Tiny Tattoo Form

Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.

Todays Date

Date

In consideration of receiving a tattoo from Yem at Stelletta Beauty, including all artists, apprenticeships, employees (hereinafter referred to as the "tattoo studio" I agree to the following

I the client, have been fully informed of the inherit risk 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 dictation of melanoma and allergic reactions to tattoo, pigments, latex, gloves, and or soap having been informed of the potential risk associated with getting a tattoo I wish to proceed with the tattoo, procedure and application and freely accept and expressively, assume any and all risks that may arise from tattooing

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I wave and released 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 hers, 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, were caused by the negligence or fault of either the tattoo studio or otherwise.

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The tattoo studio has given me the full opportunity to ask any questions about the procedure and application of my tattoo and all of my questions if any have an answer to my total satisfaction

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The 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 partially if I do not follow the instructions given to me. if any touchup work to the tattoo is needed due to my own negligence. I agree that the work will be done at my own expense

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I am not under the influence of alcohol or drugs, and I am voluntary submitting to be tattooed by the tattoo studio without duress or coercion

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I do not suffer from diabetes, epilepsy, hemophilia, heart conditions, nor do I take blood thinning medication. I do not have any other medical or skin conditions that may interfere with the procedure application or healing of the tattoo. I am not the recipient of an organ or bone marrow transplant or if I am, I have taken the prescribe preventative regiment of antibiotics that is required by my doctor in advance of any invasive procedure such as tattooing or piercings, I am not pregnant or nursing. I do not have a mental impairment that may affect my judgment in getting the tattoo.

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Stelletta Beautt is not responsible for the meaning or spelling of the symbol or text that I have provided to them or chosen from the flash design sheet

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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 overtime, the color and the clarity of my tattoo will fade due to unprotected exposure to the sun and the natural occurring dispersion of pigment under the skin

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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

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I release the right to any photographs taken of me and the tattoo and give consent in advance to their reproduction and print or electronic form for assurance. If you do not initial this provision, please inform the tattoo studio, not to take any pictures of you and your completed tattoo

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I agree that the tattoo studio has a NO REFUND policy on tattoos, piercings and or retail sales and I will not ask for a refund of any reason whatsoever

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I agree to reimburse the tattoo studio of any attorney fees, and cost in current in any legal action I bring against the tattoo studio, and in which either the artist of the tattoo studio is the prevailing party, I agree that the court of location in the country of Canada within the province of British Columbia shall have jurisdiction and venue over me and shall I have exclusive jurisdiction for the purpose of litigating any disputes arising out of or related to this agreement

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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, waving certain rights to recover damages against the tattoo studio

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if any provision selection, subsection clause or phrase of this release is found to be under unenforceable or invalid that portion shall be served from this contract. The remainder of this contract will then be constructed as through the unenforceable portion had never been contained in this document.

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I hear by a declare that I am of legal age and have provided valid proof of age and identification and am competent to sign this agreement

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

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Name

First NameLast Name

Date of Birth

Date

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