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Phone: (239) 997-TATS

WAIVER RELEASE AND CONSENT TO TATTOO OR PIERCE

Please initial each provision on the lines provided after reading to show that you understand each provision.

In consideration of receiving a tattoo from the artist (the artist) at Loyal 2 The Coil Tattoos LLC. (together with its employees,apprentices and agents at Loyal 2 Coil Tattoos LLC) I agree to the following:

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, latex gloves, 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 AND RELEASE to the fullest extent permitted by law each of the artist and the tattoo studio 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 and 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 tattoo studio, or otherwise. 

That both the artist and the tattoo studio have given me the full opportunity to ask any and all questions about the application of my tattoo and all of my questions have been answered to my total satisfaction. 

The artist and the tattoo studio have given me instructions on the care of my tattoo while it's healing and I understand them and will follow them, I acknowledge that it is possible that the tattoo can become infected, particulary 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 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 do not have diabetes, opilepsy, hemophilla, a heart condition, nor do I take blood medication. I do not have any other medical or skin conditions that may interfere with the application or healing of the tattoo. I am not the recipitent of an o rgan or bone marrow transplant or, if I am, I have taken the prescribed preventive regimen of anti-biotics that is required by my doctor in advance of any invasive procedure such as tattooing or piercing. I am not pregnant of nursing. I do not have a mental impairment that may affect my judgement in getting the tattoo. 

Neither the artist nor the tattoo studio is responsible for the meaning or spelling of the symbol or text that I have provided to them or chosen from the flash (design) sheets. 

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 occuring dispersion of pigment under the skin. 

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

I release all my rights to any photographs taken of me and the tattoo and give consent in advance to their reproduction in print or electronic form. ( If you do not initial this provision, please advise and remind your artist and the tattoo studio NOT to take any pictures of you and your completed tattoo!). 

I agree to reimburse each of the artist and the tattoo studio for any attorneys fees and costs incurred in any legal action I bring against either the artist or the tattoo studio and in which either the artist or the tattoo studio is the prevailing party. I agree that the courts of [Florida] in [Lee County] shall have personal jurisdiction and venue over me and shall have exclusive jurisdiction for the purpose of  litigating any dispute arising out of or related to this agreement. 

I acknowledge that I have been given adequate opportunity to read and understand this document, that it was not presented to me at the last minute, and I understand that I am signing a legal contract waiving certain rights to recover against the artist and the tattoo studio. If any provision, section, subsection, clause or phrase of this release is found to be unenforceable or invalid, that portion shall be severed from this contract. The remainder of this contract will then be construed as though the unenforceable portion had never been contained in this document.

I hereby declare that I am of legal age (and have provided valid proof of age) and am competent to sign this agreement or, if not that my parent or legal guardian shall sign on my behalf, and that my parent or legal guardian is in complete understanding and concurrence with this agreement.

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

Date: December 26, 2024

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

Description of Tattoo: *
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

Description of Tattoo: *
Third Participant's Name

First Name*

Middle Name

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

Description of Tattoo: *
Fourth Participant's Name

First Name*

Middle Name

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

Description of Tattoo: *
Fifth Participant's Name

First Name*

Middle Name

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

Description of Tattoo: *
Sixth Participant's Name

First Name*

Middle Name

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

Description of Tattoo: *
Seventh Participant's Name

First Name*

Middle Name

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

Description of Tattoo: *
Eighth Participant's Name

First Name*

Middle Name

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

Description of Tattoo: *
Ninth Participant's Name

First Name*

Middle Name

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

Description of Tattoo: *
Tenth Participant's Name

First Name*

Middle Name

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

Description of Tattoo: *
Participant's 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*
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Tattoo Artist Information
Please select the artist who will be tattooing you:*
Drivers License ID Upload
  
Please be sure to upload a photo of your ID. If you do not we cannot proceed with tattooing you.
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

Description of Tattoo: *
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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