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The Old Haunt Tattoo Studio

9 St Helens Ave Tacoma, Wa. 98402

theoldhaunttattoo.com

CUSTOMER RELEASE

Please inform your artist of any medical or skin conditions you may have prior to your appointment.  

We are unable to tattoo pregnant women and reserve the right to refuse services.


  • I acknowledge that I am over the age of eighteen. —
    I Agree
  • I acknowledge that a tattoo is permanent, and obtaining a tattoo is by choice and I consent to the application of the tattoo. —
    I Agree
  • I acknowledge that my artist is not responsible for any misspelling or meaning of any script and/or symbol and I confirm that I agree to final placement and design of any tattoo on my body. —
    I Agree
  • I acknowledge that variations in color and design may exist between any tattoo represented on paper selected by me and what is ultimately applied to my body. —
    I Agree
  • I acknowledge that I am not under the influence of drugs or alcohol or any other intoxicating substances. —
    I Agree
  • I acknowledge that it is not reasonably possible for my artist to determine whether I might have an allergic reaction to the pigment used in my tattoo. I agree to accept the risk that such a reaction is possible. —
    I Agree
  • I acknowledge that infection is always possible, and I recognize that the responsibility for properly healing my tattoo is entirely my own. —
    I Agree
  • I agree to follow all directions contained in the aftercare (written copies are available upon request.) —
    I Agree
  • I acknowledge that I have been informed that in the event of medical complications I should seek medical advice following a consultation with my artist. — 
    I Agree
  • I hereby acknowledge my artist’s copyright of their artwork and grant permission to publish photographic portraits of the tattoo or pictures of me, or reproductions of the tattoo in any form deemed appropriate such as media art and advertising. I waive any rights I may have to inspect or approve the finished product or the use of its content. —
    I Agree
  • I agree to release my artist and the studio in which my tattoo was applied from any claims, damages, or legal actions arising from designing and/or applying my tattoo. I am, and have been, satisfied with the services provided to me. —
    I Agree

October 16, 2026

Tattoo Details
Artist's Name *

Write a brief description of the tattoo. Include spelling of any words, phrases, or names if applicable *
Client'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*
Check to receive information, news, and discounts by e-mail.
Medical History

Do you have any known allergies? Including to any specific tattoo inks/pigments, or products used in the tattoo application? Leave blank if no

Do you currently have or have you ever had a communicable disease or infection your artist should be aware of? If no or unknown leave blank
Parent or Guardian's Driver's License / ID Card
Driver's License / ID Card Number*
Issuing State*
First Client's Name
First Name*
Middle Name
Last Name*
Phone*
First Client's Date of Birth*
Date of Birth
First Client's Signature*
Second Client's Name
First Name*
Middle Name
Last Name*
Client's Date of Birth*
Date of Birth
Third Client's Name
First Name*
Middle Name
Last Name*
Client's Date of Birth*
Date of Birth
Fourth Client's Name
First Name*
Middle Name
Last Name*
Client's Date of Birth*
Date of Birth
Fifth Client's Name
First Name*
Middle Name
Last Name*
Client's Date of Birth*
Date of Birth
Sixth Client's Name
First Name*
Middle Name
Last Name*
Client's Date of Birth*
Date of Birth
Seventh Client's Name
First Name*
Middle Name
Last Name*
Client's Date of Birth*
Date of Birth
Eighth Client's Name
First Name*
Middle Name
Last Name*
Client's Date of Birth*
Date of Birth
Ninth Client's Name
First Name*
Middle Name
Last Name*
Client's Date of Birth*
Date of Birth
Tenth Client's Name
First Name*
Middle Name
Last Name*
Client's Date of Birth*
Date of Birth
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*
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.


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