Let’s Lock in, together. Please ensure to book your appointment prior to completing this form. * First Name Last Name Phone * (###) ### #### Email * Date of Appointment * MM DD YYYY 1. Because all appointments are held in a home office, I agree to keep the location of "Locked In" private. * Yes 2. I acknowledge that “Locked In” is not responsible for any adverse reactions related to allergies (including metals or pets), skin conditions, or existing skin issues. * Yes 3. I understand that the jewelry I am receiving is permanently welded. This means that removal requires special tools and may not be easily removed without professional assistance. * Yes 4. I am aware that my jewelry is subject to tarnishing if repeatedly exposed to chemicals, lotions, perfumes, or other substances * Yes 5. I understand that the jewelry may come off if it becomes snagged or pulled. I will exercise caution to avoid situations where my jewelry could be caught. * Yes 6. If for any reason my jewelry comes off or requires a reweld, I understand that I must submit accurate contact information to receive the free rewelding service. * Yes 7. I understand that my permanent jewelry may retain heat in saunas, hot tubs, and other heated environments. I agree to take precautions and release Locked In from any liability for burns or discomfort. * Yes 8. I acknowledge that I am fully committed to the purchase and service, and no refunds will be issued for any reason after the jewelry has been welded. * Yes 9. By signing this form, I give my informed consent to participate in the "Locked In" permanent jewelry experience, acknowledging that I have read and understood the details provided above. * Yes SIGNATURE (Print name) * First Name Last Name Thank you!
