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Client Consent Form

Client's Consent

Final Sale Acknowledgement: I understand that every piece of jewelry is custom-fit and personalized. For this reason, all purchases are FINAL SALE. No refunds or replacements are offered under any circumstances

Welding Heat Risk: I understand that the welding process involves a small burst of heat and light near my skin, and that while rare, there is a slight risk of minor burns or discomfort if the jewelry shifts during welding. (A piece of leather protectant will be placed between the weld site and your skin)

Jewelry Removal Instructions: Permanent jewelry does not have a clasp and can only be removed by cutting it off. I understand that I am responsible for informing medical professionals and removing the jewelry when advised. If I need to remove my jewelry for any reason (MRI, surgery, style change, etc.), I can do so using nail clippers or household scissors at the weld site (jump ring).

Reweld Policy: Pretty Little Pirate Permanent Jewelry offers a complimentary reweld within 12 months of the original appointment, provided you bring back the same chain in good condition. Customer is responsible for traveling to next scheduled event for Pretty Little Pirate for reweld requests.

Durability & Customer Responsibility: I understand that although called “permanent” jewelry, no jewelry is indestructible. Our chains and jump rings are made to be durable, but not dangerous — meaning they may break under excessive force or pressure. It is my responsibility to care for my jewelry, and I accept full responsibility for any damage that may occur. 

Allergy Acknowledgment: I confirm that I do not have any known metal allergies or skin sensitivities that may be triggered by wearing this jewelry. If I do, I have informed the technician before the service.

Medical Disclosure:  I acknowledge that I have disclosed any relevant medical conditions or concerns to the technician and take full responsibility for proceeding with the service. 

Photo/Video Marketing Release: I agree that any photos or videos taken during my appointment may be used by Markham’s Permanent Jewelry on social media, marketing materials, the website, or for promotional purposes. 

Website: www.PrettyLittlePirate.com 

Agreement

I have completed this form to the best of my ability. I’ve had the opportunity to ask any questions and have received satisfactory answers. I understand the risks and possible side effects associated with permanent jewelry, and acknowledge that results may vary between individuals. If I am under 18, this form has been completed by my legal guardian. I will not hold the technician, Pretty Little Pirate Permanent Jewelry, or its representatives liable for any issues not disclosed during the service or for any adverse effects from the procedure. This agreement remains in effect for this and any future appointments. 

By signing below, I acknowledge that I have read, understood, and consent to the above checklist and the permanent jewelry procedure, as well as any signage or materials posted at Pretty Little Pirate Permanent Jewelry’s booth.

Date: September 18, 2025

First Participant's Name
First Name*
Last Name*
Phone*
First Participant's Date of Birth*
Date of Birth
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
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*
Last Name*
Phone*
Parent or Guardian's Date of Birth*
Date of Birth
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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