Language
English (US)
Spanish (Latin America)
Inkxeption Studio Tattoo LLC
5600 NW 7th Ave, Miami, Florida, 33127 - contact@inkxeption.com - https://inkxeption.com - +1 (786) 397-0501
Release Form
Full Name
First Name
Last Name
Email
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Phone Number
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DOB
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Month
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Day
Year
Date of birth
Address
Street Address
Apartment / Unit #
City
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Postal / Zip Code
Description and Location of tattoo
Check which applies to you:
Diabetes
Glaucoma
HIV
History of hepatitis
History of heart disease
History of heart attack
History of bleeding disorders
Eye disease/infection
Fainting Spells
Pregnancy
List any skin conditions:
Please read and Agree to the following terms and conditions:
I understand and agree to follow the aftercare instructions provided by the artist/studio.
I acknowledge the risks associated with tattooing, including injuries, infections, scarring, and allergic reactions. Despite this, I wish to proceed and assume all associated risks.
I understand and take full responsibility for the symbols or text chosen for my tattoo. I confirm sobriety and consent to the tattoo willingly.
I consent release all rights to photographs or videos of me and my tattoo, consenting to their reproduction.
I read and consent all of above
Artist Name
Please Select
Luis Carmona
Lourdes Mejias
Daniel Rivas
Victor Mantilla
Dayana Aguin
Date:
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