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Home / Tooth Gems / test-booking

test-booking

$20.00

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TOOTH GEM CONSENT, RELEASE OF LIABILITY, AND WAIVER OF ALL CLAIMS

Please read the following and initial each provision on the line provided to show that you understand and agree to the provision. In consideration of both (a)receiving a tooth gem, gold charm, or similar tooth gem product from the Tooth Gem Technician and (b) the use of facilities provided by Wicked Tooth Gems and its employees, you agree to the following:

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I certify that this Informed consent, and waiver form was completed by me and that I understand all the questions, terms and conditions, and all entries in it and information are true and complete to the best of my knowledge. I agree to observe and obey all posted, written and oral rules and warnings, including on those materials provided by the studio.*

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I agree to waive and release to the fullest extent permitted by applicable state law each of the Tooth Gem Technician, all employees, contractors, and the management of the 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 or consequential damages, which result or arise from the application of, or my accidental swallowing of tooth gems, weather caused by the negligence or fault of the Tooth Gem Technician.*

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I am 16 years old or over.*

Although there is no age limit for tooth gems, if under 16 years of age, I verify that my parent or guardian approves me getting this service

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I understand that the application of tooth gems and products does not include any drilling into the tooth or breaking skin and may cause marks or discoloration of my teeth.*

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I understand that the application process of tooth gems may affect my tooth enamel, and I have been given the opportunity to talk about the risks associated with my tooth gem products with my Tooth Gem Technician and dentist.*

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I understand that the bonding agent used to apply my tooth gem may affect my teeth, and that I have been given the opportunity to talk about the risks associated with the bonding agent with my Tooth Gem Technician and dentist.*

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I understand and agree that the tooth gem application procedure is semi-permanent and there is no guaranteed amount of time the products will remain on my teeth.*

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I understand that certain tooth gems may fall off for any or no reason after applying the gems to my teeth. I understand and agree that Wicked Tooth Gems & Action Tattoo is not responsible for replacing or substituting any products, including any gems, diamonds or gold charms, if my tooth gem falls off.*

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I understand that I should continue to see a dentist regularly to maintain proper oral health and hygiene for my teeth.*

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I have been advised that I should contact a dentist to remove all residue from the bonding agent from my tooth if my tooth gem falls off or if I wish to remove it.*

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I understand and will follow the aftercare instructions given to me by the Tooth Gem Technician to ensure the longevity of my tooth gem.*

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I have been advised to not bleach or perform blue light whitening procedures on my teeth because such procedures may affect the bonding agent used to apply my tooth gem and the tooth gem itself.*

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I agree to indemnify and defend the studio and Wicked Tooth Gems owner, representatives, employees, contractors, and agents, against all claims, causes of action, damages, judgements, costs or expenses, including attorney fees and other litigation costs, which may in any way arise from my use of, or presence upon the facilities of the studio.*

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I hereby authorize my Tooth Gem Technician and the studio permission to take photographs and use my likeness in a photograph or video for its promotional materials and publications, print and digital. I understand and agree that all rights to any photograph of me belong to Wicked Tooth Gems. If you do not authorize permission to take and use your photos, you must not initial here.*

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The invalidity or unenforceability of any provision of this Release of Liability shall not have any effect on any other provision of this Release of Liability or of any other applications of such provision, and such unenforceable provision shall be deemed not to be a part of this Release of Liability.*

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The parties will attempt to resolve any dispute arising out of or relating to this Release of Liability through friendly negotiations. If the matter is not resolved, the parties agree to using mediation.*

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I HAVE READ THIS DOCUMENT AND UNDERSTAND ITS CONTENTS. I FURTHER UNDERSTAND THAT BY SIGNING THIS RELEASE OF LIABILITY, I VOLUNTARILY SURRENDER CERTAIN RIGHTS. WICKED TOOTH GEMS IS NOT RESPONSIBLE FOR ANY DAMAGE CAUSED BY THE TOOTH GEM APPLICATION.*

I understand that my deposit is non-refundable and reschedules must be made before 24 hours of my scheduled appointment or my deposit will be forfeitted. I understand that if I no-call, no-show to my scheduled appointment, I will be charged a $50 fee. I understand that the balance due must be in cash at my appointment or there will be a service charge for credit cards.*

I have read & agree to all terms & conditions*

I understand that my deposit is non-refundable and reschedules must be made before 24 hours of my scheduled appointment or my deposit will be forfeitted.

I understand that if I no-call, no-show to my scheduled appointment, I will be charged a $50 fee.

I understand that the balance due must be in cash at my appointment or there will be a service charge for credit cards.

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Pay a deposit of $20.00 per item

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Categories: Gold & Diamond Charms, Temecula, Tooth Gems

A woman with white teeth and black lettering on her smile.

A woman with purple lips and white teeth.

A woman with white teeth and black lettering on her smile.

A man with purple lips and white teeth.

A woman with purple lips and teeth smiling.

A picture of the face and words wicked tooth care

A clock with the time of 1 2 : 3 0 pm.

A collage of different types of letters and numbers.

A woman 's mouth with a tooth mark on it.

A woman with teeth that are missing and one tooth has been replaced.

A man with a piercing on his upper lip.

Description

Description

One of the largest selection of tooth gems available! Hundreds of tooth gems to choose from including 18k Gold, Real Diamonds & Authentic Swarovski Crystals!

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Contact Information:

Private Studio in Wildomar, CA

By Appointment Only

(714) 469-9332 Text Us

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