This pdf is 7 pages long, 1 page SRD, leaving 6 pages of content.

The basic idea of this pdf is that certain ritual scarifications and mortifications have an inherent power that can be harnessed via Knowledge (Religion) if the scar is given to the character in a ceremony and, for a price, grant the power of the scar to you. I really like the concept and the potential it has, so with that being said, let's jump to the execution!

That is unfortunately also where not all of the scars hold up to the excellent premise. While all of the scarifications and mutilations somewhat evoke a grisly ritual, pain and cool benefits, there is a slight disjunction in some of the penalties the supplicant gains for the benefits - "Amazonian Sacrifice" (cutting of a breast) nets a bonus to ranged attacks for a penalty on AC, due to the "reckless courage". I don't really get that. Another problem I have with the otherwise great flavor text is that often a chance of not surviving the procedure is mentioned, which in the case of e.g. "Blood Eagle" makes perfect sense. However, rules-wise, no mechanics are given for a chance to die.

Conclusion:
The scars are cool and felt balanced. Editing and formatting do not suffer from the same glitches of other files of this series and are top-notch. Due to the discrepancy between the fluff and the rules and the lack of "You could die"-rules somewhat upset me and would make me rate this 3 stars. I really hope to see the idea being expanded and refined in some future publications.