Rowan Ear Piercing and Aftercare Release and Consent Form

Rowan, Inc.
54 W 40th Street, New York, NY 10018
Phone: (646) 565-0563
www.heyrowan.com

 

EAR PIERCING AND AFTERCARE RELEASE AND CONSENT FORM

I, the undersigned, hereby grant Rowan, Inc. (“Rowan”) my consent to perform the earlobe piercing described above on the Customer.

I hereby represent and agree that the Customer is not suffering (and has not in the past suffered) from diabetes, allergies, or discoloration, swelling, lumps, or signs of irritation of the ear lobes or cartilage. I understand that the earrings purchased from Rowan are not designed for nose piercing or other piercings on the Customer’s body.

I realize the importance of proper care in permitting the ears to heal without infection. I have read, understand, and promise to follow each step of the instructions on the PIERCING AFTERCARE sheet that has been provided to me. I acknowledge the importance of these instructions in maintaining healthy ears. Further, I understand that since Rowan will not have the opportunity to monitor me at home after care, it is solely my responsibility to follow the PIERCING AFTERCARE instructions provided at the time of the ear piercing.

I hereby agree to release and forever discharge and hold harmless the Piercer and Rowan and all its employees, directors and representatives from any and all claims, damages or legal actions arising from or connected in any way with the earlobe piercing, or the procedure and conduct use in the piercing. I certify that the Customer willingly submits to the earlobe piercing described above.

I understand that I must carefully follow all instructions on the PIERCING AFTERCARE sheet provided to me. I agree to do so, and hereby release and forever discharge and hold harmless the Piercer, Rowan, and all its employees, directors and representatives from any and all claims, damages or legal actions arising from or connected in any way with my failure to carefully follow all aftercare instructions.

You must be 18 years or older to have your ears pierced without your parent’s consent. Your signature at the bottom indicates that you are over 18, or that you are the parent/legal guardian giving consent.

Who will be participating?

Adult  Adult and Children  Children

Signee Information

Helix or Lobe

Sign Here

By clicking 'I Agree' below, you agree that you have read and agree with the terms of the waiver and that the information you provided is accurate. You furthermore agree that your submission of this form, via the 'I Agree' button, shall constitute the execution of this document in exactly the same manner as if you had signed, by hand, a paper version of this agreement.