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The Coven
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Today's Date:
Tue Feb 11 2025 01:56
Tattoo Release Agreement
Tattoo Studio: The Coven LLC, an Alaska limited liability company with its principal place of business at 3820 Lake Otis Pkwy, Anchorage, AK 99508
Tattoo Studio includes everyone who is acting on behalf of the Tattoo Studio, including its artists, associates, apprentices, agents, or employees.
I, the Client named below, desire to receive a tattoo(s) from the Tattoo Studio. In consideration for receiving the tattoo(s) from the Tattoo Studio, I agree to the following:
1. Client’s Statement of Risks:
I understand that getting a tattoo involves puncturing my skin with needles and inserting ink. I acknowledge that I have been fully informed of the inherent risks associated with getting a tattoo, including but not limited to: infection (bacterial, viral, etc.), allergic reaction, scarring, discomfort or pain, bleeding, transmission of bloodborne diseases (which the Tattoo Studio mitigates by following proper sterilization procedures), difficulties in the detection of melanoma, and all other inherent risks associated with receiving a tattoo. Having been informed of the potential risks associated with getting a tattoo, I nevertheless voluntarily choose to proceed with the tattoo procedure and application and freely accept and expressly assume all risks arising out of receiving a tattoo(s), including those risks not expressly stated in this document.
2. Client’s Statement of Health:
I hereby represent that I have had the opportunity to consult my physician about receiving a tattoo(s) and that I am in good health and free from any conditions that could increase the risks of tattooing, including but not limited to: (i) active skin conditions (eczema, psoriasis, etc.), (ii) diabetes, (iii) hemophilia or other bleeding disorders, (iv) weakened immune system, (v) heart conditions, (vi) being on blood thinning medication, and (vii) all other health conditions that might increase the risks of tattooing. If I am not free from any of the conditions listed above, I represent that I have consulted my physician and have been informed of the proper precautions I need to take to safely receive the tattoo(s) and the proper after care treatments to properly heal. I represent that I am not pregnant, am not under the influence of drugs or alcohol, and am not mentally impaired in any way and that my judgment in getting the tattoo(s) is not in any way affected. I represent that I have informed the Tattoo Studio if I have any of the conditions listed above or any other health condition that the Tattoo Studio should know so that the Tattoo Studio can take proper precautions during the procedure and provide me with additional after care instructions. I acknowledge that the Tattoo Studio will keep any such information confidential and not disclose it to anyone else except for emergency purposes as authorized in this agreement.
I hereby grant permission to the Tattoo Studio to administer emergency first aid, CPR, or AED and to transport me or secure emergency transport or medical care if the Tattoo Studio decides it’s necessary to do so. The Tattoo Studio may also release any medical information they have about me in such an event. I hereby voluntarily release the Tattoo Studio from all claims, demands, or related causes of action.
3. Consent:
I acknowledge that I have carefully reviewed the design of the tattoo(s) I am to receive and give my full consent for the Artist named above to perform the described tattoo(s). I understand the Tattoo Studio is not responsible for the meaning or spelling of the symbols or text I have provided to them for the design of the tattoo(s) described above. I understand that variations in color and design may exist between the tattoo(s) design I have selected and the actual tattoo when it is applied to my body. I understand that over time, the colors and clarity of my tattoo will fade. I understand that tattooing is a permanent form of body modification and that removal is expensive, difficult, and may leave scars or disfigurement. I understand that no refunds will be given for the tattoo(s) for any reason.
4. Express Assumption, Waiver, and Release (Including Negligence Claims):
I hereby voluntarily accept and assume all of the risks related to getting a tattoo. This means I’m not just assuming the inherent risks of the activity but rather I’m assuming all of the risks of the activity, even those not expressly stated in this document. I hereby voluntarily release the Tattoo Studio from all claims, demands, or causes of action related to my participation in getting a tattoo, including claims that alleges negligent acts or omissions on the part of the Tattoo Studio and claims related to intellectual property rights. I also agree to pay for all of the Tattoo Studio’s attorney’s fees and costs to enforce this agreement. With this release I know that I’ll have to pay for all of my financial losses related to getting a tattoo even if the Tattoo Studio is at fault.
5. Grant of Permission & Assignment of Recording:
I hereby grant permission to the Tattoo Studio to take any type of recording of me such as photos, video, or audio while participating in the tattoo(s) procedure and to use the recording however it wants in all media throughout the world in perpetuity without paying me. I hereby assign all of my interests in such media to the Tattoo Studio.
6. Acknowledgement of Receipt of After Care Instructions:
I hereby acknowledge that Alaska law requires the Tattoo Studio to provide me with the following written instructions for the care of my tattoo(s) during the healing process:
a. leave the moisture barrier covering on overnight; remove in the morning and wash tattoo with mild soap and warm water;
b. gently massage lotion or ointment into the tattoo 6 times a day for at least 10 days and to not wear tight clothes, elastic, nylons, or panty hose for 2 weeks;
c. not get the tattoo wet for one week except for a daily gentle wash (short showers only); no bathing, hot tubs, or swimming;
d. keep tattoo out of the sun for 3 weeks;
e. be aware that tattoos will peel like a sunburn in 2-5 days.
I further acknowledge that Tattoo Studio has advised me to consult a physician at the first sign of infection.
7. Statements About my Signature:
I hereby represent that I am at least 18 years of age and legally competent to enter this agreement. I acknowledge that I have been given adequate opportunity to read and understand this agreement and that I have not been coerced or pressured in any way to sign it. I am signing this agreement voluntarily. I have had full opportunity to ask questions about the procedure and application of the tattoo(s) and have no further questions. I know that by signing this document that a court of law may find that I have waived my rights as specified in this document. If any part of this agreement is determined to be unenforceable, the remaining parts are to be enforced. Alaska law controls this agreement. Venue for all disputes is Anchorage, Alaska. Waivers must be in writing. No clause is to be construed against the Tattoo Studio or Client since this agreement was negotiated in the spirit of mutual cooperation. Neither party is liable for force majeure events. Captions are for convenience only.
I HAD ENOUGH TIME TO READ THIS DOCUMENT. I HAVE READ AND UNDERSTAND IT AND I AGREE TO BE BOUND BY ITS TERMS.
Please read and answer
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Name of your artist:
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Location of tattoo on body:
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Short description of tattoo:
Any medical conditions or allergies you’d like us to be aware of? Please also inform us of these in person at your appointment.
We have apprentices in the studio now, check this box if you are comfortable with them coming in to observe during this session.
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.
Client Information
I hereby declare that I am of legal age (with valid proof of age) and am competent to sign this Agreement.
Legal Name:
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Pronoun:
-select-
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Chosen name:
Address:
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Postcode:
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Date of birth:
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You must be 18 or older
Phone #:
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Email:
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Signature:
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Sign above or type signature:
Parent/Legal Guardian
I, as custodial parent or legal guardian of the above minor under -18 years of age, hereby consent to the terms and conditions set forth in this release form and I attest that all documentation I have provided is true and accurate.
Guardian's Legal Name:
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Signature:
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Emergency Contact
If something happens, your emergency contact might need to explain your medical history, allergies, or medications.
Name:
Phone #:
Photo ID
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Please take photo(s) of your government issued photo IDs and related paperwork.
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