Hustler's Daughter Release Form 11.2024

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ID frontPlease take a photo of the front of your ID
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ID backPlease take a photo of the back of your ID
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Full Name* This field is required.
First Name
Last Name
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Age* This field is required.
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Date of Birth* This field is required.
Date
Month
Day
Year
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Phone Number* This field is required.
Area Code
Phone Number
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Email* This field is required.
example@example.com
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Mailing Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Are you under the influence of drugs or alcohol?* This field is required.
Yes
No
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Are you pregnant or nursing?
Yes
No
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Do you have a communicable disease?* This field is required.(If yes, you can discreetly discuss with your artist.)
Yes
No
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Skin conditions (e.g. rash, eczema, infection, psoriasis, etc.)
If yes, please identify the condition.
13
Medical History (e.g. DIabetes, Cardiovascular Disease, Epilepsy, Blood-related disease etc.)
If yes, please identify the condition.
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* This field is required.
I am aware of the potential risks associated with getting a tattoo, and still wish to proceed with the tattoo process. I freely accept any and all risks that may arise from tattooing. These inherent risks include but are not limited to: infection, scarring, difficulty in detecting skin conditions/illnesses, and allergic reactions.
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* This field is required.
To my knowledge I do not have any mental or physical impairment, disability, or health condition which could affect my wellbeing as a direct/indirect result of getting tattooed.
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* This field is required.
I agree to waive and release each of the Artists and Hustler's Daughter Tattoo Studio from all liability whatsoever, for any and all claims or legal causes of action that I, my legal representatives, 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 and all damages, costs of litigation, attorney’s fees, and all other costs which may arise from my decision to get a tattoo by a representative of Hustler's Daughter Tattoo Studio.
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* This field is required.
I agree that Hustler's Daughter Tattoo Artists have given me instructions to care for my healing tattoo and I understand and will comply with these instructions. I am aware that infection can occur due to improper aftercare. 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. Without aftercare negligence, touch-ups are free up to a year after the tattoo is finished.
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* This field is required.
I am voluntarily submitting to be tattooed by the Artist without duress or coercion.
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* This field is required.
Neither the Artist nor Hustler's Daughter Tattoo Studio is responsible for the meaning or spelling of the symbol or text that I have provided to them. I have reviewed the design and agree that it is what I want.
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* This field is required.
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 pigment is dark, the colors may appear differently than on lighter pigment. If my skin contains melanin, I received suggestions from my artist of which colors work best with my individual tone at the time of my consultation.
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I release all rights to any photographs taken of my tattoo.
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* This field is required.
I hereby declare that I am at least 18 years of age and have provided valid identification with proof of age.
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Type a question* This field is required.
I understand that Artists at Hustler's Daughter Studio possess the right to refuse service - even during the tattoo session - if a client initiates or participates in intimidating, harassing, abusive, discriminatory, derogatory, or demeaning speech, conduct, particularly those related to sex, gender, sexual orientation, race, ability, age, cultural background, education, ethnicity, immigration status, language, nationality, national origin, physical appearance, economic status, or religion, violence, threats of violence, or violent language or symbols directed against another person, lewd or offensive behavior or language, including but not limited to using sexually explicit or offensive language, materials or conduct, or any language, behavior, or content that contains profanity, obscene gestures, or racial, religious, or ethnic slurs.
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* This field is required.
I agree that I have been given adequate opportunity to read and understand this document, and I understand that I am signing a legal contract waiving certain rights and releasing all artists of Hustler's Daughter Tattoo Studio from liability for my decision to get tattooed.
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* This field is required.
I confirm that the information I provided in this document is accurate and true.
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Signed Date* This field is required.
Date
Month
Day
Year
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Participant Signature* This field is required.
Clear
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