Piercing Liability Waiver

Disclosures, Agreements, Acknowledgments & Release

Health Risk Advisory. I understand that there are inherent health risks associated with ear piercing including, but not limited to, allergic reactions, skin infections, tissue damage, nerve damage, prolonged bleeding, swelling, hypertrophic scarring, a decreased ability of physicians to locate skin melanoma in regions concealed by body art, febrile illness, tetanus, systemic infection, keloid formation, pain and general discomfort. Such complications may occur at the location of the piercing or elsewhere on the body. There are increased risks for adolescents during certain stages of development. Additionally, existing medical conditions, or a history of certain medical conditions, such as allergies; heart disease; diabetes; hemophilia (bleeding); skin disorders; skin disease; skin lesions; skin sensitivities to soaps, disinfectants, etc.; skin cancer; allergies, anaphylactic reaction, or other adverse reaction to pigment, dyes, or other sensitivities; epilepsy, seizures, fainting, or narcolepsy; peripheral nerve disease; any deficiency of the immune or circulatory system; use of medications such as anticoagulants, which thin the blood or interfere with blood clotting; hepatitis; HIV; a history of infection; pregnancy; conditions that affect the immune system; or any other known or unknown medical condition may increase the risk of complications from ear piercing. I hereby represent that I have been advised to consult with a physician prior to the procedure if the Customer falls into any of the above heightened risk categories; and that I have consulted with a physician regarding any concerns I may have regarding the potential health risks that obtaining the above-described piercing may pose to the Customer. NOTWITHSTANDING THESE RISKS, I ACKNOWLEDGE THAT I AM VOLUNTARILY CHOOSING TO PROCEED WITH THE PIERCING PROCEDURE WITH KNOWLEDGE OF THE RISKS INVOLVED.

For Jewelry Change Appointments, PLU shall not be held liable for any damage that may occur to non-PLU jewelry. By signing this waiver, you acknowledge that PLU, along with its agents, will not be responsible for any such damage from all claims and losses arising from such incidents.

Notice Regarding Permanence of Body Piercing. Body piercing procedures are permanent in nature and may leave visible scarring.

Aftercare. I understand and acknowledge the importance of proper aftercare in reducing the risk of infection or other medical complications following any piercing procedure. I understand that, despite PLU's best efforts and the Customers proper after care, the potential for infection or other medical complications still exists. I also acknowledge that certain known or unknown medical conditions, medications, and medical treatments can impede the healing process, and therefore PLU cannot guarantee healing times. I have read, understand, and agree to follow each step of the instructions regarding Piercing Aftercare which has also been explained to me verbally. Further, I understand that since PLU will not have the opportunity to monitor my at home after care, it is solely my responsibility to follow the Piercing Aftercare instructions provided at the time of the ear piercing.

Photographic Release. I grant permission and consent to PLU for the use of a close up photograph of the piercing completed for presentation under any legal condition, including but not limited to: publicity, copyright purposes, illustration, advertising, marketing, and web content. I understand that there shall be no payment, royalties, or revocation for this release.

Release of Liability/Waiver of Claims. I hereby agree to accept and assume all risks of illness, personal injury, psychological injury, pain, suffering, disability, death, property damage, and/or financial loss arising from the above described piercing procedure. I hereby expressly waive and release any and all claims, now known or hereafter known, against PLU, its officers, managers, agents, employees, directors, representatives, independent contractors, retail partners, affiliates, successors, and assigns (collectively Releasees) on account of personal or psychological injury, illness, pain, suffering, disability, death, property damage, or financial loss arising out of or attributable to the ear piercing, whether arising out of the ordinary negligence of PLU or any Releasees, my failure to carefully adhere to all aftercare instructions, or otherwise. I covenant not to make or bring any such claim against PLU or any other Releasee, and forever release and discharge PLU and all other Releasees from liability under such claims. This waiver and release does not extend to claims for gross negligence, willful misconduct, or any other liabilities that state law does not permit to be released by agreement.

I, the undersigned, acknowledge and agree that I have read this Ear Piercing and Aftercare Waiver, Release and Consent Agreement in its entirety, fully understand and agree to its contents. I confirm that the information herein regarding health conditions which may increase any health risks associated with this piercing have been explained to me verbally; that the Customer does not have any health conditions that would prevent the Customer from receiving the piercing procedure described herein; and hereby grant PLU consent to perform the ear piercing described above on the Customer. I understand that PLU will not perform the requested piercing services unless this form is completed in its entirety and signed by me. I further represent and warrant that all information set forth above is true and correct, and that the Customer willingly submits to the piercing procedure described herein.

Piercing Consent

I acknowledge by signing this Release I have been given the full opportunity to ask any and all questions which I might have about obtaining a piercing from Carol Ladonna Bell (hereinafter known as the Piercer) and all my questions have been answered to my full and total satisfaction.

- I am not pregnant or nursing. If I have any condition that might affect the healing of this piercing, I will inform my Piercer.   

- I do not suffer from medical or skin conditions such as, but not limited to: keloid or hypertrophic scarring, psoriasis at the site of the piercing or any open wounds or lesions at the site of the piercing.   

- I have advised the Piercer of any allergies to metals, latex gloves, soaps and medications. I acknowledge it is not reasonably possible for the Piercer to determine whether I might have an allergic reaction to the piercing or processes involved in the piercing and further acknowledge that such a reaction is possible.   

- I have trustfully represented to the Piercer I am over the age of 18 years. I am not under the influence of drugs or alcohol. To my knowledge, I do not have any physical, mental or medical impairment or disability which might affect my well-being as a direct or indirect result of my decision to have a piercing done at this time.   

- I acknowledge that obtaining this piercing is my choice alone and will result in a permanent change to my appearance, and that no representation has been made to me as to the ability to later restore the skin involved in this piercing to its pre-piercing condition.   

- I acknowledge infection is always possible as a result of obtaining a piercing. I have received aftercare instructions and I agree to follow all of them while my piercing is healing.   

- I will not at any time, directly or indirectly, create, publish or communicate to any person or entity or in any public forum any defamatory or disparaging remarks, comments, reviews, or statements concerning PLU Piercing Artistry, Carol Ladonna Bell, or its affiliated businesses, or any of its employees, officers, shareholders, members or advisors, or any member of the company. This includes anything published on social media and search engine platforms and written word.

- I understand I will be pierced using appropriate instruments and sterilization.   

- I understand this type of piercing usually takes up to a month or longer to heal.

- I agree to release and forever discharge and hold harmless the Piercer and all employees from any and all claims, damages or legal actions arising from or connected in any way with my piercing, or the procedure and conduct used in my piercing. 

Having been informed of the potential risks associated with receiving a body piercing, I still wish to proceed with the procedure. I assume any and all risks that may arise from the body piercing.

Therefore, I request the Piercer to pierce: Ear and/or Nose.