Fill and Sign the Consent Tattoo Form

Waiver, Release, and Consent to Tattoo For and in consideration of receiving a tattoo from ________________________., a corporation doing business at _______________________________________________ (street address, city, zip) ( A Studio @ ) and ___________________________ ( A Artist @ ), the undersigned ______________________________________ (name of customer) hereafter referred to as at ( A Client @ ) agrees to the following: 1. I have been fully informed of the inherent risks, associated with getting a tattoo. I fully understand that these risks, known and unknown, can lead to injury, including but not limited to infection, scarring, difficulties in detecting melanoma and allergic reactions to tattoo pigment, latex gloves, and/or soap. Having been informed of the potential risks associated with getting a tattoo, I still wish to proceed with the tattoo application and I freely accept and expressly assume any and all risks that may arise from tattooing. 2. I waive and release to the fullest extent permitted by law the Artist, Studio, and its employees from all liability whatsoever, for any and all claims or causes of action that I, my estate, heirs, executors or assigns may have for personal injury or otherwise, including any direct and/or consequential damages, which result or arise from the application of my tattoo, whether caused by the negligence or fault of either the Artist, Studio, and any of its employees. 3. I acknowledge that the Artist has given me the full opportunity to ask any and all questions about the application of my tattoo, and all of my questions have been answered to my total satisfaction. 4. I acknowledge that the Artist has given me instructions on the care of my tattoo while it is healing, and I understand them and will follow them. I acknowledge that it is possible that the tattoo can become infected, particularly if I do not follow the instructions given to me. If any touch-up work to the tattoo is needed due to my own negligence, I agree that the work will be done at my own expense. 5. I am not under the influence of alcohol or drugs, and I am voluntarily submitting to be tattooed by the Artist without duress or coercion. 6. I do not have diabetes, epilepsy, hemophilia, a heart condition, diabetes, hepatitis, hemophilia, HIV-AIDS, tuberculosis or any other communicable disease, nor do I take blood thinning medication. I do not have any other medical or skin condition that may interfere with the tattoo. I am not pregnant or nursing. I do not have a mental impairment that may affect my judgment in getting the tattoo. I acknowledge that it is not reasonably possible for the Artist or Studio to determine whether I might have an allergic reaction to the pigments or processes used in my tattoo, and I agree to accept the risk that such a reaction is possible. 7. Neither the Artist nor the Studio is responsible for the meaning or spelling of the symbol or text that I have provided to them or chosen from the flash (design) sheets. Variations in color and design may exist between the tattoo art I have selected and the actual tattoo when it is applied to my body. I also understand that over time, the colors and the clarity of my tattoo will fade due to unprotected exposure to the sun and the naturally occurring dispersion of pigment under the skin. 8. I understand that a tattoo is a permanent change to my appearance and can only be removed by laser or surgical means, which can be disfiguring and/or costly and which in all likelihood will not result in the restoration of my skin to its exact appearance before being tattooed. 9. I release to the Studio all rights to any photographs taken of me and the tattoo and give consent in advance to their reproduction in print or electronic form. 10. I agree to reimburse the Artist and the Studio for any attorneys = fees and costs incurred in any legal action I bring against either the Artist or the Studio and in which either the Artist or the Studio is the prevailing party. 11. I acknowledge that I have been given adequate opportunity to read and understand this document, that it was not presented to me at the last minute, and I understand that I am signing a legal contract waiving certain rights to recover damages against the Artist and the Studio. 12. If any provision, section, subsection, clause or phrase of this Waiver and Release is found to be unenforceable or invalid, that portion shall be severed from this Waiver and Release. The remainder of this Waiver and Release will then be construed as though the unenforceable portion had never been contained in this document. 13. I acknowledge that I have truthfully represented with photo ID to the Artist and Studio that I am eighteen years of age or older, and that this information is true and correct. 14. I have read this Agreement; I understand it; and I agree to be bound by it. Print Full Name: ___________________________________ Signature of Client: ___________________________________ Date of Birth: ________________ Address: _________________________________________________________________ Date: ________________