TATTOO CONSENT FORM

THIS DOCUMENT IS TWO PAGES. FEEL FREE TO

ASK ANY QUESTIONS REGARDING THIS WAIVER

In consideration of receiving a tattoo from ____________________ including its artists,

associates, apprentices, agents, or any employees (hereinafter referred to as the “Tattoo
Studio” I agree to the following:

1. RISKS. I, ___________________, have been fully informed of the inherent risks associated
with getting a tattoo. Therefore, I fully understand that these risks, known and unknown, can
lead to injury including but not limited to: infection, scarring, difficulties in the detection of
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 wish to proceed with the
tattoo procedure and application and freely accept and expressly assume any and all risks
that may arise from tattooing.

2. WAIVER AND RELEASE. I WAIVE AND RELEASE to the fullest extent permitted by law
any person of the Tattoo Studio from all liability whatsoever, including but not limited to, 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 procedure and application of my tattoo, whether caused by the
negligence or fault of either the Tattoo Studio, or otherwise.

3. QUESTIONS. The Tattoo Studio has given me the full opportunity to ask any question about
the procedure and application of my tattoo and all of my questions, if any, have been
answered to my total satisfaction.

4. AFTER CARE INSTRUCTIONS. The Tattoo Studio has given me instructions on the care of
my tattoo while it's healing. I understand 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.

5. SOBRIETY. I am not under the influence of alcohol or drugs, and I am voluntarily submitting
to be tattooed by the Tattoo Studio without duress or coercion.

6. MEDICAL CONDITIONS. If I have diabetes, epilepsy, hepatitis, hemophilia, HIV-AIDS or

any other communicable disease, heart condition or take medicine, which thins the blood, I
have advised the Tattoo Studio. I am not the recipient of an organ or bone marrow
transplant or, if I am, I have taken the prescribed preventative regimen of antibiotics that is
required by my doctor in advance of any invasive procedure such as tattooing or piercing. I
am not pregnant or nursing. I do not have a mental impairment that may affect my
judgement in getting the tattoo.

7. MEANING AND SPELLING. The Tattoo Studio is not responsible for the meaning or
spelling of the symbol or text that I have provide to them or chosen from the flash (design)
sheets.

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8. VARIATIONS. 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.

9. PERMANENCE. 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.

10. PHOTOGRAPH RELEASE. I release the right to any photographs taken of me and the
tattoo and give consent in advance to their reproduction in print or electronic form.

11. REFUNDS. I agree that the Tattoo Studio has a NO REFUND policy on tattoos, piercing
and/or retail sales and I will not ask for a refund for any reason whatsoever.

12. REIMBURSEMENT. I agree to reimburse the Tattoo Studio for any attorneys' fees and
costs incurred in any legal action I bring against the Tattoo Studio and in which the Tattoo
Studio is the prevailing party. I agree that the courts of located in the County of __________
within the State of __________ shall have jurisdiction and venue over me and shall have
exclusive jurisdiction for the purposes of litigating any dispute arising out of or related to this
agreement.

13. ACKNOWLEDGEMENT. I acknowledge that I have been given adequate opportunity to

read and understand this document, that it was not present to me at the last minute, and I
grasp that I am signing a legal contract waiving certain rights to recover damages against
the Tattoo Studio.

14. SEVERABILITY. 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 identification)
and am competent to sign this agreement.

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

Signature: ________________________ Date: ______________

Print Name: ________________________

Address: _____________________________________________________

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 TATTOO CONSENT FORM
In consideration of receiving a tattoo from ____________________ including its artists,
associates, apprentices, agents, or any employees (hereinafter referred to as the “Tattoo
Studio” I agree to the following:

1. RISKS. I, ___________________, have been fully informed of the inherent risks associated
with getting a tattoo. Therefore, I fully understand that these risks, known and unknown, can
lead to injury including but not limited to: infection, scarring, difficulties in the detection of
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 wish to proceed with the
tattoo procedure and application and freely accept and expressly assume any and all risks
that may arise from tattooing.

2. WAIVER AND RELEASE. I WAIVE AND RELEASE to the fullest extent permitted by law
any person of the Tattoo Studio from all liability whatsoever, including but not limited to, 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 procedure and application of my tattoo, whether caused by the
negligence or fault of either the Tattoo Studio, or otherwise.

3. QUESTIONS. The Tattoo Studio has given me the full opportunity to ask any question about
the procedure and application of my tattoo and all of my questions, if any, have been
answered to my total satisfaction.

4. AFTER CARE INSTRUCTIONS. The Tattoo Studio has given me instructions on the care of
my tattoo while it's healing. I understand 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.

5. SOBRIETY. I am not under the influence of alcohol or drugs, and I am voluntarily submitting
to be tattooed by the Tattoo Studio without duress or coercion.

6. MEDICAL CONDITIONS. If I have diabetes, epilepsy, hepatitis, hemophilia, HIV-AIDS or

any other communicable disease, heart condition or take medicine, which thins the blood, I
have advised the Tattoo Studio. I am not the recipient of an organ or bone marrow
transplant or, if I am, I have taken the prescribed preventative regimen of antibiotics that is
required by my doctor in advance of any invasive procedure such as tattooing or piercing. I
am not pregnant or nursing. I do not have a mental impairment that may affect my
judgement in getting the tattoo.

7. MEANING AND SPELLING. The Tattoo Studio is not responsible for the meaning or
spelling of the symbol or text that I have provide to them or chosen from the flash (design)
sheets.

8. VARIATIONS. 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.

Page 1 of 2
9. PERMANENCE. 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.

10. PHOTOGRAPH RELEASE. I release the right to any photographs taken of me and the
tattoo and give consent in advance to their reproduction in print or electronic form.

11. REFUNDS. I agree that the Tattoo Studio has a NO REFUND policy on tattoos, piercing
and/or retail sales and I will not ask for a refund for any reason whatsoever.

12. REIMBURSEMENT. I agree to reimburse the Tattoo Studio for any attorneys' fees and
costs incurred in any legal action I bring against the Tattoo Studio and in which the Tattoo
Studio is the prevailing party. I agree that the courts of located in the County of __________
within the State of __________ shall have jurisdiction and venue over me and shall have
exclusive jurisdiction for the purposes of litigating any dispute arising out of or related to this
agreement.

13. ACKNOWLEDGEMENT. I acknowledge that I have been given adequate opportunity to

read and understand this document, that it was not present to me at the last minute, and I
grasp that I am signing a legal contract waiving certain rights to recover damages against
the Tattoo Studio.

14. SEVERABILITY. 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 identification)
and am competent to sign this agreement.

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

Client Signature: ________________________ Date: ______________

Print Name: ________________________

Address: ________________________________________________

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