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PIERCING CONSENT WAIVER

Let us do this part
Today's Date:
Sat May 10 2025 12:02
PIERCING CONSENT, RELEASE, AND WAIVER
Please read and answer
PIERCING CONSENT WAIVER*
PLEASE READ CAREFULLY

By check marking this Waiver and Release, I acknowledge and agree to the following terms in consideration of receiving a piercing from Plug Tattoo and Piercings (including its owners, employees, apprentices, contractors, and agents, hereinafter referred to collectively as "the Tattoo Studio").

WAIVER OF LIABILITY AND RELEASE

I, hereby voluntarily waive, release, and discharge Plug Tattoo and Piercings and its piercers, employees, apprentices, and agents from all liability, claims, demands, or causes of action that I or my heirs, assigns, executors, or administrators may have for personal injury, infection, allergic reaction, scarring, disfigurement, or death arising out of or related to the piercing procedure, whether caused by negligence or otherwise.
This release applies to all claims resulting from services provided by the Tattoo Studio, including but not limited to:
* Infection or rejection of jewelry
* Migration or improper healing
* Unsatisfactory results from the piercing
* Any consequences from failure to adhere to aftercare instructions
I understand that body piercing is an invasive procedure and carries inherent risks, which I accept voluntarily.


CLIENT REPRESENTATIONS AND WARRANTIES

I hereby represent and warrant that:
* I am not under the influence of alcohol or drugs.
* I do not have any medical conditions that may impair healing, including but not limited to:
* Diabetes
* Epilepsy
* Hemophilia
* Heart conditions
* Nickel allergy or sensitivity
* Skin conditions or infections at the piercing site
* I am not currently pregnant or nursing.
* I do not take medications that may interfere with the healing process (e.g., blood thinners).
* I am not the recipient of an organ or bone marrow transplant, or if I am, I have consulted my physician and taken all necessary precautions.
I acknowledge that failure to disclose medical conditions may result in serious health risks, for which I release the Tattoo Studio from any liability.

JEWELRY AND MATERIALS

* I understand that only jewelry made from implant-grade stainless steel, titanium, niobium, gold (14k or higher), or platinum is recommended for initial piercings, as required by California law.
* I acknowledge that using jewelry made from alternative materials may increase the risk of infection or rejection.


ACKNOWLEDGMENT OF RISKS AND AFTERCARE

I acknowledge the following:
* I understand that improper aftercare may lead to infection, prolonged healing, or scarring.
* The Tattoo Studio will provid me with detailed aftercare instructions specific to my piercing. I agree to follow these instructions.
* Any touch-up work, jewelry changes, or follow-up procedures due to my negligence or failure to follow aftercare will be performed at my expense.

DESIGN AND PLACEMENT RESPONSIBILITY

* I accept full responsibility for the placement and selection of the piercing.
* I understand that once the piercing is performed, changing or removing the jewelry may cause the piercing to close or lead to complications.

JEWELRY RELEASE (IF APPLICABLE)

( I, brought my own jewelry for piercing.
) I acknowledge that I am voluntarily using personal jewelry not provided by the Tattoo Studio. I accept full responsibility for any issues or complications that may arise, including reactions, rejection, or damage. I release Plug Tattoo and Piercings from all liability related to the use of personal jewelry. Please let the Piercer know that you have the jewelry with you .

PHOTOGRAPHY AND PROMOTIONAL RELEASE

I consent to the Tattoo Studio taking photographs of my piercing for promotional or educational purposes.
* ( IF YOU DO NOT consent to photographs or the use of my images. Please verbally let us know.)
If I do not consent, I understand it is my responsibility to inform the Tattoo Studio prior to the procedure.

COVID-19 DISCLOSURE AND ASSUMPTION OF RISK

In light of the COVID-19 pandemic, I affirm the following:
* I have not had COVID-19 in the last 14 days.
* I have not been in contact with someone diagnosed with COVID-19 within the last 14 days.
* I do not currently exhibit symptoms of COVID-19 (e.g., fever, cough, shortness of breath, loss of taste/smell).
* I understand that by entering the Tattoo Studio, I assume the risk of exposure to COVID-19, and I waive any claims against Plug Tattoo and Piercings for potential exposure.
Y
N
Are you a Minor under 18 ? *
MINOR CONSENT AND RELEASE (FOR CLIENTS UNDER 18) California law requires parental or guardian consent for minors under 18.
 
(IF APPLICABLE) Please list any medical history that we need to know about .
 
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 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.
Name:*
Date of birth:*
If you are under 18 your parent/guardian will be required
Phone #:*
Email:*
Signature:*


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