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Liability Waiver

Please fill out the following form.

Date of birth
Month
Day
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I understand that permanent jewelry is not intended to be easily removed and that removal may require cutting the jewelry, potentially resulting in damage to the piece. I consent to the application of permanent jewelry and accept any associated risks.


I understand that although the process is typically quick and minimally invasive, some discomfort may occur during the welding process.


I agree to follow the aftercare instructions provided by the Tech.


I have disclosed any relevant medical history, allergies, or sensitivities prior.


I release the technician any liability for any injuries or adverse reactions that may occur as a result of the application. I agree to release and indemnify my technician from all claims, damages, and legal actions arising from my permanent jewelry service procedure.


I have been advised of the potential risks and benefits associated with the requested service, and I agree to proceed with the service at my own risk.


By signing this consent, I confirm that I am at least 18 years of age. I confirm that I have read and fully understand and accept the provisions of this document, and I consent to receive the permanent jewelry procedure.

Date
Month
Day
Year

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Phone

205-222-8070

Address

2367 Green Acres Rd Ste. 2

Fayetteville, AR 72703

Email

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