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Save time at your impressions appointment by filling out our waiver ahead of time
Note: You will have to present a picture ID at your impression appointment. This form can not be filled out ahead of time by those that are purchasing goods for others. This form can not be filled out by minors and must be filled out in person by a legal guardian.
1of1 Custom / ACS Custom USA Ear Impression Waiver
I understand that a representative of 1of1 Custom LLC (1of1) will take an impression of my ear for the purpose of creating custom fit ear plugs and/or in-ear monitors. I understand that prior to making the impression the Representative shall visually inspect my inner and outer ear to make sure there are no blockages or abnormalities that would prevent from making a proper impression and/or injure me.
I understand that the 1of1 Representative is fully trained and capable of taking ear impressions. 1of1 Representative reserves the right to refuse to make ear impressions for any reason and to refer me to an ENT doctor.
I understand that in very rare circumstances, ear impressions may cause damage in the ear canal that may require medical intervention and/or that can damage my ear.
In the light of the foregoing, I agree to indemnify, release and forever hold harmless 1of1 Representative and 1of1 from any and all claims, damages and/or legal actions arising from or connected in any way with the ear impressions administered by Representative.
I HAVE READ AND UNDERSTAND THE FOREGOING AND BY FILLING OUT THE INFORMATION ON THE RIGHT I AGREE TO THE ABOVE STATED.
