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Deuce Tattoos Tattoo Waiver 

 

BY SIGNING THIS DOCUMENT YOU WILL WAIVE OR GIVE UP CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE OR CLAIM COMPENSATION FOLLOWING ANY TATTOOING PROCEDURE.

 

I acknowledge by signing this agreement that I have been given the full opportunity to ask any and all questions which I might have about the obtaining of a tattoo and that all of my questions have been answered to my full satisfaction. I specifically acknowledge I have been advised of the facts and matters set forth below and I agree as follows:

 

  • I am up to date on all of my vaccinations, if I am not I must inform my tattoo artist.

  • If I have any condition that might affect the healing of this tattoo, I will advise my tattoo artist.

  •I am not pregnant or nursing.

  •I am not under the influence of alcohol or drugs.

  •I do not have medical or skin conditions such as but not limited to: acne, scarring (Keloid) eczema, psoriasis, freckles, moles or sunburn in the area to be tattooed that may interfere with said tattoo. If I have any type of medical condition, infection or rash anywhere on my body, I will advise my tattoo artist.

  •I understand the receiving this tattoo may lower my immune system and make me susceptible to Covid19.

 

I will provide my tattoo artist in advance of the tattoo procedure with written permission from my doctor, to receive a tattoo if I have a medical condition such as but not limited to: history of diabetes, heart disease, seizures, skin disorders or bleeding disorders

 

I acknowledge it is not reasonably possible for the representatives and employees of this tattoo shop 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.

 

I acknowledge that infection is always possible as a result of the obtaining of a tattoo, particularly in the event that I do not take proper care of my tattoo. I have received aftercare instructions and I agree to follow them while my tattoo is healing. I agree that any touch-up work needed, due to my own negligence, will be done at my own expense.

 

I realize that variations in color and design may exist between any tattoo as selected by me and as ultimately applied to my body. I understand that if my skin color is dark, the colors will not appear as bright as they do on light skin.

 

I understand that if I have any skin treatments, laser hair removal, plastic surgery or other skin altering procedures, it may result in adverse changes to my tattoo.

 

I acknowledge that a tattoo is a permanent change to my appearance and that no representations have been made to me as to the ability to later change or remove my tattoo.

 

I acknowledge that if I request the tattoo to be tattooed upside down I can NOT expect or demand the tattoo artist to change it later unless I agree to pay for it in full. Deuce Tattoos is not responsible for my spelling mistakes.

 

To my knowledge, I do not have a physical, mental or medical impairment or disability that might affect my wellbeing as a direct or indirect result of my decision to have a tattoo.

 

I acknowledge I am over the age of eighteen and that I have truthfully represented to my tattoo artist that the obtaining of a tattoo is by my choice alone. I consent to the application of the tattoo and to any actions or conduct of the representatives and employees of the tattoo shop reasonably necessary to perform the tattoo procedure.

 

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, tattoo ointments 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.

 

-TO WAIVE ANY AND ALL CLAIMS that I have or may in the future have against the RELEASEES AND TO RELEASE THE RELEASEES from any and all liability for any loss, damage, expense or injury, including death, that I may suffer or that my next of kin may suffer, as a result of services offered by DEUCE TATTOOS (Lucky Deuce Tattoos). DUE TO ANY CAUSE WHATSOEVER, INCLUDING NEGLIGENCE, BREACH OF CONTRACT, OR BREACH OF ANY STATUTORY OR OTHER DUTY OF CARE, INCLUDING ANY DUTY OF CARE OWED UNDER THE OCCUPIERS LIABILITY ACT, ON THE PART OF THE RELEASEES, AND FURTHER INCLUDING THE FAILURE ON THE PART OF THE RELEASEES TO SAFEGUARD OR PROTECT ME FROM THE RISKS, DANGERS AND HAZARDS OF TATTOOING PROCEDURES.

 

I understand and accept that being tattooed requires professional physical bodily contact between the tattoo artist and myself. I agree to this type of contact as necessary and incidental throughout the tattooing process, as it ensures proper placement of the tattoo, and allows the tattoo artist to work in relative comfort so I may receive the best work possible. The tattoo artist wishes to respect my bodily autonomy, so I agree to discuss in advance any areas which are sensitive, or any areas in which I do not feel comfortable touching or being touched. Additionally, if I feel uncomfortable at any time once the tattoo artist has begun work, I agree to speak to the artist, so that the artist can make reasonable  accommodations for my comfort, if possible

 

*I CONFIRM THAT I HAVE READ AND UNDERSTOOD THIS RELEASE AGREEMENT PRIOR TO SIGNING IT, AND I AM AWARE THAT BY SIGNING THIS RELEASE AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS, ASSIGNS AND REPRESENTATIVES MAY HAVE AGAINST THE RELEASEES.

