Tattoo Consent Form

1
I have been fully informed of the inherent risks associated with getting a tattoo. Therefore, I fully understand that these risks, known and unknown, can lead to injury including but not limited to: infection, scarring, difficulties in the detection of 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 wish to proceed with the tattoo procedure and application and freely accept and expressly assume any and all risks that may arise from tattooing.* This field is required.
I AGREE
2
I WAIVE AND RELEASE to the fullest extent permitted by law any person of STABBY ANGEL from all liability whatsoever, including but not limited to, 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 STABBY ANGEL, or otherwise.* This field is required.
I AGREE
3
STABBY ANGEL has given me the full opportunity to ask any question about the procedure and application of my tattoo and all of my questions, if any, have been answered to my total satisfaction.* This field is required.
I AGREE
4
STABBY ANGEL has given me instructions on the care of my tattoo while it's healing. I understand 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 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.* This field is required.
I AGREE
5
I am not under the influence of alcohol or drugs, and I am voluntarily submitting to be tattooed by STABBY ANGEL without duress or coercion.* This field is required.
I AGREE
6
I do not suffer from diabetes, epilepsy, hemophilia, heart condition(s), nor do I take blood thinning medication. I do not have any other 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 or piercing. I am not pregnant or nursing. I do not have a mental impairment that may affect my judgement in getting the tattoo.* This field is required.
I AGREE
7
STABBY ANGEL is not responsible for the meaning or spelling of the symbol or text that I have provide to them or chosen from the flash (design) sheets.* This field is required.
I AGREE
8
Variations in color 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 colors 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.* This field is required.
I AGREE
9
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.* This field is required.
I AGREE
10
I agree that STABBY ANGEL has a NO REFUND policy on tattoos, piercing and/or retail sales and I will not ask for a refund for any reason whatsoever.* This field is required.
I AGREE
11
I agree to reimburse STABBY ANGEL for any attorneys' fees and costs incurred in any legal action I bring against STABBY ANGEL and in which either the Artist of STABBY ANGEL is the prevailing party. I agree that the courts of located in the County of BROOKLYN/QUEENS/MANHATTAN within the State of NEW YORK shall have jurisdiction and venue over me and shall have exclusive jurisdiction for the purposes of litigating any dispute arising out of or related to this agreement.* This field is required.
I AGREE
12
I acknowledge that I have been given adequate opportunity to read and understand this document that it was not presented to me at the last minute and grasp that I am signing a legal contract waiving certain rights to recover damages against STABBY ANGEL. 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 and identification) and am competent to sign this Agreement.* This field is required.
I AGREE
13
I HAVE READ THE AGREEMENT, I UNDERSTAND IT, AND I AGREE TO BE BOUND BY IT.* This field is required.
First Name
Last Name
14
DATE OF BIRTH* This field is required.
Date
Month
Day
Year
15
ADDRESS* This field is required.
Street Address
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16
SIGNATURE* This field is required.
17
TODAY'S DATE* This field is required.
Date
Month
Day
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18
IDENTIFICATION (DRIVER'S LICENSE/PASSPORT)* This field is required.
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