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By checking the boxes below, answering the questions, and signing, you agree that: being of sound mind, of my own free will, and not under the influence of alcohol and/or drugs, do hereby release Barbella Studios, Deep Roots Tattoo & Body Piercing, High Priestess, HTC Studios, Ten Tigers, or any other DBA of Best Studio Ever, INC., their employees, agents, and/or representatives (hereby collectively referred to as Best Studio Ever) from all liabilities and responsibilities regarding the modifying of my piercing(s) by Best Studio Ever.  

I understand that I am responsible for taking proper care of my piercing(s) and that any infection or damage resulting from not following suggested aftercare procedures is my responsibility and not the responsibility of Best Studio Ever. I understand that by modifying my piercing the piercing may never go back to it’s former state. I have received and had full opportunity to review all written information and instructions regarding piercing risks and proper piercing aftercare procedures. I agree that I have been given full and fair opportunity to ask any and all questions that I might have about obtaining piercings from Best Studio Ever and that all of my questions have been answered to my full and total satisfaction. I further agree to call or otherwise personally contact Best Studio Ever with any questions and/or concerns I might have during the duration of the healing process or thereafter. Additionally, I understand that Best Studio Ever is not responsible for any possible effect my new piercing(s) may have on any other preexisting piercing(s).

I represent and warrant to Best Studio Ever, under penalty of perjury, that the information supplied on this form is true, complete, and correct to the best of my knowledge and that I understand the terms of this release.

I Agree


Please select who will be participating...
AdultMinor
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First Client's Name

First Name*

Middle Name

Last Name*

Phone*
First Client's Date of Birth*
First Client's Information

Preferred name (If different)

Pronoun (Optional)

What is your full address? *
First Client's Signature*
Parent or Guardian's Email Address

Email*

Confirm Email*
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What service will we be providing?
Please select your service*

For which piercing(s)?

Age of piercing(s)?

Time piercing has been out (if re-establishing)

List any problems you are having with this piercing (if any)
Did you bring your own, personal jewelry you’d like us to install which you bought previously from somewhere else? If yes, please understand that our piercer may not be willing to use the jewelry if it does not conform to our strict parameters for proper long-term wearing in a piercing. By indicating yes, I agree that any damage that may occur to my jewelry while being installed is my sole responsibility. I additionally understand and agree that BSE cannot and does assume responsibility for any such damage.*
No
Yes
Please attach a photo of your state or government issued photo ID. For minors, please provide the parent/guardian ID(Please note: You will also need to provide your ID in person when you arrive for your appointment)
  
Upload a photo of your ID *
Valid file types: JPG, GIF, PNG, and PDF
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Preferred name (If different)

Pronoun (Optional)

What is your full address? *
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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