Tattoo Consent Form

In consideration of receiving a tattoo from Avanti Tattoo including its artists, associates, apprentices, agents, or any employees (hereinafter referred to as the “Tattoo Shop” I agree to and acknowledge the following:

I understand that there are risks associated with getting a tattoo both known and unknown which 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. In consideration of these 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.

I WAIVE AND RELEASE to the fullest extent permitted by law any person of the Tattoo Shop 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 Shop, or otherwise.

I understand that I need to follow the instructions the Tattoo Shop provides me regarding the care of my tattoo while it's healing and I agree to follow those instructions. I acknowledge that it is possible for the tattoo to 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 re-work will be done at my own expense.

I certify that I am not under the influence of alcohol or drugs, and that I am voluntarily submitting to be tattooed by the Tattoo Shop without duress or coercion.

I understand that the Tattoo Shop is not responsible for the meaning or spelling of any symbols or text that I have provided to them or have chosen from flash (design) sheets.

I understand that 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.

I understand that a tattoo is a permanent change to my skin and body and can only be removed by laser or surgical means, which can be disfiguring and/or costly and which in all likelihood would not result in the restoration of my skin to its exact appearance before being tattooed.

I acknowledge that the Tattoo Shop has a NO REFUND policy on tattoos and I will not ask for a refund for any reason whatsoever.

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.

I agree to reimburse the Tattoo Shop for any attorneys' fees and costs incurred in any legal action I bring against the Tattoo Shop and in which either the Artist or the Tattoo Shop is the prevailing party. I agree that the courts located in the County of Eagle within the State of Colorado 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.

Do you have a skin disease or skin lesions?*

YesNo

Please provide details.

Do you have Diabetes?*

YesNo

Do you have Hemophilia?*

YesNo

Do you have allergies or adverse reactions to latex, pigments, dyes, disinfectants, soaps, or metals?*

YesNo

Please describe.

Are you being treated with anticoagulants or other medications that thin the blood and/or interfere with blood clotting?*

YesNo

Please describe.

Provide any other information that would aid the body artist in your body art healing process evaluation.

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 grasp that I am signing a legal contract waiving certain rights to recover damages against the Tattoo Shop.

I confirm that the information I provided in this document is accurate and true.

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.

Signed Date

Date

Client Signature

Full Name*

First NameLast Name

Date of Birth*

Date

Current Phone Number*

Area CodePhone Number

Email*

example@example.com

Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Location of Tattoo on Your Body*

Date of Tattoo Procedure*

Date

Tattoo Consent Form

Pre-Procedure Questionnaire

Acknowledgment and Waiver

Client Information