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Consultation Form

Permanent Jewelry is a process that involves the use of welding the jewelry together while on your body. The procedure is generally painless and is performed with your safety in mind. This consent form is intended to inform you of the risks of the procedure and to obtain your informed consent for the procedure.

Please review all of the below policies agreeing to each statement and initialing each section.

PLEASE INITIAL EACH STATEMENT:

I Agree
I understand that although rare, an allergic reaction to the jewelry can occur.

I Agree
I agree to follow the jewelry care instructions recommended by the technician.

I Agree
I understand that although this jewelry is intended to be permanent, durable and long-lasting, the length of wear can vary depending on my physical activity and other factors. I understand my jewelry is not indestructible.

I Agree
I understand that there may be some instances where I will be required to remove my jewelry, including but not limited to medical procedures like MRI and surgery. I understand that the jewelry can easily be removed with clippers and re-attached by the jeweler at a later date free of charge.

I Agree
I give the technician/jeweler permission to photograph my jewelry and procedure for their own marketing and promotional purposes.




PHOTO & VIDEO RELEASE

We would like to request your consent to use your name, image, and likeness in our promotional materials. This includes photographs, video recordings, and digital images, in any and all media formats.

By signing this form, you authorize The Babe Bodega to use your image or likeness in its promotional materials, which may be distributed to the general public or specific target audiences, including on our website, social media platforms, marketing materials, and other promotional materials.

You will not receive any compensation or royalty fees for the use of your likeness. Please note that you may withdraw your consent at any time by notifying The Babe Bodega in writing.

If you choose to do so, The Babe Bodega will make a good-faith effort to remove your likeness from any promotional materials that have not yet been distributed.

I, hereby give my consent to The Babe Bodega to use my name, image, and likeness for promotional purposes.

I Agree



Cancellation Policy

We understand that sometimes it is necessary to cancel or reschedule appointments. At The Babe Bodega, we have a cancellation policy in place to ensure that we can accommodate all of our clients in a fair and efficient manner.

OUR POLICY IS AS FOLLOWS:

  • If you need to cancel or reschedule your appointment, we require at least 24 hours notice. This allows us enough time to offer the appointment slot to another client.
  • If you cancel or reschedule your appointment with less than 24 hours notice, we will charge a cancellation fee of 50% of the total cost of the appointment.
  • If you do not show up for your appointment and do not give us any notice, we will charge a no-show fee of 100% of the total cost of the appointment.
  • We require a credit card on file to book an appointment, and we will charge the applicable fee to your card in the event of a late cancellation or no-show.
  • Exceptions to our cancellation policy may be made in cases of emergency or illness, at the discretion of The Babe Bodega.
  • By signing this form, you acknowledge that you have read and undersand our Cancellation Policy, and that you agree to abide by it.

I Agree


Permanent Jewelry Application and Care Waiver

1. Voluntary Participation:

I Agree
I voluntarily choose to have a permanent bracelet applied to me at The Babe Bodega.

2. Acknowledgment of Risks:

I Agree
I am aware that the application of a permanent bracelet may involve certain risks, including but not limited to skin irritation, allergic reactions, discomfort, and potential injury.

I Agree
I agree to follow all instructions provided to me regarding how to sit and conduct myself during this service, understanding that failure to do so may result in injury to myself or the technician.

3. Release of Liability:

I Agree
In consideration of the services provided by The Babe Bodega I, for myself, my heirs, executors, administrators, and assigns, hereby release, waive, discharge, and hold harmless The Babe Bodega its owners, employees, agents, and representatives from any and all claims, demands, actions, or causes of action arising out of or related to the application, use, or care of the permanent bracelet.

4. Medical Conditions:

I Agree
I have disclosed any known medical conditions or allergies that may affect the application or care of the permanent bracelet.

5. Photo/Video Release:

I Agree
I give The Babe Bodega and its team permission to take photos or videos of me and my permanent jewelry during and after application. I’m okay with The Babe Bodega using these photos, with or without my name, for any lawful purpose like promotions, advertising, or website content. I acknowledge that I will not receive any compensation for the use of these images or videos. I am aware that I can withdraw this consent at any time by notifying The Babe Bodega in writing.



Please review the waiver and ensure all information is correct before signing. If you have any questions or concerns, please address them with the store representative before proceeding.

ACKNOWLEDGEMENT

I completed the above form to the best of my knowledge. I have had the opportunity to ask any questions and have received satisfactory answers. I understand the risks and potential side effects associated with the permanent jewelry procedure. I understand that the results of the procedure are not guaranteed and may vary from person to person. I am over the age of 18 and consent to the procedure. If I am under the age of 18, a parent or guardian must sign. I will not hold the technician/jeweler, salon, or employees liable for any issues not disclosed at the time of my service or any adverse effects from the permanent jewelry procedure. This agreement remains in effect for this procedure and any follow-up appointments.

Electronic Signature Consent:

By indicating my acceptance to this waiver, I understand and agree that my electronic signature, whether digital or encrypted, is legally binding and equivalent to my manual signature. I consent to the use of electronic signatures in connection with the execution of this Permanent Jewelry Application and Care Waiver. I acknowledge that my electronic signature signifies my agreement to the terms and conditions of the waiver, just as if I had signed my name in ink.


Today's Date: May 27, 2025

First Client's Name
First Name*
Last Name*
First Client's Age Acknowledgment*
First Client's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Client's Signature*
Second Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Third Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Fourth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Fifth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Sixth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Seventh Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Eighth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Ninth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Tenth Client's Name
First Name*
Last Name*
Client'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 Age Acknowledgment*
Parent or Guardian's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
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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