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FIL.%J"l VF.EJ N R, RELEASE ANDCONSENT TCJJfrT00 NOV 15 2013 1011111MEWAL HEALTH THIS DOCUMENT IS TWO PAGES(OR TWO SIDED)PLEASE IMAL EACH PROVISION ON THE LINES P OVI 61RE�011 READING TO SHOW THAT YOU UNDERSTAND EACH PROVISION. INCONSIDERATION OF RECEIVING ATATTOO FROM I(Arfist I Guest Artist at CLASSIC TORCH TATTOO)I AGREE TO DO THE FOLLOWING That 1. (dearly PRINT your name)have been fully informed of the inherent risks,associated with getting a taftoo.I fully understand that these risks,known and unknown,can lead to injury,including but not limited to Infection,scarring, difficufties in detecting melanornas and allergic reactions to tattoo pigment.Iatex:gloves andfor soapHaving been inforined of the potar"risks associated with getting a taftoo,I still wish to proceed with the taftoo application and I'freely accept and expressly assume all risks tot may arise fro taftoolng. To WAIVE AND RELEASE to the fullest extent permitted by Im each of the ARTIST/Guest Artist and CLASSIC TORCH TATTOO from all liability whatsoever,for any and all claims or causes of action that 1,my estate,heirs,executors or assigns may have for personal injury or otherwise,Including any direct andfor consequential damages,which result or arise from the application of my tattoo, whether caused by the negligence or fauft of ether the ARTIST/Guest Artist or CLASSIC TORCH TATTOO,or othevwIse. That both the ARTIST I Guest Arlist and CLASSIC TORCH TATTOO have given me the full opportunity to ask any and all questions about the application of my taltoo and all of my questions have been answered to my total satisfaction. The ARTIST/Guest Artist and CLASSIC TORCH TATrOO have given me Instructions on the cam of my tattoo while its heating,and I understand them and will follm them. I ackriowledge that it is possible that the tattoo can become infected,particularly If I do not follow the inskudions given to me. If any touch-up work to the tattoo is needed due to my own neglkjence, I agree that the work will be done at my own expense- I am not under the influence of alcohol or drugs,and I am voluntarily submitting to be tattooed by the 11ST/Guest Artist without duress or coercion. I do not have diabetes,epilepsy,hemophilia,a heart condition,nor do I take blood thinning medications.I do not haw any other medical or skin conditions that may interfere with the application or healing of the talloo. I am not the recipient of an organ or bone marrow transplant or if 1 am, I have taken the prescribed preventive 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 judgment in getting the tattoo. Nelther the AR11ST/Guest Artist nor CLASSIC TORCH TATTOO is responsible for the meaning or spelling of the symbol or text that I have provided to them or chosen frorn the flash(design)sheets. variations in color and design may exist between the tattoo art I have selected and the actual Moo 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. A tattoo is a permanent change to my appearance and can only be removed by law or surgical means,which can be dWguring ancVor cosily and which in all likelihood will not result in the restoration of my skin to its exact appearance before being tattooed. I release all rights to any photographs taken of me and the talloo and give concent in advance to their reproduction in print or electronic form.(if you do not initial this provision,please advise and rernind your ARTIST I Guest Artist or CLASSIC TORCH TATTOO NOT to take any pictures of you and y our com~tattoo. I agree to reimburse each of the ARTIST/GuestArtist and CLASSIC TORCH TATTOO fbr any attorneys fees and costs incurred in any legal action I bring against either the ARTIST I Guest Artist or CLASSIC TORCH TATTOO and in which either the ARTIST I Guest Artist or CLASSIC TORCH TATTOO is the prevailing party. I agree that the courts of(CALIFORNIA)[SAN JOAQUIN COUNTY],shall have personal jurisdiction and venue over me and shall haw exclusive jurisdiction for the purpose of Illigating any dispute arising out of or relaW to this agreement 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 I understand to I am signing a IMW contrad walving certain rights to recover against the ARTIST I Guest Artist and CLASSIC TORCH TATTOO. If any provision,section,subsection,clause or phrase of fts release is found to be unenforceable or invalid,that portion shall be severed from this contract.The rernainder of this conlract will then be construed as though the unenforceable portion had never been contained In this documenL