Don't forget to bring government issued photo ID with you to your appointment, its required!
Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people
Lucky’s Tattoo and Piercing have put in place preventative measures to reduce the spread of COVID-19; however, Lucky’s Tattoo and Piercing cannot guarantee that you will not become infected with COVID-19. Further, getting a tattoo or piercing could increase your risk of contracting COVID-19.
By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by entering Lucky’s Tattoo and Piercing and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Lucky’s Tattoo and Piercing employees.
I voluntarily agree to assume all of the possible 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 my attendance at Lucky’s Tattoo and Piercing.
I hereby release, discharge, and hold harmless Lucky’s Tattoo and Piercing LLC, its employees, agents, 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 Lucky’s Tattoo and Piercing employees, agents, whether a COVID-19 infection occurs before, during, or after participation in any tattoo, piercing work, or any other services provided by Lucky’s Tattoo and Piercing LLC.
CLIENT HEALTH QUESTIONNAIRE
PRIOR TO THE START OF MY SERVICE, I CONFIRM THAT:
I have not been diagnosed with or cared for someone diagnosed with COVID-19 in the past two weeks.
I have not shown symptoms of COVID-19 or come in close contact with anyone exhibiting these symptoms in the past two weeks.
I have not traveled outside of my immediate daily routine for the past two weeks.
I do not have a cough, fever, chills, shortness of breath, or loss of taste or smell.
If I begin to show symptoms of COVID-19 within the next two weeks, I will contact Lucky's Tattoo and Piercing as soon as possible.
I will follow all posted studio rules to keep myself, studio staff, and those around me safe.
For Piercing Assessment, Stretching, Insertion, or Removal
By signing this form, I induce Lucky's Tattoo & Piercing to STRETCH or ASSESS my previous piercing, or to INSERT or REMOVE jewelry into/from my previous piercing, and in consideration of doing so, I hereby release Lucky's Tattoo and Piercing and its employees and agents, from all manner of liabilities, claims, actions and demands, in low or in equity, which I or my heirs have or might have now or hereafter by reason of complying with my request to have my piercing assessed, stretched, or to have my jewerly inserted/removed. Aftercare instructions available at http://www.luckystattoo.org/piercing-aftercare
By my signature below, I give permission for said insertion / removal / stretching / assessment and I further understand that if I give false information or produce false documents stating my name and age to be other than correct, then I am liable for presecution.
Today's Date: September 28, 2022