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I acknowledge by signing this release form that I have been given the full opportunity to ask any and all questions which I might have about any procedures I am obtaining from Endeavour Tattoo & Piercing, and that all my questions have been answered to my full and total satisfaction. 

I hereby waive and release to the fullest extent permitted by law, Endeavour Tattoo and Piercing, along with all its associates, and/or artists from all liability whatsoever, for any and all claims or cause of action, that I, my estate, heirs, executors or assigns may have personal injury or otherwise, including any direct and/or consequential damages, which result or arise from the application of my tattoo/piercing, whether caused by the negligence or fault of either Endeavour Tattoo & Piercing, it's associates, or otherwise.

I Agree

I will follow all aftercare instructions given to me by the artist.

I Agree

I understand that infection is possible with disregard for the aftercare instructions given to me.

I Agree
 

I am not pregnant or nursing.

I Agree

I have informed my artist of any health issue or medications being taken (HIV/AIDS, blood thinners, diabetes, heart disease, skin disorders, infections or blood disorders.)

I Agree

I acknowledge that the procedure may result in a permanent change to my body and appearance.

I Agree

I am not under the influence of drugs/alcohol and am making my decision on my own without duress.

I Agree

I release all rights and consent to the use of photos in print or electronic forms taken by the artist.

I Agree

I agree to reimburse both the artist and tattoo studio for my attorney fees and costs incurred in and legal action I bring against either the artist or the tattoo studio and in which either the artist or the tatoo studio is the prevailing party. I agree that the Courts of Ontario shall have personal jurisidiction and venue over me and shall have exclusive jurisdiction for the purpose of litigating any disupute arising out of or related to this agreement.

I Agree

I am of legal age and will provide proof of identification unless with parental consent.

I Agree

 

ADDITIONAL CONSENT REGARDING COVID-19

I understand that I am opting for an elective tattoo or body piercing that is not urgent and is not medically necessary.

I Agree

I also understand that the novel coronavirus, COVID-19, has been declared a worldwide pandemic by the world health organization.

I Agree

I further understand that COVID-19 is extremely contagious and is believed to be spread by person-to person contact: and as a result, federal and provincial health agenices recommend social distancing.

I Agree

I recognize that Endeavour Tattoo and Piercing and all the staff are closely monitoring this situation and have put in place mandatory preventative measures aimed to reduce the spread of COVID-19.

I Agree

I understand there is an inherent risk of becoming infected with COVID-19 by virtue of proceeding with this tattoo or piercing.

I Agree

I hereby acknowledge and assume the risk of becoming infected with COVID-19 through this tattoo or body piercing and I give my permission for Endeavour Tattoo and proceed with the same

I Agree

I understand that, even if I have been tested for COVID-19 and recieved a negative test result the tests in some cases may fail to detect the virus or I may have contracted COVID-19 after the test.

I Agree

I understand that, if I have COVID-19 infection, and even if I do not have any symptoms for the same, proceeding with this tattoo or body piercing can lead to a higher chance of complication and death

I Agree

I understand that possible exposure to COVID-19 before/during/after my tattoo or body piercing may result in the following: a positive COVID-19 diagnosis, extended quarantine/self isolation, additional tests, hospitalization that may require medical therapy, intensive care treatment, possible need for intubation/ventilator support, short-term or long-term intubation, other potential complications, and the risk of death.

I Agree

I understand that COVID-19 may cause additional risks, some or many of which may not currently be known at this time.

I Agree

In addition to the risks described herein, as well as those risks for the tattoo and body piercing I have been given the option to defer my tattoo and body piercing to a later date. However, I understand all the potential risks, including but not limited to the potential short-term and long-term complications related to COVID-19.

I Agree

I would like to proceed with my desired tattoo and body piercing.

I Agree

 

 

**You will have to confirm e-mail address after submission in order for us to recieve your request.**

 

 

First Client Name

First Name*

Middle Name

Last Name*

Phone*
First Client Date of Birth*
First Client Information

Desired Artist *

Description of Tattoo (including size and placement) *

Ideal time and date(s) for your appointment *
First Client Signature*
Second Client Name

First Name*

Middle Name

Last Name*
Second Client Date of Birth*
Second Client Information

Desired Artist *

Description of Tattoo (including size and placement) *

Ideal time and date(s) for your appointment *
Third Client Name

First Name*

Middle Name

Last Name*
Third Client Date of Birth*
Third Client Information

Desired Artist *

Description of Tattoo (including size and placement) *

Ideal time and date(s) for your appointment *
Fourth Client Name

First Name*

Middle Name

Last Name*
Fourth Client Date of Birth*
Fourth Client Information

Desired Artist *

Description of Tattoo (including size and placement) *

Ideal time and date(s) for your appointment *
Fifth Client Name

First Name*

Middle Name

Last Name*
Fifth Client Date of Birth*
Fifth Client Information

Desired Artist *

Description of Tattoo (including size and placement) *

Ideal time and date(s) for your appointment *
Sixth Client Name

First Name*

Middle Name

Last Name*
Sixth Client Date of Birth*
Sixth Client Information

Desired Artist *

Description of Tattoo (including size and placement) *

Ideal time and date(s) for your appointment *
Seventh Client Name

First Name*

Middle Name

Last Name*
Seventh Client Date of Birth*
Seventh Client Information

Desired Artist *

Description of Tattoo (including size and placement) *

Ideal time and date(s) for your appointment *
Eighth Client Name

First Name*

Middle Name

Last Name*
Eighth Client Date of Birth*
Eighth Client Information

Desired Artist *

Description of Tattoo (including size and placement) *

Ideal time and date(s) for your appointment *
Ninth Client Name

First Name*

Middle Name

Last Name*
Ninth Client Date of Birth*
Ninth Client Information

Desired Artist *

Description of Tattoo (including size and placement) *

Ideal time and date(s) for your appointment *
Tenth Client Name

First Name*

Middle Name

Last Name*
Tenth Client Date of Birth*
Tenth Client Information

Desired Artist *

Description of Tattoo (including size and placement) *

Ideal time and date(s) for your appointment *
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
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.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Desired Artist *

Description of Tattoo (including size and placement) *

Ideal time and date(s) for your appointment *
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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