Tattoo Consent & Release Form
Flying Eye Tattoo Studio, LLC
Name
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First Name
Last Name
Date of Birth
*
MM/DD/YYYY
Age
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Emergency Contact Number
*
Please enter a valid phone number.
Driver's License Number / ID Number
*
Acknowledgement
I acknowledge by signing this agreement that I have read this form thoroughly, and that I have been given the full opportunity to ask all questions which I might have about the obtaining of a tattoo / piercing and that all my questions have been answered to my full satisfaction.
By clicking the circles, you are agreeing to the following:
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I am at least 18 years old.
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I understand that TATTOOS ARE PERMANENT.
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I understand there is a possibility of an allergic reaction, infection, or other skin problems.
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I acknowledge that it is not possible for the artists and employees of Flying Eye Tattoo Studio, LLC to determine whether I may have an allergic reaction to the pigments or processes used in my tattoo and agree to accept the risk that such a reaction is possible.
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I agree that the said tattoo is drawn to my specifications and take responsibility for the correctness of the artwork once placed on my body.
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I agree to allow for ARTISTIC INTERPRETATION.
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I acknowledge that I have received aftercare instructions and understand that it is necessary to follow these instructions. I acknowledge that once leaving here today it is up to me to take proper care of my tattoo / piercing.
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I consent to the application of this tattoo and to any actions or conduct of the representatives and artists necessary to perform the procedure.
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I am not under the influence of drugs or alcohol.
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I understand that I may feel lightheaded, dizzy, or faint due to my decision to be tattooed. I agree to immediately inform the artist if I feel lightheaded, dizzy and/or faint before, during or after the procedure. Failure to do so releases Flying Eye Tattoo Studio and its artists of all responsibility.
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I hereby release and forever discharge Flying Eye Tattoo Studio and its artists, past or present, from all claims, demands, damages, and actions arising from the application of this tattoo / piercing.
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I hereby release Flying Eye Tattoo Studio and its artists, past or present, from any liability for any medical problems, which may arise from infection, or other problems related to the application of the tattoo / piercing.
Initial here to acknowledge your agreement to this Consent and Release Form
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Initials
Artist Name
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Christian Oropeza
Billy Cerrato
Victor Figueroa
Andy Quiroz
Cesar Theis
Hayden Jilek
Location
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La Familia Tattoo Parlor (Spring, TX)
Flying Eye Tattoo Studio (Montgomery, TX)
Walk-In
Please Select
Yes
No (Appointment)
Submit
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