I, Legal name*, the client, hereby acknowledge and understand the potential risks associated with receiving a handpoked tattoo. By signing this waiver, I agree to release and discharge the tattoo artist, Alyson Golub (Inky Algae LLC) from any liability or legal claims arising from the handpoked tattoo procedure.

I acknowledge that by signing this agreement that I have been given the full opportunity to ask any and all questions which I might have about obtaining a handpoked tattoo and that all of my questions have been answered to my full satisfaction.

I specifically acknowledge that I have been advised of the facts and matters set forth below and I agree as follows:

Inherent Risks: I understand that tattooing involves the penetration of the skin using needles and pigments. Handpoked tattoos, in particular, utilize a manual method and may have specific risks compared to machine tattoos. These risks include, but are not limited to:

• Pain or discomfort during the procedure
• Potential for uneven lines, shading, or color distribution
• Risk of scarring or keloid formation
• Infection, allergic reaction, or skin irritation
• Possibility of ink spreading or fading over time

Health Risks: I certify that I am in good health and free from any medical conditions that may interfere with the tattooing process or increase the risk of complications. I acknowledge that the tattoo artist has recommended that I consult with a medical professional if I have any concerns regarding my health and before getting a handpoked tattoo.

Sterilization and Sanitation: I understand that the tattoo artist will follow strict sterilization and sanitation practices to minimize the risk of infection. This includes using new and sterilized needles, disposable gloves, and sanitizing all equipment and surfaces. I acknowledge that I will follow the aftercare instructions provided by the tattoo artist to promote proper healing and minimize the risk of infection.

Consent to Tattoo: I confirm that I am of legal age (18 years or older) and fully competent to give consent for the handpoked tattoo procedure.

Full Disclosure: I have disclosed any medical conditions, allergies, or medications that may affect the tattooing process or my healing ability. I understand that failure to disclose accurate and complete information may increase the risk of complications in the tattoo process.

I am not pregnant or nursing.

If I have diabetes, epilepsy, hepatitis, hemophilia, HIV-AIDS, or any other communicable disease, heart condition or take medicine which thins the blood I have advised my tattoo artist.

I do not have medical or skin conditions such as but not limited to: eczema, psoriasis, rash, infection, lesion, moles or sunburn in the area to be tattooed. If I have any type of infection, rash, or lesion anywhere on my body, I will advise my tattooist.

I am not under the influence of alcohol or drugs.

Voluntary Participation: I acknowledge that the decision to proceed with the handpoked tattoo procedure is voluntary, and I have not been coerced or pressured into getting the tattoo. I acknowledge that a tattoo is a permanent change to my appearance and that no representations have been made to me as to the ability to later change or remove my tattoo. I understand that I have the right to ask questions and seek clarification about the procedure before giving my consent.

I understand that Alyson Golub (Inky Algae LLC) reserves all rights to use any photos of tattoos taken. This includes, but is not limited to:

• Use on social media platforms (Instagram, website, etc.)
• Marketing and promotional materials (flyers, business cards, event promotions)
• Online and print portfolios

I acknowledge that these images may be shared publicly, but my personal information will not be disclosed.

By signing below, I acknowledge that I have read and understood this waiver and release form. I voluntarily assume any and all risks associated with the handpoke tattoo procedure, and I release the tattoo artist and shop from any liability or claims that may arise from the procedure.

Therefore, I request the tattoo artist, Alyson Golub (Inky Algae LLC) tattoo my Part of body being tattoed*. I understand that handpoked tattoos usually takes four weeks or longer to heal. I hereby release and forever discharge and hold harmless Alyson Golub (Inky Algae LLC), the tattoo artist from any and all claims, damages or legal actions arising from or connected in any way with my tattoo, or the procedure used in my obtaining my tattoo, to the fullest extent of the law.

By signing below, I,Legal name* agree that I have read the Tattoo Consent Form provided by Alyson Golub (Inky Algae LLC) and agree to its terms.

Printed Name: Legal name*
Date: Date of tattoo