Tattoo Waiver

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Tattoo Waiver

Waiver for Tattoo Service at MY Ink Tattoo Studio

Full Name *

Address *

Street, city, province/state, country

Phone *

Email *

Where is the placement of your tattoo? *

What is your Instagram name? We will provide promotion gifts on IG for our clients occasionally.

Birth Date *

YYYY

Appointment Date *

YYYY

Artist name *

Medical Conditions

Please list any and all relevant medical conditions

I acknowledge by signing this agreement that I have been given the full opportunity to ask any and all questions which I might have about the obtaining of a tattoo and that all of my questions have been answered to my full satisfaction. I specifically acknowledge I have been advised of the facts and matters set forth below and I agree as follows: *

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 my tattooist. I am not pregnant or nursing. I am not under the influence of alcohol or drugs.

I do not have medical or skin conditions such as but not limited to: acne, scarring (Keloid), Eczema, psoriasis, rash, infection, lesion, freckles, moles or sunburn in the area to be tattooed that may interfere with said tattoo. If I have any type of infection, rash, or lesion anywhere on my body, I will advise my tattooist.

I acknowledge it is not reasonably possible for the representatives and employees of MY Ink Tattoo Studio to determine whether I might have an allergic reaction to the pigments or processes used in my tattoo, and I agree to accept the risk that such a reaction is possible.

I acknowledge that infection is always possible as a result of the obtaining of a tattoo, particularly in the event that I do not take proper care of my tattoo. I agree to follow all aftercare instructions while my tattoo is healing. I agree that any touch-up needed, due to my own negligence or failure to follow such instructions, will be done at my own expense. I further acknowledge that MY Ink Tattoo Studio's policy charges for touch-ups of tattoos on hands, feet, face, and neck.

I realize that variations in colour and design may exist between any tattoo as selected by me and as ultimately applied to my body. I understand that the appearance of the tattoo may change over time and colours may fade due to exposure to sun and other factors.

I understand that the tattoo deposit is non-refundable and I must give at least 1 weeks notice to reschedule or change my appointment or I will be required to purchase a new deposit.

I understand that if I have any skin treatments, laser hair removal, plastic surgery or other skin altering procedures, it may result in adverse changes to my tattoo.

I acknowledge that a tattoo is a permanent change to my appearance and that no representations have been made to me as to the ability to later change or remove my tattoo. To my knowledge, I do not have a physical, mental or medical impairment or disability which might affect my well-being as a direct or indirect result of my decision to have a tattoo.

I acknowledge I am over the age of eighteen (or I require parent/guardian consent) and that I have truthfully represented to my tattooist that the obtaining of a tattoo is by my choice alone. I consent to the application of the tattoo and to any actions or conduct of the representatives and employees of the tattoo shop reasonably necessary to perform the tattoo procedure.

I understand that MY Ink Tattoo Studio reserves all rights to use any photo or video of my tattoo and I consent to photo and video being taken during and after my tattoo procedure.

I hereby release and forever discharge and hold harmless MY Ink Tattoo Studio, the tattooist and all affiliates, owners, managers, and employees from any and all claims, damages, or legal actions arising from or connected in any way with my tattoo, or the procedure and conduct used in the process of tattooing, and at all times while on the premises, to the fullest extent allowed by the law.

I acknowledge that I have read and understand this tattoo waiver. I further understand that I am forfeiting substantial rights, including the rights to sue, and that I am submitting this waiver voluntarily.

Required

How did you find us? *

Did you book an appointment or are you a walk-in? *

Who referred you? Please leave us their full name and contact info (your friend who referred you will get a 10% off discount for their next full price service).

Parental/Guardian Consent

I hereby hold harmless all members and affiliates of MY Ink Tattoo Studio and grant permission for my child to receive tattooing services.

All of my questions have been answered fully and I will provide both my ID and my child's ID.

Signature *

By typing my first and last name here, I agree to any and all conditions present on this waiver, and I affirm that the above information is true.

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