Permanent Jewelry Service Waiver and Consent
Client Name: ______________________________________
Phone Number: ______________________________________
Email: ____________________________________________
Date of Service: ____________________________________
Thank you for choosing TPAIGE Jewelry as your permanent jewelry service provider. Permanent jewelry involves welding a piece of jewelry (such as a bracelet, anklet, or necklace) directly onto you, the client, without a clasp, creating a continuous piece. This waiver serves to inform you of the nature of the service and obtain your consent.
Please read the following statements carefully and sign below to indicate your understanding and agreement.
1. Consent for Service
I, the undersigned, am voluntarily undergoing the permanent jewelry service provided by TPAIGE Jewelry. I understand that this service involves the use of welding equipment to permanently secure a piece of jewelry on my body.
2. Understanding of the Welding Process
I acknowledge that the process involves minimal heat and that there may be minor risks associated with the welding process, including (but not limited to) brief discomfort, minor burns, skin irritation, or other unforeseen reactions.
3. Release of Liability
I understand and agree that TPAIGE Jewelry and its employees, agents, and representatives are not responsible for any injury, harm, or allergic reactions that may occur as a result of this procedure or the materials used. I agree to release and hold harmless TPAIGE Jewelry from any claims or liabilities related to this service.
4. Material Information
The materials used in permanent jewelry are solid gold, gold-filled and its base metals, 925 sterling silver. I have been informed of the metals used and understand that it is my responsibility to inform the provider of any known allergies or sensitivities.
5. Aftercare and Removal
I understand that permanent jewelry is intended to be long-lasting and that if I wish to remove it in the future, it may require cutting the jewelry. TPAIGE Jewelry is not responsible for the removal or any associated costs, including potential damage to the jewelry if removal is necessary.
6. Risks and Responsibilities
I understand that it is my responsibility to properly care for the jewelry and to be cautious during activities that could potentially harm the jewelry (e.g., sports, heavy lifting, or exposure to harsh chemicals).
7. Cancellation and Refund Policy
I acknowledge that once the service is completed, there are no refunds or exchanges. If I need to reschedule or cancel, I agree to abide by the cancellation policy set by TPAIGE Jewelry.
8. Medical Conditions
I confirm that I do not have any medical conditions (such as metal allergies, skin conditions, etc.) that would be negatively impacted by wearing permanent jewelry. I will inform TPAIGE Jewelry of any concerns before the service begins.
9. Waiver for Minors (Clients Under 18)
For clients under the age of 18, a parent or legal guardian must be present and give consent for the permanent jewelry service.
I, the parent or legal guardian of the minor named below, give my full consent for the minor to receive permanent jewelry from TPAIGE Jewelry. I understand and agree to all terms outlined in this waiver, including the potential risks and responsibilities involved with permanent jewelry.
I also confirm that the minor does not have any medical conditions that would be negatively impacted by wearing permanent jewelry and that I am responsible for overseeing the minor’s aftercare.
Minor’s Name: ____________________________________________
Minor’s Age: _____________________________________________
Parent/Guardian Name: ____________________________________
Parent/Guardian Signature: _________________________________
Date: _______________________________________________
10. Photography Release (Optional)
I give TPAIGE Jewelry permission to take photographs of my jewelry and consent to the use of these photos for marketing purposes, including social media, websites, and promotional materials.
[ ] Yes
[ ] No
Acknowledgment and Signature
By signing this waiver, I confirm that I have read, understood, and agree to the terms outlined above. I voluntarily consent to receive permanent jewelry from TPAIGE Jewelry and assume all risks involved.
Client Signature: _____________________________________
Date: _______________________________________________
Service Provider Signature: _____________________________
Date: _______________________________________________