Loading...

FOUR STAR TATTOO

TATTOO RELEASE FORM

 

 

 

 

 

 

 

 

 

 

 

 

 

PLEASE READ AND BE CERTAIN YOU UNDERSTAND THE IMPLICATIONS OF SIGNING THIS DOCUMENT. PLEASE CHECK EACH BOX PROVIDED AFTER READING TO SHOW THAT YOU UNDERSTAND EACH PROVISION.

In consideration of receiving a tattoo from any of the artists at Four Star Tattoo Inc. (together with its employees, apprentices and agents, Four Star Tattoo Inc.), I agree to the following:

That I have been fully informed of the inherent risks, associated with getting a tattoo. I fully understand 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 fully 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.

I Agree

TO WAIVE AND RELEASE to the fullest extent permitted by law each of the artists and Four Star Tattoo Inc. 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 or Four Star Tattoo Inc., or otherwise.

I Agree

The artist and Four Star Tattoo Inc. have 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.

I Agree

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.

I Agree

To the best of my knowledge, I do not have any contagious or communicable diseases of the blood or skin. I do not have any physical, mental, or medical conditions or disabilities, which might affect my well being as a direct or indirect result of my decision to have any tattoo related work done at this time. I am not pregnant or nursing.

I Agree

Neither the artist nor Four Star Tattoo Inc. is responsible for the meaning and spelling of the symbol or text that I have provided to them or chosen from the design sheets or images found online.

I Agree

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.

I Agree

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 all likelihood will not result in the restoration of my skin to its exact appearance before being tattooed.

I Agree

I agree to allow Four Star Tattoo Inc. and any of its artists to photograph this tattoo for any and all uses such as publication, advertisement, and all other personal uses. I have read and understand that there are no refunds on tattooing. I understand that New Mexico sales tax will be collected in addition to all services. I understand that my identity will remain confidential. I agree to leave the premises promptly upon request, for any reason whatsoever. I hereby declare that I am of legal age (and have provided valid proof of age) and am competent to sign this agreement.

I Agree

I HAVE READ THIS AGREEMENT, I UNDERSTAND IT, I AGREE TO BE BOUND BY IT.

I Agree

 

 


First Clients Name

First Name*

Middle Name

Last Name*

Phone*
First Clients Date of Birth*
First Clients Signature*
Second Clients Name

First Name*

Middle Name

Last Name*

Phone*
Second Clients Date of Birth*
Third Clients Name

First Name*

Middle Name

Last Name*

Phone*
Third Clients Date of Birth*
Fourth Clients Name

First Name*

Middle Name

Last Name*

Phone*
Fourth Clients Date of Birth*
Fifth Clients Name

First Name*

Middle Name

Last Name*

Phone*
Fifth Clients Date of Birth*
Sixth Clients Name

First Name*

Middle Name

Last Name*

Phone*
Sixth Clients Date of Birth*
Seventh Clients Name

First Name*

Middle Name

Last Name*

Phone*
Seventh Clients Date of Birth*
Eighth Clients Name

First Name*

Middle Name

Last Name*

Phone*
Eighth Clients Date of Birth*
Ninth Clients Name

First Name*

Middle Name

Last Name*

Phone*
Ninth Clients Date of Birth*
Tenth Clients Name

First Name*

Middle Name

Last Name*

Phone*
Tenth Clients Date of Birth*
Parent or Guardian's Driver's License / ID Card

Driver's License / ID Card Number*

Issuing State*
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 events by email
Artist
Type of tattoo
Location of tattoo on body
Date of signing
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*
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!