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RELEASE and CONSENT to TATTOOING

 

PLEASE READ the FOLLOWING NOTICE:

YOU ARE HEREBY NOTIFIED OF THE POSSIBLE RISKS AND DANGERS ASSOCIATED WITH THE APPLICATION of EACH TATTOO.  THESE RISKS and DANGERS INCLUDE, BUT ARE NOT LIMITED TO, AT LEAST THE FOLLOWING:

  • THE POSSIBILITY of DISCOMFORT or PAIN
  • THE PERMANENCE of the TATTOO
  • THE RISK of INFECTION
  • THE POSSIBILITY of ADVERSE or ALLERGIC REACTION

NO PERSON WHO APPEARS to be UNDER THE INFLUENCE OF ALCOHOL or DRUGS MAY BE TATTOOED

First Client Name
First Name*
Middle Name
Last Name*
Phone*
First Client Date of Birth*
Date of Birth
First Client Signature*
Second Client Name
First Name*
Middle Name
Last Name*
Client Date of Birth*
Date of Birth
Third Client Name
First Name*
Middle Name
Last Name*
Client Date of Birth*
Date of Birth
Fourth Client Name
First Name*
Middle Name
Last Name*
Client Date of Birth*
Date of Birth
Fifth Client Name
First Name*
Middle Name
Last Name*
Client Date of Birth*
Date of Birth
Sixth Client Name
First Name*
Middle Name
Last Name*
Client Date of Birth*
Date of Birth
Seventh Client Name
First Name*
Middle Name
Last Name*
Client Date of Birth*
Date of Birth
Eighth Client Name
First Name*
Middle Name
Last Name*
Client Date of Birth*
Date of Birth
Ninth Client Name
First Name*
Middle Name
Last Name*
Client Date of Birth*
Date of Birth
Tenth Client Name
First Name*
Middle Name
Last Name*
Client Date of Birth*
Date of Birth
Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
Parent or Guardian's Driver's License / ID Card
Driver's License / ID Card Number*
Issuing State*
Tattoo Details
Tattoo Artist*
Description of tattoo *
Tattoo Placement *
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Middle Name
Last Name*
Phone*
Parent or Guardian's Date of Birth*
Date of Birth
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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