Consent to application of PIERCING and release and waiver of all claims.
I acknowledge by signing this document that I have been given the full opportunity to ask any and all questions that I might have about obtaining a piercing from X-Treme Ink Tattoo. Also, I acknowledge that all of my questions were answered to my full and total satisfaction. I specifically acknowledge that I have been advised of the facts and matters set forth below and agree as follows.
Please INITIAL all that apply:
I am eighteen (18) years of age or older. Piercings are given to minors ONLY with parental consent and attendance during the procedure.
I am not pregnant. If you are, we cannot pierce you. PERIOD!
I am free from all communicable diseases (Hepatitis A, B, C, HIV, AIDS, etc.). If you are not, please inform your piercer.
I do not have an allergy to nickel. If you do, please inform the piercer.
Although X-Treme Ink uses all proper sanitation and sterilization processes (Hospital grade chemicals and autoclave), I understand that there is a risk of infection and compliance with our aftercare instructions is absolutely imperative to prevent this.
I understand that, although rare, there is a risk of allergic reaction from the processes used to obtain a piercing.
The obtaining of this piercing is by my choice alone and I consent to the application and to any actions or conduct the associates, agents, or representatives of X-Treme Ink Tattoo feel are necessary to perform the piercing.
I agree to release and forever discharge and hold harmless X-Treme Ink Tattoo and its associates, agents, representatives, and shareholders from any and all claims , damages, or legal actions arising from or connected in any way with my obtaining of the piercing or the procedures and consent used to apply my piercing.
Credit/Debit/Gift cards have a convenience charge of $2.
***Relax and sit still during the piercing. Moving can negatively affect the piercing process.***
***No phone calls, face time, or live videos while being pierced***
Today's Date: February 5, 2023