First Client's Name Name

First Name*

Middle Name

Last Name*

Phone*
First Client's Name Date of Birth*
First Client's Name Information
Have you or traveled outside of Canada in the last 14 days*
No
Yes
Have you traveled within Canada in the last 14 days?*
No
Yes
Have you been on a cruise ship in the last 14 days*
No
Yes
Have you and/or anyone in your household/work been in close contact with anyone who has traveled domestically or internationally in the last 14 days*
No
Yes
Have you attended any events or gatherings with more than 10 people*
No
Yes
Have you been in close contact with a person known to have the 2019 Novel Coronavirus*
No
Yes
Have you and/or anyone in your household/work been asked to self-quarantine?*
No
Yes
Do you currently have fever or lower respiratory symptoms such as a cough or shortness of breath, severe chest pain, losing consciousness, and or feeling unwell.*
No
Yes
First Client's Name Signature*
Second Client's Name Name

First Name*

Middle Name

Last Name*

Phone*
Second Client's Name Date of Birth*
Second Client's Name Information
Have you or traveled outside of Canada in the last 14 days*
No
Yes
Have you traveled within Canada in the last 14 days?*
No
Yes
Have you been on a cruise ship in the last 14 days*
No
Yes
Have you and/or anyone in your household/work been in close contact with anyone who has traveled domestically or internationally in the last 14 days*
No
Yes
Have you attended any events or gatherings with more than 10 people*
No
Yes
Have you been in close contact with a person known to have the 2019 Novel Coronavirus*
No
Yes
Have you and/or anyone in your household/work been asked to self-quarantine?*
No
Yes
Do you currently have fever or lower respiratory symptoms such as a cough or shortness of breath, severe chest pain, losing consciousness, and or feeling unwell.*
No
Yes
Third Client's Name Name

First Name*

Middle Name

Last Name*

Phone*
Third Client's Name Date of Birth*
Third Client's Name Information
Have you or traveled outside of Canada in the last 14 days*
No
Yes
Have you traveled within Canada in the last 14 days?*
No
Yes
Have you been on a cruise ship in the last 14 days*
No
Yes
Have you and/or anyone in your household/work been in close contact with anyone who has traveled domestically or internationally in the last 14 days*
No
Yes
Have you attended any events or gatherings with more than 10 people*
No
Yes
Have you been in close contact with a person known to have the 2019 Novel Coronavirus*
No
Yes
Have you and/or anyone in your household/work been asked to self-quarantine?*
No
Yes
Do you currently have fever or lower respiratory symptoms such as a cough or shortness of breath, severe chest pain, losing consciousness, and or feeling unwell.*
No
Yes
Fourth Client's Name Name

First Name*

Middle Name

Last Name*

Phone*
Fourth Client's Name Date of Birth*
Fourth Client's Name Information
Have you or traveled outside of Canada in the last 14 days*
No
Yes
Have you traveled within Canada in the last 14 days?*
No
Yes
Have you been on a cruise ship in the last 14 days*
No
Yes
Have you and/or anyone in your household/work been in close contact with anyone who has traveled domestically or internationally in the last 14 days*
No
Yes
Have you attended any events or gatherings with more than 10 people*
No
Yes
Have you been in close contact with a person known to have the 2019 Novel Coronavirus*
No
Yes
Have you and/or anyone in your household/work been asked to self-quarantine?*
No
Yes
Do you currently have fever or lower respiratory symptoms such as a cough or shortness of breath, severe chest pain, losing consciousness, and or feeling unwell.*
No
Yes
Fifth Client's Name Name

First Name*

Middle Name

Last Name*

Phone*
Fifth Client's Name Date of Birth*
Fifth Client's Name Information
Have you or traveled outside of Canada in the last 14 days*
No
Yes
Have you traveled within Canada in the last 14 days?*
No
Yes
Have you been on a cruise ship in the last 14 days*
No
Yes
Have you and/or anyone in your household/work been in close contact with anyone who has traveled domestically or internationally in the last 14 days*
No
Yes
Have you attended any events or gatherings with more than 10 people*
No
Yes
Have you been in close contact with a person known to have the 2019 Novel Coronavirus*
No
Yes
Have you and/or anyone in your household/work been asked to self-quarantine?*
No
Yes
Do you currently have fever or lower respiratory symptoms such as a cough or shortness of breath, severe chest pain, losing consciousness, and or feeling unwell.*
No
Yes
Sixth Client's Name Name

