Piercing Contest

First Name: Last Name: Age:

Zip Code: Phone:

E-Mail:

Piercing I Desire

Terms and Conditions
In consideration of receiving a body piercing from contestant’sartist of choice at contestant’s
studio of choice (together with its employees, apprentices and agents, the ”Piercing Studio” ) I
agree to the following:

That I, Contestant, have been fully informed of the inherent risks, associated with getting a
piercing. I fully understand that these risks, known and unknown, can lead to injury,
including but not limited to infection, scarring and keloiding, allergic reactions to jewelry,
latex gloves, and/or soap. Having been informed of the potential risks associated with
getting a piercing, I still wish to proceed with the piercing and I freely accept and
expressly assume any and all risks that may arise from piercing.

TO WAIVE AND RELEASE to the fullest extent permitted by law Wicked Body Jewelz, the Artist
and the Piercing Studio from all liability whatsoever, for any and all claims or causes of action
that I, my estate, heirs, executors or assigns may have for personal injury or otherwise,
including any direct and/or consequential damages, which result or arise from the piercing,
whether caused by the negligence or fault of either the Artist or the Piercing Studio, or
otherwise.

I affirm that I am not under the influence of alcohol or drugs, and I am voluntarily entering a
contest that may lead to getting a piercing without duress.

I affirm that I do not have diabetes, epilepsy, hemophilia, nor do I have a heart condition or take
blood thinning medication. I do not have any other medical or skin condition that may interfere
with the procedure or healing of the piercing. I am not the recipient of an organ or bone marrow
transplant or, if I am, I have taken the prescribed preventive regimen of anti-biotic that is
required by my doctor in advance of any invasive procedure such as piercing. I am not pregnant or nursing.

I acknowledge that the piercing will result in a permanent change to my appearance and that
my skin may not be restored to its pre-piercing condition even after its removal.

I acknowledge that I have been given adequate opportunity to read and understand this
document, that it was not presented to me at the last minute, and I understand that I am
signing a legal contract waiving certain rights to recover against Wicked Body Jewelz,
Artist, or Piercing Studio.

I agree to reimburse each of Wicked Body Jewelz, the Artist and the Piercing Studio for any
attorneys fees and costs incurred in any legal action I bring against either Wciked Body Jewelz, the Artist or the Piercing Studio and in which either Wicked Body Jewelz, the Artist or the
Piercing Studio is the prevailing party. I agree that the courts of (Contestant’s State) in
(Contestant’s County of Contestant’s State Where Shop Located) 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.

I hereby declare that I am 18 or older.

I acknowledge Wicked Body Jewelz will take financial responsibility for ONE piercing to be
determined between myself Wicked Body Jewelz and Piercing Studio once Winner is picked.

I acknowledge Wicked Body Jewelz will NOT be responsible for any other financially burdens
the piercing may lead to such as, but not limited to, aftercare products, infections, rejections,
jewelry, etc.

I Certify I am 18 or older

Read Terms & Conditions