←
Jewelry Hold
Let us do this part
Today's Date:
Mon Nov 18 2024 12:11
Practitioner:
*
-- Select --
Kelly Carvara
Rhett Mercury
Corky Pagleno-Brewer
Other
Item name/Description:
*
Quantity:
*
If you have any questions, comments, or concerns, please feel free to reach out at any time.
For information about our general studio policies, please see https://monarchpiercing.com/terms
(Should your pronouns not be adequately represented in the drop-down listed, please feel free to write them in the preferred name area, as we sadly do not have control over the options there. Thank you!)
Please read and answer
Y
N
Shipping
*
Do you wish to have your jewelry mailed to you if you do not pick it up at the end of the 60 days?
By selecting YES, I understand there will be a shipping fee and accept the additional $8 charge.
If selecting YES, please ensure that your ENTIRE mailing address is included in your personal information at the bottom of this document.
Contact Consent
*
I give my explicit consent granting Monarch Fine Jewelry + Professional Piercing, the Piercer, the Piercing Studio, and its employees to contact me through email and phone, including text regarding services, appointments, jewelry, and other aspects pertaining to the business.
I understand that I am responsible for informing Monarch Fine Jewelry + Professional Piercing if my contact information changes.
I understand the Piercing Studio does not have control over Square, Squarespace, or other companies/tools used by the Piercing Studio and the way in which they use data provided. If I wish to revoke the ability to be contacted, I must let the Piercing Studio know in writing, and this will not inherently remove what contact is done through the services of Square, Squarespace, or other companies/tools the Piercing Studio uses.
60-Day Hold/
*
For the health and safety of all those in the studio, the Piercing Studio cannot hold worn/used items for an extended period. I understand that, should I fail to pick up the jewelry within sixty (60) days of drop-off, I risk forfeiture of my jewelry to the Piercing Studio.
I understand that, if the Piercing Studio is unable to contact me by the end of thirty (30) days following the initial 60-day period, I forfeit my jewelry and items. If I have not made arrangements to pick up my items within the thirty (30) days following the initial 60-day period, I forfeit my jewelry and items.
Release
*
I, the individual whose jewelry has been left, and anyone claiming on my and/or the individual receiving the service(s)'s, behalf release, waive, and forever discharge to the fullest extent permitted by law each Piercer, the Piercing Studio, its affiliates, successors and assigns, employees, representatives, partners, and anyone claiming through them from all liability whatsoever in their individual and/or corporate capacities, for any and all claims or causes of action that I, my estate, heirs, executors, or assigns may have, for personal injury, damage, loss, or otherwise, including any direct and/or consequential damages which result, arise, or relate, whether caused by the negligence or fault of the Piercer, the Piercing Studio, its affiliates, successors and assigns, employees, representatives, partners, and anyone claiming through them, or otherwise.
Additionally, I agree to reimburse each of the Piercer(s), the Piercing Studio, and the Studio employees for any attorney's fees and costs incurred in any legal action I and/or the person receiving services bring against the Piercer, the Piercing Studio, its affiliates, successors, employees, representatives, and anyone claiming through them in which the Piercer, the Piercing Studio, its affiliates, successors, employees, representatives, and anyone claiming through them is the prevailing party. I agree that the court(s) shall have personal jurisdiction and venue over me and shall have exclusive jurisdiction for the purpose of litigating any dispute arising out of or related to this agreement.
Legal Document
*
I acknowledge that I have been given adequate opportunity to read and understand this document.
I understand that I am signing a legal contract.
If any provision, section, subsection, clause or phrase of this release is found to be unenforceable or invalid, that portion shall be severed from this contract. The remainder of this contract will then be construed as though the unenforceable portion had never been contained in this document.
Client Information
I hereby declare that I am of legal age (with valid proof of age) and am competent to sign this Agreement or, if not, that my parent or legal guardian shall sign on my behalf, and that my parent or legal guardian is in complete understanding and concurrence with this agreement.
Legal Name:
*
Pronoun:
-select-
He/Him
She/Her
They/Them
He/Them
She/Them
He/She
He/She/They
Chosen name:
Address:
*
Postcode:
*
Date of birth:
*
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If you are under
18
your parent/guardian will be required
Phone #:
*
Email:
*
Social Handle:
If you don't mind us tagging you in photos online
Signature:
*
Sign above or type signature:
Parent/Legal Guardian
I, as custodial parent or legal guardian of the above minor under 18 years of age, hereby consent to the terms and conditions set forth in this release form and I attest that all documentation I have provided is true and accurate.
If signing on behalf of a minor, you MUST be the parent, legal guardian, or legal custodian of the individual being pierced. To falsify legal standing as to parentage or being the legal guardian or legal custodian is a Class C misdemeanor in the state of Tennessee.
Guardian's Legal Name:
*
Signature:
*