty from BODY PIERCING BY BINK, LLC or any jewelry manufacturer; you are solely responsible for the care of any items purchased with us. If you have a defective piece that you believe may be covered under a manufacturer warranty, contact us to discuss any potential next steps.
 
I understand that I may have a copy of this statement if I request it. I certify under Penalty of Perjury that all included information is true and correct.
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:
Chosen name:
Address:*
Postcode:*
Date of birth:*
Phone #:*
Email:
Signature:*


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