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*** Important information***

To ensure a safe and hygienic ear-procedure, SilverWorks will strictly adhere to the safety protocols set
by SilverWorks management, Mall management and the Government’s regulations.


GUIDELINES:
1. ONLY earlobe piercing will be allowed at this time until further notice.
2. ONLY adults of the age and between the ages 21 to 59 are allowed to have their ear pierced. A
Government issued I.D. will be checked for verification.
3. We will only allow the customer to be inside the SilverWorks store during the procedure.
4. We will check the customer’s temperature and an alcohol will be provided for sanitation prior
entering the store.
5. A health declaration and ear piercing waiver will be asked to sign before the procedure.
6. The customer is required to wear a face mask and face shield all the time during the procedure.
7. We will prioritize customers who have scheduled their earlobe piercing procedure through our
website (www.silverworks.com).
8. Make sure to arrive 10 minutes within your scheduled appointment.


Day of the scheduled appointment

a. SilverWorks employee should be in a proper protective piercing ensemble. Complete with SilverWorks apron,
gloves, face mask, and face shield.
b. Before the customer enters the store, their temperature will be checked and if it is within the safe
temperature, they will be allowed to sign the contact tracing form and waiver form.
c. Once signed, they will be sanitized with a sufficient amount of alcohol or sanitizer.

Sanitation after every piercing schedule

a. SilverWorks employee has the responsibility to sanitize and clean the area/ seat occupied by the customer. Including the materials/ equipment used, before performing another piercing service to the next scheduled customer.

Name *
Surname, Given Names, Middle Intial
Contact Number *
Ear Piercing Service *
SilverWorks Branch *
Note: Only selected SilverWorks branch offers piercing services
When? *
Monday to Sunday with an interval of 30 minutes from 10am to 8pm
MM
/
DD
/
YYYY
Time *
Choose a 30-minute time between 11:00AM to 7:00PM
Time
:
Do you agree with the Terms of Agreement?
AGREEMENTS & RELEASE OF LIABILITY /WAIVER OF CLAIMS SILVERWORKS uses a safe and hygienic ear piercing procedure. However, improper care of newly pierced ears on my part, or other causes, can lead to problems over which.SILVERWORKS has no control. I, the undersigned, acknowledge that i am aware that ear piercing carries some risks. These risks include, but are not limited to, infection, metal sensitivity, allergic reactions, inflammation, embeddings, scarring, fainting and other complicationsI understand that any employee of SILVERWORKS, when performing an ear piercing, does not act in the capacity of a medical professional. The recommendations made by any employee of SILVERWORKS are just recommendations. They are not to be constructed as or taken in lieu of advice from a medical professional. I voluntarily agree to thus ear piercing procedure for myself, or my minor child, fully aware of the potential risks and complications. In addition, I hereby assume all risks of loss or injury of any kind whatsoever that may be associated with ear piercing.In signing this RELEASE OF LIABILITY/WAIVER OF CLAIMS, I hereby acknowledge and represent that: IHAVE READ THIS RELEASE OF LIABILITY/WAIVER OF CLAIMS, UNDERSTAND IT, AND SIGN IT VOLUNTARILY I am or over 21 years of age, and I hold only myself liable and hereby release and waive any and all claims that I may have against SILVERWORKS, its agents and its employees with respect to this ear piercing. OR I further agree that should I or anyone else make a claim against SILVERWORKS for compensation for damages or harm allegedly incurred because of negligence of SILVERWORKS, its agents, or its employees, I shall indemnify and hold SILVERWORKS harmless against all such claims and associated costs, including any attorney fees SILVERWORKS incurs in defendingagainst such claims. For purposes of signing this RELEASE OF LIABILITY/WAIVER OF CLAIMS, Iunderstand that a fraudulent act is committedif either (i) a minor represents that he or she is an adult, or (ii) I falsely represent that I am theparent or legal guardian of a minor under 18 years of age.AFTER CARE AGREEMENTI understand that I must carefully follow all AFTER CARE PROCEDURES, agreeto do so, and hereby release SILVERWORKS from any and all claims that I may have as a result of myfailure to carefully follow all PROCEDURES.PROCEDURE ACKNOWLEDGEMENTI hereby acknowledge and represent that:1. I have observed thatthe associate wore new, disposable ear piercing gloves for my ear piercing.2. I have observed that theassociate cleaned the ear piercing instrument and each of my ears with a separate, single-usedisinfectant/antiseptic wipe before the piercing.
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