Studio 278 consent form

STUDIO 278

CONSENT FORM
WAIVER, RELEASE AND CONSENT TO TATTOO PLEASE READ AND BE CERTAIN YOU UNDERSTAND THE IMPLICATIONS OF SIGNING THIS FORM.
Name*

First Last
DOB*
Age*
Phone Number*
Email*
example@example.com
ID type*
ID number*
You will be asked to present this ID
In consideration of receiving a tattoo from Studio 278 I agree to the following
1. That I (Please state your full 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, difficulties in detecting melanoma and allergic reactions to tattoo pigment, latex gloves and/or soap. Having been informed of the potential risks associated with getting a tattoo, I still wish to proceed with the tattoo application, and I freely accept and expressly assume any and all risks that may arise from tattooing.

2. TO WAIVE AND RELEASE to the fullest extent permitted by law, each of the Artists and Studio 278 (including all servants, staff and agents) 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 results or arise from the application of my tattoo, whether caused by the negligence of fault of either the Artists and/or Studio 278, or otherwise.

3. My artist has given me the full opportunity to ask any and all questions about the application of my tattoo and all of my questions have been answered to my total satisfaction. 4. My artist has given me instructions on the care of my tattoo while it is healing, and I understand them, and will follow them. I acknowledge that it is possible that the tattoo can become infected, particularly if I do not follow the instructions given to me. If touch up work to the tattoo is needed due to my own negligence, I agree that the work will be done at my own expenses.

4. I am not under the influence of alcohol or drugs and I am voluntarily submitting to be tattooed without duress or concern.

5. A tattoo is a permanent change to my appearance, and can only be removed by laser or surgical means, which possibly 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. Please complete the following:
I confirm, that I do not have diabetes epilepsy haemophilia a heart condition nor do I take blood thinning medication

YES, I confirmNO, Please provide details in comments at the end of this form.
I Confirm that I do not have any other medical or skin condition that may interfere with the application or healing of the tattoo

YES, I confirmNO, Provide details at the end of this form
I Confirm, that I am not the recipient of an organ or bone marrow transplant or if I am I have taken the prescribed regimen of antibiotics that is required by my doctor in advance of an invasive procedure

YES, I confirmNO, Provide details at the end of this form
I Confirm, that I am not pregnant or breastfeeding

YES, I confirmNO, Provide details at the end of this form
I Confirm, that I do not have a mental impairment that may affect my judgement in getting the tattoo

YES, I confirmNO, Provide details at the end of this form
I confirm that I am not currently taking, nor have I previously taken, any of the following medications. (If any of these medications apply to you, it is essential that you inform your artist before proceeding with the tattoo.)

Acccutane/Roaccutane (Isotretinoin)Prednisone (or any topical or oral steriod based medication - taken within the last 3 months).).WarfarinDabigatran (Pradaxa)Apixaban (Eliquis)Rivaroxaban (Xarelto)Have had Cytotoxic treatment within the last 7 daysNone of the above (I have not ever taken any of these medications
7. Neither the Artist nor Studio 278 is responsible for the meaning or spelling of the symbol or texts that I have provided to them.

8. Variations in colour,and design may exist between the tattoo art 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 the naturally occurring dispersion of pigment under the skin.

9. I release all rights to any photographs taken of me and the tattoo and give consent in advance to their repred the use by the artist/studio.

10. I agree to reimburse the Artist and Studio for any legal fees and costs incurred in any legal action I bring against either the Artists, or owners of Studio 278, and in which either the artists or studio is the prevailing party. I agree that the courts of Queensland in Australia shall have personal jurisdiction and venue over me, and shall have exclusive jurisdiction for the purpose of litigating any dispute arising out of, or relating to this agreement.

11. I acknowledge 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 to recover against the Artists and Studio 278. If any provision, section, subsection, clause or phrase of this release is found to be unenforceable or invalid, that part 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 (18 years of age or older for a tattoo and have provided valid proof of age if required) and am competent to sign this agreement

I HAVE READ THIS AGREEMENT: I UNDERSTAND IT AND AGREE TO BE BOUND BY IT.
ARTIST

Kam (k.j_tattoos)Jack (alienboyy.ink)Aaron (aaronallom13)Jozef (etched_in_graphite)Harold (hazidtattoo)Megan (meg.tatts)Nu (nuuzart)Masa (masa_ink_)Antonia (wrath bone.tattoo)Juan Castro (tattoos.jdcastro)Other
Are you currently feeling unwell or experiencing flu- like symptoms

No, I am NOT feeling unwell or experiencing flu-like symptomsYes, I AM feeling unwell/ experiencing flu-like symptoms
PRINT YOUR FULL NAME*
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Comments (If you did not Confirm to all questions please provide details below)
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STUDIO 278