Consent Form

In consideration of receiving a tattoo from
(Tattoo Artist)*and Remedy Tattoo (and it’s employees, apprentices and agents, here and after collectively referred to as “Remedy Tattoo”), I agree to the following:

I,(Type Name)*have been fully informed of the inherent risks associated with getting a tattoo. I fully understand that these risks, known and unknown, can lead to injury, including but not limited to infection, scarring and allergic reactions to tattoo pigment, latex gloves and/or soap. Having been informed of the potential risks associated with getting a tattoo, I, (Type Name)* still wish to process
with the tattoo procedure and application and freely accept and expressly assume any and all risks that may arise from being tattooed.

I WAIVE AND RELEASE to the fullest extent and permitted by law each of the Artist and Remedy Tattoo from all liability whatsoever, for 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 Artist or Remedy Tattoo, or otherwise.

Both the Artist and Remedy Tattoo have given me the full opportunity to ask any and all questions about the procedure and application of my tattoo and all of my questions have been answered to my total satisfaction.

The Artist and Remedy Tattoo will provide me with written and verbal instructions on the care of my tattoo while it’s healing. I agree to follow their instructions to the best of my ability and to ask if I have any questions or concerns. I acknowledge that it is possible that the tattoo can 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 work will be done at my own expense.

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

I do not have diabetes, epilepsy, hemophilia, a heart condition, nor do I take blood thinning medication. I do not have any medical or skin condition 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 prescribed preventative regimen of antibiotics that is required by my doctor in advance of any invasive procedure such as tattooing. I am not pregnant or nursing. I do not have mental impairment that may affect my judgment on getting the tattoo.

Neither the Artist nor Remedy Tattoo is responsible for the meaning or spelling of the symbol or text that I have requested and/or provided to them, resulting in the final tattoo design, which I have seen and consented to prior to the tattoo procedure and application.

Variations in colour and design may exist between the tattoo art/design I have selected and the actual tattoo when it is applied to my body. I also understand that over time the colours and the clarity of my tattoo will fade due to unprotected exposure to the sun and naturally occurring dispersion of the pigment under the skin.

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.

I understand that if I have any future skin treatments, laser hair removal, plastic surgery or other skin altering procedures, it may result in adverse changes to my tattoo.

I release the right to any photographs taken of me and the tattoo and give consent in advance to their reproduction in the print or electronic form. (if you do not initial this provision, please inform your Artist and Remedy Tattoo NOT to take any pictures of you and your completed tattoo).

I agree that Remedy Tattoo has a NO REFUND policy on tattoos and I will not ask for a refund for any reason whatsoever

I understand that the applicable 5% GST tax is included in the Artist’s hourly rate.

I acknowledge that I have been given adequate opportunity to read and understand the document, and I understand that I am signing a legal contract waiving certain rights to recover against the Artist and Remedy Tattoo. 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 an identification) and am competent to sign this Agreement.

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

BOUND BY IT

Print Full Name:
First and Last Name*

Date of Birth: (DD/MM/YYYY)*

Telephone:
(1+)*

Date (DD/MM/YYYY): Todays Date*

Take Photo *Required*

Signature*

WAIVER, RELEASE AND CONSENT TO TATTOO