You can always press Enter⏎ to continue
Consent & Covid Release Form
Please fill out this form AFTER your appointment has been scheduled :)
19
Questions
START
1
BY SIGNING THIS DOCUMENT I UNDERSTAND/AGREE IN ORDER TO RECEIVE A TATTOO OR TATTOO RELATED WORK FROM CRYBABY STUDIOS, I VERIFY THAT I AM OF LEGAL AGE (18). I ALSO MEET THE FOLLOWING REQUIREMENTS AND GUIDELINES
Previous
NEXT
Submit
Press
Enter
2
DO YOU HAVE A HEART CONDITION?
*
This field is required.
YES
NO
Previous
NEXT
Submit
Press
Enter
3
DO YOU HAVE EPILEPSY?
*
This field is required.
YES
NO
Previous
NEXT
Submit
Press
Enter
4
ARE YOU A HEMOPHILIAC (BLEEDER)?
*
This field is required.
YES
NO
Previous
NEXT
Submit
Press
Enter
5
ANY BLOOD BORNE DISEASES?
*
This field is required.
If so, please specify. If not, please indicate by submitting "NO" below
Previous
NEXT
Submit
Press
Enter
6
DO YOU HAVE AN ALLERGY TO LATEX?
*
This field is required.
YES
NO
Previous
NEXT
Submit
Press
Enter
7
HAVE YOU RECEIVED SERVICES FROM US BEFORE?
*
This field is required.
YES
NO
Previous
NEXT
Submit
Press
Enter
8
*I HAVE RECEIVED AFTERCARE INSTRUCTIONS AND AGREE TO FOLLOW AS
(PLEASE INITIAL BELOW)
Clear
Previous
NEXT
Submit
Press
Enter
9
PLEASE READ & CONFIRM TERMS & CONDITIONS
*
This field is required.
TO MY KNOWLEDGE I DO NOT HAVE ANY PHYSICAL OR MENTAL IMPARITIES WHICH MIGHT AFFECT MY WELL BEING AS A DIRECT OR INDIRECT RESULT OF MY DECISION TO HAVE ANY TATTOO RELATED WORK DONE AT THIS TIME. I AM NOT UNDER THE INFLUENCE OF ANY TYPE OF CONTROLLED SUBSTANCE. I AGREE TO FOLLOW ALL INSTRUCTIONS CONCERNING THE CARE OF MY TATTOO OR PIERCING WHILE IT IS HEALING. I AGREE THAT ANY TOUCH UP WORK NEEDED, DUE TO MY OWN NEGLIGENCE, WIL BE DONE AT MY OWN EXPENSE. I UNDERSTAND THAT IF MY SKIN IS DARKER, THAT COLORS WILL NOT APPEAR AS BRIGHT AS THEY DO ON LIGHTER SKIN. I HEREBY RELEASE ANY AND ALL PERSONS REPRESENTING CRYBABY STUDIOS FROM RESPONSIBILITY. I ACCEPT ANY AND ALL RESPONSIBILITIES MYSELF FOR ANY CONSEQUENCES THAT MAY STEM FROM MY DECISION TO HAVE ANY TATTOO RELATED WORK DONE BY CRYBABY STUDIOS. I AGREE FOR MYSELF, HEIRS, ASSIGNS AND LEGAL REPRESENTATIVES TO HOLD HARMLESS FROM ALL DAMAGES, ACTIONS, CLAIM ADJUSTMENTS, COST LITIGATION, ATTORNEY FEES, AND ALL OTHER COST AND EXPENSES THAT MIGHT ARISE FROM MY DECISION TO HAVE ANY TATTOO RELATED WORK DONE BY CRYBABY STUDIOS. I AGREE TO PAY FOR ANY/ALL DAMAGES AND INJURIES TO ANY/ALL PERSONS OR PROPERTY REPRESENTING OR BELONGING TO CRYBABY STUDIOS OR PERSONS WHOM CRYBABY STUDIOS MAY BECOME LIABLE CONTRACTUALLY OR BY OPERATION OF LAW, CAUSED BY, OR RESULTING FROM MY DECISION TO HAVE ANY TATTOO RELATED WORK DONE BY CRYBABY STUDIOS. I AGREE TO LEAVE THE PREMISES OF CRYBABY STUDIOS PROMPTLY UPON REQUEST, FOR ANY REASON POSSIBLE BY ANY AGENT OR EMPLOYEE OF CRYBABY STUDIOS. I RELEASE CRYBABY STUDIOS OF ALL RESPONSIBILITIES SHOULD AN ARTIST RELOCATE OR FAIL TO COMPLETE WORK AND HOLD THE ARTIST RESPONSIBLE FOR COMPLETION OR COMPENSATION.
I REPRESENT AND WARRANT TO CRYBABY STUDIOS THAT THE FOLLOWING INFORMATION IS TRUE AND CORRECT.
Previous
NEXT
Submit
Press
Enter
10
PLEASE READ & CONFIRM SHOP POLICY
*
This field is required.
