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26 B. The Releasor agrees that in the event of a controversy between the Releasor and the Releasee involving a claim in court,the parties shall resolve their dispute through small claims court. C. The Releasor agrees that in the event that the Releasor prevails in a judgement against the Releasee,the Releasor agrees that the Releasor will not be entitled to a settlement that exceeds the amount paid for the work accomplished by the Releasee. D. The Releasor acknowledges receipt of pre-procedure information and post-op care instructions,has read them,has been verbally told them,understands them,and agrees to adhere to them in order to help prevent infection. E. The Releaser understands that follow up procedures maybe required 5® CNS TO PERMANENT COSME77C PROCEDURE The Releasor fully and voluntarily consents to have the release perform the permanent cosmetic procedure(s)and is fully aware and informed of all and any inherent risks,dangers,and complications that may occur as a result of the procedure(s)as described in this agreement.The Releasee has reviewed the medical history of the Releasor and has answered all of the Releasor's questions satisfactorily. 2. REL OFALL CLAIMS a. In order for the Releasee to perform any permanent cosmetic procedure on the Releasor for which the Releasee is volunteering to have performed after having been fully informed of all dangers and risks involved as described in this agreement including but not limited to swelling,allergy to pigment,pain,infection,redness,soreness,eye injury,and itching. I ,voluntarily request that the Releasee performs such procedure(s)and I,for myself,my respective heirs,assigns,administrators,personal representatives,and next of kin,hereby will forever release and hold harmless the Releasee, management, their affiliates,officers,members,agents,employees,other participants,and sponsoring agencies from and against any and all claims,damages,or liabilities that may result from the permanent cosmetic procedure(s)as described in this agreement including costs of medical care that may arise from the procedure including post-op care.The Releasor acknowledges that no other claims or guarantees have been made by the Releasee other than is expressly written in the agreement. In witness whereof both parties,the Releasor and the Releasee enter into this agreement by their signatures below on the date opposite their names Signature of Releasor Date Signature of Releasee Date RECITALS a. the Releasor wishes to have the permanent cosmetic procedure(s)performed by the Releasee. b. The Releasor has been informed by the Releasee that permanent cosmetics is the same as tattooing.Therefore the facial area will be cosmetically tattooed.Color will be implanted into the skin and as a result the skin color will be permanently altered. C. The Releasor has been informed by the Releasee that there is pain involved in the procedure(s). d. The Releasor has been informed by the Releasee that there may be adverse side affects such as swelling,bruising(extremely rare), temporary minor bleeding,redness or pinkness,and soreness. e. The Releasor has been informed by the Releasee that the permanent cosmetic facial tattoo procedure is a process and there will be some fading of the color.The Releasee has made no guarantees or promises to the Releasor as to how much color Will be retained or This document is Copyright protected by Soffap(l Inc. It may not be reproduced without the expressed written permission of SoffapqD Inc, Call 925 248-6301 or write to 550 N. Canyons Parkway,Livermore,CA 94551. All rights reserved. 0 Copyright,2014 Soffap@ Inc. Seek legal advice before using this document.