PIERCING MINOR WAIVER | Eterna Tattoo Studio

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Parent/Guardian
Piercing Consent Form

Please fill out form in its entirety.

First Name

Last Name

Phone

Email

Date of Birth

Parent/Guardian Name

Parent/Guardian Phone

Type of Piercing

Name of Piercing Artist

Piercee/Client Consent

Please read and check each box when you are certain you understand the implications of signing this document.

All questions about the body piercing procedure have been answered to my satisfaction, and I have been given aftercare instructions for the body piercing I am about to receive.

I have been informed about what I can expect following the body piercing listed on the piercing consent form, including medical complications that may occur following this body piercing.

I understand that body piercing can result in nerve damage, bone and tooth loss, and that if I choose to remove my jewelry, permanent holes or scars may be left.

I am the person on the legal ID presented as proof that I am at least 18 years of age, or the body piercing will be performed in the presence of my parent or legal guardian.

I am not under the influence of alcohol or drugs and I am voluntarily submitting to body piercing without duress or coercion.

I understand there is a possibility of an allergic reaction to the jewelry inserted into the fresh body piercing.

I understand there is a possibility of getting an infection, and I have been advised of the signs and symptoms of infection that indicate a need to seek medical attention.

I agree to follow all instructions concerning the care of my body piercing.

I understand there is a chance I might feel light-headed or dizzy during or after being pierced.

I agree to immediately notify the body piercer in the event I feel light-headed, dizzy, and/or faint before, during, or after the procedure.

I have been fully informed of the risks of body piercing, including but not limited to infection and other medical complications, allergic reactions to jewelry, nitrile gloves, and antibiotics (if required). Having been informed of the potential risks associated with receiving a body piercing, I wish to proceed with the procedure. I assume any and all risks that may arise from the body piercing.

Piercee/Client Signature

Today's Date

Parent/Guardian Consent

Please read and check each box when you are certain of the implications of signing this document.

I request the Piercer/Piercing Artist to pierce my son/daughter/legal dependent. 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 the piercing, or procedure/conduct used in his/her/their piercing.

By my signature below, I certify that I am the parent/legal guardian of stated piercee/piercing client who is submitting willingly to these procedures.

Parent/Guardian Signature

Today's Date

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