First Name*

Middle Name

Last Name*

Phone*
Sixth Client's Name Date of Birth*
Sixth Client's Name Information
Have you or traveled outside of Canada in the last 14 days*
No
Yes
Have you traveled within Canada in the last 14 days?*
No
Yes
Have you been on a cruise ship in the last 14 days*
No
Yes
Have you and/or anyone in your household/work been in close contact with anyone who has traveled domestically or internationally in the last 14 days*
No
Yes
Have you attended any events or gatherings with more than 10 people*
No
Yes
Have you been in close contact with a person known to have the 2019 Novel Coronavirus*
No
Yes
Have you and/or anyone in your household/work been asked to self-quarantine?*
No
Yes
Do you currently have fever or lower respiratory symptoms such as a cough or shortness of breath, severe chest pain, losing consciousness, and or feeling unwell.*
No
Yes
Seventh Client's Name Name

First Name*

Middle Name

Last Name*

Phone*
Seventh Client's Name Date of Birth*
Seventh Client's Name Information
Have you or traveled outside of Canada in the last 14 days*
No
Yes
Have you traveled within Canada in the last 14 days?*
No
Yes
Have you been on a cruise ship in the last 14 days*
No
Yes
Have you and/or anyone in your household/work been in close contact with anyone who has traveled domestically or internationally in the last 14 days*
No
Yes
Have you attended any events or gatherings with more than 10 people*
No
Yes
Have you been in close contact with a person known to have the 2019 Novel Coronavirus*
No
Yes
Have you and/or anyone in your household/work been asked to self-quarantine?*
No
Yes
Do you currently have fever or lower respiratory symptoms such as a cough or shortness of breath, severe chest pain, losing consciousness, and or feeling unwell.*
No
Yes
Eighth Client's Name Name

First Name*

Middle Name

Last Name*

Phone*
Eighth Client's Name Date of Birth*
Eighth Client's Name Information
Have you or traveled outside of Canada in the last 14 days*
No
Yes
Have you traveled within Canada in the last 14 days?*
No
Yes
Have you been on a cruise ship in the last 14 days*
No
Yes
Have you and/or anyone in your household/work been in close contact with anyone who has traveled domestically or internationally in the last 14 days*
No
Yes
Have you attended any events or gatherings with more than 10 people*
No
Yes
Have you been in close contact with a person known to have the 2019 Novel Coronavirus*
No
Yes
Have you and/or anyone in your household/work been asked to self-quarantine?*
No
Yes
Do you currently have fever or lower respiratory symptoms such as a cough or shortness of breath, severe chest pain, losing consciousness, and or feeling unwell.*
No
Yes
Ninth Client's Name Name

First Name*

Middle Name

Last Name*

Phone*
Ninth Client's Name Date of Birth*
Ninth Client's Name Information
Have you or traveled outside of Canada in the last 14 days*
No
Yes
Have you traveled within Canada in the last 14 days?*
No
Yes
Have you been on a cruise ship in the last 14 days*
No
Yes
Have you and/or anyone in your household/work been in close contact with anyone who has traveled domestically or internationally in the last 14 days*
No
Yes
Have you attended any events or gatherings with more than 10 people*
No
Yes
Have you been in close contact with a person known to have the 2019 Novel Coronavirus*
No
Yes
Have you and/or anyone in your household/work been asked to self-quarantine?*
No
Yes
Do you currently have fever or lower respiratory symptoms such as a cough or shortness of breath, severe chest pain, losing consciousness, and or feeling unwell.*
No
Yes
Tenth Client's Name Name

First Name*

Middle Name

Last Name*

Phone*
Tenth Client's Name Date of Birth*
Tenth Client's Name Information
Have you or traveled outside of Canada in the last 14 days*
No
Yes
Have you traveled within Canada in the last 14 days?*
No
Yes
Have you been on a cruise ship in the last 14 days*
No
Yes
Have you and/or anyone in your household/work been in close contact with anyone who has traveled domestically or internationally in the last 14 days*
No
Yes
Have you attended any events or gatherings with more than 10 people*
No
Yes
Have you been in close contact with a person known to have the 2019 Novel Coronavirus*
No
Yes
Have you and/or anyone in your household/work been asked to self-quarantine?*
No
Yes
Do you currently have fever or lower respiratory symptoms such as a cough or shortness of breath, severe chest pain, losing consciousness, and or feeling unwell.*
No
Yes
Client's Name 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*
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
Have you or traveled outside of Canada in the last 14 days*
No
Yes
Have you traveled within Canada in the last 14 days?*
No
Yes
Have you been on a cruise ship in the last 14 days*
No
Yes
Have you and/or anyone in your household/work been in close contact with anyone who has traveled domestically or internationally in the last 14 days*
No
Yes
Have you attended any events or gatherings with more than 10 people*
No
Yes
Have you been in close contact with a person known to have the 2019 Novel Coronavirus*
No
Yes
Have you and/or anyone in your household/work been asked to self-quarantine?*
No
Yes
Do you currently have fever or lower respiratory symptoms such as a cough or shortness of breath, severe chest pain, losing consciousness, and or feeling unwell.*
No
Yes
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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