Tattoo Release Form

Let us do this part

Today's Date:

Mon Dec 23 2024 08:11

Practitioner:*

Welcome to Contender Tattoo Studio.

Please read through this release form and answer the following questions accurately.

You will need to fill out this release form every time a service is provided.

Please read and answer

Tattoo Location*

Where is the tattoo being placed on your body? If multiple locations, please list them. If unsure, a general answer like "left arm" will suffice. This answer is required by the state.

(Example: left arm)

Procedure Time*

Please write your estimated procedure time. Your best guess is fine, this is required by the state.

(Example: two hours)

Diabetes*

Are you a diabetic? This will not prevent you from being tattooed, but you may require extra instructions from your artist. You may experience slower and varied healing.

Pregnancy or Nursing*

Are you pregnant, or currently breastfeeding/nursing? If yes, you are not eligible to be tattooed under Kansas state law.

There is a risk of potential infection being spread through breast milk to your child if you receive a tattoo and are breastfeeding. Please answer this question accurately, your appointment can be rescheduled to a later date.

Blood Sugar*

Have you eaten a meal in the past 1-2 hours? More than a light snack is recommended. If you answer No, you may be asked to eat prior to your tattoo.

It's a good idea to eat before getting a tattoo, it helps keep your blood sugar stable.

Please let your artist know if you have any blood sugar disorders.

Please enter when you last ate prior to this appointment.

(Example: 12pm)

Details:

Payment*

Do you have payment available for your tattoo? Cash, Venmo, and Cash App are currently accepted forms of payment.

Your deposit will be applied to the total fee, and the remainder is due at the end of your service.

Communicable Diseases*

Do you have any bloodbourne pathogens, transmittable diseases or recent illnesses?

These include: Common illness or sickness, HIV, Hepatitis, Staph infections, open lesions, cold sores or fever blisters.

Risks*

I 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, ink spreading under the skin (known as a blowout), changes in skin texture, difficulties in detecting melanoma, and allergic reactions to tattoo pigment, latex gloves, metal equipment and soap.

I understand that pigment and materials coming into contact with my body may produce undesirable or unforeseen conditions in the future.

I understand that healing can be unpredictable and can have unknown results. I will consult a medical professional if the need arises, and at my own expense treat any medical conditions, infections, or ailments as a result of being tattooed.

Having been informed of the potential risks, I still wish to proceed with the tattoo application and I freely accept and expressly assume any and all risks associated with being permanently tattooed.

Waiver*

I do WAIVE AND RELEASE to the fullest extent permitted by law all contracted artists and Contender Tattoo Studio 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 result or arise from my tattoo, whether caused by the negligence or fault of either the contracted artist or Contender Tattoo Studio, or otherwise.

Healing*

I have received instructions for the care of my tattoo while it is healing (both written and verbal), and I understand them and will follow the instructions provided.

I acknowledge that it is possible for the tattoo to 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.

Influence*

I am not under the influence of alcohol or drugs, and I am voluntarily submitting myself to be tattooed by the contracted artist without duress or coercion.

Health Conditions*

I do not have epilepsy, hemophilia, a heart or lung condition, nor do I take blood thinning medication. I do not have any other condition that may interfere with the application or healing of the tattoo.

I do not have a mental impairment that may affect my judgment in getting the tattoo.

Spelling and Location*

Neither the contracted artist nor Contender Tattoo Studio is responsible for the meaning or spelling of the symbol or text that I have provided to them or chosen for myself.

Any information I provide (including dates) is my responsibility and I will not hold Contender Tattoo Studio liable for any omissions, errors, or mis-spelling that may occur.

I am ultimately responsible for the correct placement of the tattoo on my body, and will not hold Contender Tattoo Studio liable for any variance in appearance or positioning of the tattoo on my body.

I give my express permission to the contracted artist to position and apply the tattoo to my body.

Fading*

Variations in color and design may exist between the art I have selected and the actual tattoo.

I understand that over time, the colors and the clarity of my tattoo will fade due to natural dispersion of pigment under the skin.

I understand that there are many variables known and unknown that may impact the appearance and condition of the tattoo, including ultraviolet (sun) exposure.

Permanent Change*

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.

If I choose to remove or alter my tattoo in any way, I do so at my own expense and liability.

Legal Action*

I agree to reimburse each of the contracted artists and Contender Tattoo Studio for any attorneys' fees and costs incurred in any legal action I bring against either the contracted artist or Contender Tattoo Studio and in which either the artist or Contender Tattoo Studio is the prevailing or losing party.

I agree that the courts of Kansas in the United States of America shall have personal jurisdiction and venue over me and shall have exclusive jurisdiction for the purpose of litigating any dispute arising out of or related to this agreement.

Accuracy and Timely Response*

I acknowledge that I have been given adequate opportunity to read and understand this document, that any and all of my questions have been answered, that it was not presented to me at the last minute.

I understand that I am signing a LEGAL CONTRACT waiving certain rights to recover against the contracted artist and Contender Tattoo Studio.

I have answered all questions accurately, with soundness of mind.

Photography / Video*

I release all rights to any photographs and / or video taken of myself and the tattoo at Contender Tattoo Studio.

I give consent in advance to their reproduction and use in print or electronic form.

How did you hear about Contender Tattoo Studio?

This is not required, but thanks for sharing!

Cover Up Tattoos*

Do you have a tattoo that will be covered up during this session?

If so, please Tap "Additional Photo" under Photo ID, to add a 'before' picture of your current tattoo that will be covered up.

Apprentice in Training

Are you willing to allow an apprentice in training to view your tattoo being completed, and allow the apprentice to assist in the setup or finalization of your procedure?

The apprentice will not actively be tattooing you unless you are scheduled with them to do so.

Apprentice Tattoo Release

Check this box if you are being tattooed by a tattoo apprentice. By checking this box, you understand that your resulting tattoo may differ from a tattoo created by a fully licensed artist and by checking this box and signing this release form will not hold the apprentice, trainer, or Contender Tattoo Studio responsible for any errors or problems arising from this procedure.

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:*

Chosen name:

Address:*

Postcode:*

Date of birth:*

You must be 18 or older

Phone #:*

Email:*

Signature:*

Sign above or type signature:

Photo ID*

Please take photo(s) of your government issued photo IDs and related paperwork.