Convention Flash Tattoo Consent Form New

I acknowledge by signing this agreement that I have been given the full opportunity to ask any and all questions have been answered to my full satisfaction. I specifically acknowledge I have been advised of the facts and matters set forth below and I agree as follows:

Tattoo - A Mark on a person or a part of the body with an indelible design by inserting pigment into punctures in the skin.

Full Name*

First NameLast Name

Home address:

Street Address

CityState / Province

Postal / Zip CodeCountry

ID or Drivers License #*

Birth Date*

MonthDayYear

Phone Number*

Area CodePhone Number

I acknowledge and give consent by submitting this form to be contacted via text message by Spark Project Collective about upcoming and ongoing promotions. The quantity of messages will not exceed 3 messages in any given month.

I AM AWARE THAT THIS IS FOR A SPECIAL PRICED FLASH TATTOO. Due to the special pricing no touch ups are permitted on my tattoo. If I want to have the tattoo touched up the cost will be the same as what I am paying for the tattoo today. No exceptions will be allowed.*

I agree

I acknowledge I am over the age of eighteen and that I have truthfully represented to my tattooer that I obtaining of a tattoo is by my choice alone. I consent to the application of the tattoo and to any actions or conduct of the representatives and employees of the tattoo shop reasonably necessary to perform the tattoo procedure. I acknowledge that Spark Project Collective reserves the right to record the buildings 24 hours per day inside all rooms, public areas and its surrounding parking lot to protect the staff and possible loss of any equipment and property. I DO NOT have diabetes, epilepsy, hepatitis, hemophilia, HIV-AIDS, or any other communicable disease, heart condition or take medicine which thins the blood in which I have not informed my tattoo artist of.*

Agree

I am NOT under the influence of drugs or alcohol. I acknowledge that a tattoo is a permanent change to my appearance and that no representations have been made to me as the ability to later change or remove my tattoo. To my knowledge, I do not have a physical, mental or medical impairment or disability which might affect my well being as a direct or indirect result of my decision to have a tattoo.*

Agree

I acknowledge that infection is always possible as a result of the obtaining of a tattoo, particularly in the event that i do not take proper care of my tattoo. I have received aftercare instructions and I agree to follow them while my tattoo is healing. I agree that any touch-up work needed, due to my own negligence, will be done at my own expense.*

Agree

I acknowledge it is not reasonably possible for the representatives and employees of this tattoo shop to determine whether I might have an allergic reaction to the pigments or processes used in my tattoo, and I agree to accept the risk that such a reaction is possible. I realize that variations in color and design may exist between any tattoo as selected by me and as ultimately applied to my body. I understand that if my skin color is dark, the colors will not appear as bright as they do on light skin. I understand that if I have any skin treatments such as laser hair removal, plastic surgery or other skin altering procedures, it may result in adverse changes to my tattoo. I am aware that tattoo inks, dyes, and pigments have not been approved by the federal Food and Drug Administration and that the health consequences of using these products are unknown.*

Agree

Signature*

Consent to Tattoo Procedure at Convention (Flash Tattoo Special)