Loading...

By checking the box below and signing you agree to the following:

I do hereby certify that I am at least 18 years old. I certify that I do not have any physical, mental, or medical impairment or disability which might affect my well being as a direct or indirect result as a decision to get any tattoo related work done at this time. I agree to all instructions regarding the care of my tattoo while it is healing. I understand that my skins pigment may influence how bright colors result in my tattoo.

I being of sound mind and body, do hereby release any and all persons, artists, or agents representing or contracted by Best Studio Ever, INC dba High Priestess Piercing & Tattoo (hereby collectively referred to as BSE) from all responsibility. I myself accept any and all responsibility for any consequences which might stem from my decision to have tattoo related work done at this time by BSE. I agree not to sue BSE in connection with any and all damages, claims, demands, rights, and cause of action of whatever kind of nature, based upon injuries or property damage to, or death of myself or any other persons arising from my decision to have tattoo related work done at this time, whether or not caused by any negligence of BSE. I agree for myself, my heirs, assigns, and legal representatives to hold BSE harmless for all damages, actions, causes of actions, claim judgments, cost of litigation, attorney's fees, and all other costs and expenses which might result from my decision to have tattoo-related work done by BSE. 

I represent and warrant to BSE that the below information is true and correct, and that I understand the above paragraphs. I understand that Oregon law prohibits tattooing anyone under the age of 18, and that if I falsify my age I will be prosecuted.

I Agree

First Client's Name

First Name*

Middle Name

Last Name*

Phone*
By checking this box, you agree to receive text message updates from the business who owns this Smartwaiver form. Msg & data rates may apply. Msg frequency is recurring. Reply STOP to opt out.
First Client's Date of Birth*
First Client's Information

Preferred name (if different)

Pronoun (optional)

What is your full address? *
First Client's Signature*
Second Client's Name

First Name*

Middle Name

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

Preferred name (if different)

Pronoun (optional)

What is your full address? *
Third Client's Name

First Name*

Middle Name

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

Preferred name (if different)

Pronoun (optional)

What is your full address? *
Fourth Client's Name

First Name*

Middle Name

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

Preferred name (if different)

Pronoun (optional)

What is your full address? *
Fifth Client's Name

First Name*

Middle Name

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

Preferred name (if different)

Pronoun (optional)

What is your full address? *
Sixth Client's Name

First Name*

Middle Name

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

Preferred name (if different)

Pronoun (optional)

What is your full address? *
Seventh Client's Name

First Name*

Middle Name

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

Preferred name (if different)

Pronoun (optional)

What is your full address? *
Eighth Client's Name

First Name*

Middle Name

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

Preferred name (if different)

Pronoun (optional)

What is your full address? *
Ninth Client's Name

First Name*

Middle Name

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

Preferred name (if different)

Pronoun (optional)

What is your full address? *
Tenth Client's Name

First Name*

Middle Name

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

Preferred name (if different)

Pronoun (optional)

What is your full address? *
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Tattoo Information

Please give a short description of that tattoo you will be getting *
Please answer "yes" or "no" to the following questions.
Are you 18 years old or older?*
No
Yes
Have you been sick in the last week?*
No
Yes
Do you understand that you should eat within 4 hours of your scheduled tattoo appointment?*
No
Yes
Are you prone to feeling dizzy or lightheaded?*
No
Yes
Does your doctor require antibiotics before dental work?*
No
Yes
Do you currently have any cold sores or fever blisters?*
No
Yes
Do you have any moles or freckles on the site of the service?*
No
Yes
Do you have any skin conditions such as eczema, psoriasis, or keloiding?*
No
Yes
Do you have any skin sensitivities or allergies to latex, iodine, alcohol, soaps, or fragrances?*
No
Yes
Do you have any medical conditions that may potentially complicate the piercing procedure and/or healing process? such as: anemia, diabetes, epilepsy, hemophilia, hepatitis, hypoglycemia, or immune deficiency or disorder.*
No
Yes

If yes to the previous question, which do you have?
Are you pregnant or nursing?*
No
Yes
By checking the boxes below you agree to the following statements
I acknowledge that the obtaining of my tattoo is by my choice alone. *
I agree
I agree that I will not be under the influence of drugs or alcohol at the time of my tattoo service. *
I agree
I agree that I have had full and fair opportunity to review all written information and ask any questions I may have about the obtaining of my tattoo from my artist and/or BSE. *
I agree
I acknowledge that I might have an allergic reaction to the dyes, pigments, or processes used in my tattoo, and I agree to accept that such a risk is possible. *
I agree
I am in good health and have no undisclosed medical conditions that may cause problems. *
I agree
I hereby give my artist and/or BSE permission to copyright and/or publish photographic portraits or pictures of me or in which I might be included in whole or in part. *
I agree
If my tattoo includes text or writing, I agree to proof read the design for spelling and grammar. *
I agree
I acknowledge that a tattoo is a permanent change to my body. *
I agree
I give my consent to receive occasional marketing text messages and emails from Best Studio Ever™ and its affiliates.
I agree
If your tattoo contains any text please list it below.

List text
Please attach a photo of your state or government issued photo ID. (Please note: You will also need to provide your ID in person when you arrive for your appointment)
  
Upload a photo of your ID
Valid file types: JPG, GIF, PNG, and PDF
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 Information

Preferred name (if different)

Pronoun (optional)

What is your full address? *
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!