48 hours notice required to reschedule with consideration of special circumstances. Deposits are not refundable with consideration of special circumstances. One reschedule is allowed under the deposit, more than one reschedule that is at the request of the client and not the artist will require a new deposit. Special circumstances will be considered for a second reschedule. We allow a 20 minute lateness grace period, any later will require the appointment to be rescheduled. New deposit is required if client no-shows. No guests may accompany clients unless previously approved until further notice. Masks or facial coverings which cover both the nose and mouth are required inside the shop at all times (unless stated otherwise).
.
Previous
NEXT
Submit
Press
Enter
11
Name
*
This field is required.
First Name
Last Name
Previous
NEXT
Submit
Press
Enter
12
Age
*
This field is required.
Previous
NEXT
Submit
Press
Enter
13
Birthday
*
This field is required.
-
Date
Year
Month
Day
Previous
NEXT
Submit
Press
Enter
14
Address
*
This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Previous
NEXT
Submit
Press
Enter
15
Phone Number
*
This field is required.
Area Code
Phone Number
Previous
NEXT
Submit
Press
Enter
16
Email
*
This field is required.
example@example.com
Previous
NEXT
Submit
Press
Enter
17
Signature
*
This field is required.
Clear
Previous
NEXT
Submit
Press
Enter
18
Upload Your ID
*
This field is required.
Previous
NEXT
Submit
Press
Enter
19
How did you hear about us?
A Friend
Instagram
Yelp
Google
Other
Previous
NEXT
Submit
Press
Enter
20
Please Read & Agree to our Updated Shop Terms and Conditions
*
This field is required.
48 hours notice required to reschedule with consideration of special circumstances. Deposits are not refundable with consideration of special circumstances. One reschedule is allowed under the deposit, more than one reschedule that is at the request of the client and not the artist will require a new deposit. Special circumstances will be considered for a second reschedule. We allow a 20 minute lateness grace period, any later will require the appointment to be rescheduled. New deposit is required if client no-shows. No guests may accompany clients unless previously approved until further notice. Masks or facial coverings which cover both the nose and mouth are required inside the shop at all times (unless stated otherwise).
Previous
NEXT
Submit
Press
Enter
21
You are acknowledging that you are willingly visiting Cry Baby Studios
*
This field is required.
YES
NO
Previous
NEXT
Submit
Press
Enter
22
Our Artists
Simba
Chris
Terrence
Dr. Z
Simba
Chris
Terrence
Dr. Z
Who would you like to see?
Previous
NEXT
Submit
Press
Enter
23
Tattoo Description
Describe the tattoo you want. The size, color, location of your body. Let us know if it's a cover up or add on, and any other information that can help us design it for you.
Attach reference photos on the next screen
Previous
NEXT
Submit
Press
Enter
24
Reference Photos
Please include any reference photos you have. This gives us an idea of what you are interested in. Send as many as you want.
Drag and drop files here
Select files to upload
Max. file size
: 10.6MB
Add Photos
Cancel
of
Previous
NEXT
Submit
Press
Enter
25
Contact Method
*
This field is required.
What is the best way to contact you and what time of day? Text, phone, email whatever your comfortable with.
Previous
NEXT
Submit
Press
Enter
26
Preferred Date
*
This field is required.
When you would like your tattoo done, and what time of day your are available. Keep in mind weekends fill up fast so please provide a range of dates as well.
Previous
NEXT
Submit
Press
Enter
27
Signature
*
This field is required.
Clear
Previous
NEXT
Submit
Press
Enter
28
Do you have any of the following symptoms?
*
This field is required.
FEVER
DRY COUGH
BODY ACHES
SORE THROAT
TIREDNESS
HEADACHES
RUNNY NOSE
SHORTNESS OF BREATH
NONE OF THE ABOVE
Previous
NEXT
Submit
Press
Enter
29
HAVE YOU BEEN ON CONTACT WITH ANYONE WHO HAS A CONFIRMED CASE OF COVID 19 IN
*
This field is required.
YES
NO
Previous
NEXT
Submit
Press
Enter
30
IF YOU ARE A HEALTHCARE PROFESSIONAL AND THE ANSWER IS YES TO ANY PREVIOUS QUESTION, WAS THIS EXPOSITE WITHOUT PERSONAL PROTECTIVE EQUIPMENT?
*
This field is required.
YES
NO
Previous
NEXT
Submit
Press
Enter
31
HAVE YOU TRAVELLED OUT OF THE COUNTRY IN THE LAST 14 DAYS?
*
This field is required.
YES
NO
Previous
NEXT
Submit
Press
Enter
32
I HEREBY AGREE THAT CRYBABY STUDIOS HAS A PROPER PLAN IN PLACE AND ADHERES TO COVID PROTOCOLS
*
This field is required.
I ALSO AGREE THAT IF I BECOME SYMPTOMATIC WITHIN 14 DAYS OF MY VISIT, I WILL NOTIFY MY ARTIST OR OTHER REPRESENTATIVE OF THE BUSINESS IMMEDIATELY.
Clear
Previous
NEXT
Submit
Press
Enter
Should be Empty:
Question Label
1
of
32
See All
Go Back
Submit