TATTOO CONSENT & RELEASE FORM

Name
Date of Birth

DayMonthYear
2 digit day, 2 digit month, 4 digit year
Email
Mobile Number
Format: 0000 000 000.
Address

Street Address 1

Street Address Line 2

CityState / Province

Postal / Zip Code
Please attach a copy of your photo ID

Cancelof
Signature
Who will be tattooing you today?
Have you eaten in the last 4 hours?
Have you consumed any alcoholic beverages in the last 8 hours?
Are you prone to fainting?
Are you prone to heavy bleeding?
Have you taken any prescription drugs, medication or recreational drugs in the last 24 hours? If "YES", what?

YES
Have you taken aspirin, nurofen, or anticoagulants within the last 24 hours? If ‘YES’, what?

YES
wE OFTEN TAKE PHOTOS AND VIDEOS FOR SOCIAL MEDIA WITHIN THE STORE, WHICH MIGHT MEAN YOU ARE IN THE BACKGROUND OR INVOLVED IN A VIDEO ETC. ARE YOU COOL WITH BEING RECORDED AND REPOSTED? (YOUR ARTIST WILL DISCUSS ANY PERSONALISED CONTENT CREATION ABOUT YOUR PROJECT DIRECTLY)
Today's date

DayMonthYear
2 digit day, 2 digit month, 4 digit year
In consideration of receiving a tattoo from my chosen artist
at the premises of Westside Tattoo Brisbane, and together with all employees, proprietors and agents, I agree to the following provisions in our terms and conditions.
I, First Name* Last Name* waive and release to the fullest extent permitted by law, each of the artist, the tattoo studio, its employees, proprietors and agents from all liability whatsoever, for any and all claims or causes of action or demand that 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 application of my tattoo.
(IF REQUESTING SCRIPT/TEXT/WORDS/LETTERING
AS A TATTOO, please clearly print the exact spelling/grammar of your requested
piece
Aftercare Instructions
Should be Empty: