Piercing Release Form

I hereby induce the staff of Mint Piercing to perform a piercing; and in consideration of doing so, I hereby release the piercer, Mint Piercing, and Rancho Relaxo inc from all manner of liabilities, claims, actions and demands in law, or in equity, which I or my heirs might now or hereafter by reason of complying with my request to be pierced. I fully understand that the body piercer, in performing a piercing, does not act in the capacity of a medical professional. The suggestions made by the piercer are just suggestions. They are not to be construed as, or substituted for, advice from a medical professional. I understand that I will be pierced using appropriate aseptic technique, sterilized equipment and jewelry. I also understand that infections/irritations can occur due to sleeping on the piercing, lack of proper care and/or metal sensitivities. I understand that this piercing may leave noticeable, permanent scarring. To ensure proper healing of my piercing, I agree to follow the aftercare procedures suggested in the verbal/written aftercare sheet provided.

I will inform the piercer if I have any of the following: diabetes, hemophilia, high blood pressure, epilepsy, seizures, or narcolepsy.

I am not pregnant or nursing.

I am not currently taking Isotretinoin (Accutane, Zenatane, etc.) or medications to thin blood or stop clotting.

I am not currently under the influence of alcohol or drugs.

I do not have any skin or immune health conditions which might affect the execution or healing of this piercing.

I consider myself healthy enough to heal this piercing.

I will be able to keep the initial piercing jewelry in at all times during the healing period (3 months minimum). This includes even short periods of time for sports or medical procedures. 

I agree to allow any photos taken of me at Mint Piercing Studio to be used for promotional and instructional purposes. Mint staff will not take any photos without your verbal consent as well.

I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with being in the Facility and/or receiving services (“Claims”). On my behalf, I hereby release, covenant not to sue, discharge, and hold harmless the Facility, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the Facility, its employees, agents, and representatives, whether a problem occurs before, during, or after receiving services within the facility.