RELEASE OF LIABILITY

Tooth Gem. GRILLZ and Teeth Whitening, Release of Liability, and Waiver of Claims

**Section 1: Tooth Gems Release of Liability**

I certify that I have completed this informed consent and waiver form knowingly and voluntarily,

and that I understand all questions, terms, and conditions contained within. All information

provided is accurate and complete to the best of my knowledge. I agree to comply with all

posted, written, and verbal rules and warnings, including those provided by the studio.

I agree to waive and release, to the fullest extent permitted by applicable law, all of the tooth

gem technicians, jewelers, employees, contractors, and management of the studio from any

liability. This includes any claims or causes of action arising from personal injury or other

damages, whether direct or consequential, related to the application or accidental ingestion of

the tooth gems or products regardless of negligence or fault.

I confirm that I am 16 years of age or older.

I understand that the application of tooth gems and related products does not involve any

drilling into the tooth or breaking of the skin, but may result in temporary marks or discoloration

of my teeth.

I acknowledge that the application procedure is semi-permanent and that there is no guarantee

regarding the duration the tooth gems will remain affixed.

I understand that tooth gems may fall off for any reason after application. I agree that Hella

Tooth Gems & GRILLS is not responsible for replacing or substituting any items, including gems,

diamonds, or gold charms, if they fall off.

I recognize the importance of regular dental checkups to maintain proper oral health and

hygiene.

I have been advised to consult a dentist to remove any residual bonding material from my teeth

if my tooth gem falls off or if I choose to have it removed.

I agree to follow all aftercare instructions provided by the certified tooth gem technician to

ensure the longevity of my tooth gem.

I authorize the technician to take photographs and videos of me for promotional purposes, both

print and digital. I understand that all rights to these images belong to Hella Tooth Gems &

GRILLS. If I do not consent to photography and usage, I will not initial here.

**Section 2: Custom Grillz Release of Liability**

I understand that custom grillz are for cosmetic use only and are not intended for eating,

sleeping, or long-term wear.

I understand that grillz should not be used as a substitute for dental work or dental appliances.

I acknowledge that grillz are non-refundable once the impression and/or production has started.

I understand that wearing grillz may cause tooth/gum irritation, sensitivity, or allergic reactions if

not properly maintained.

I understand that improper use or extended wear can contribute to dental issues, including

shifting teeth, decay, or gum irritation, and I release Hella Tooth Gems and GRILLZ from liability

for such issues.

I agree to follow all care instructions provided and assume full responsibility for how I wear and

care for my custom grillz.

**Section 3: Teeth Whitening Release of Liability**

I understand that results may vary depending on individual tooth composition, lifestyle, and

habits.

I have been informed that teeth whitening may cause temporary sensitivity or gum irritation.

I confirm that I do not have any untreated dental issues such as cavities, gum disease, or open

sores that could be aggravated by whitening treatment.

I understand that the whitening service is cosmetic and not a dental procedure.

I acknowledge that follow-up and maintenance treatments may be necessary for optimal and

long-lasting results.

I agree to follow all aftercare instructions and understand that failure to do so may reduce the

effectiveness of the treatment.