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1 agree that these waivers also pertain to and are designed to protect any and all establishments <br /> where Briana conducts business. <br /> Current medication: <br /> If u need additional room use the back of this page. <br /> I represent and warrant to Brianna that the following information is true and correct. <br /> Name: Age: Date: <br /> Address: Phone: <br /> I have read and understood each of the five paragraphs. <br /> Signature: <br /> Tattoo: <br /> Location: <br /> ALL WORK MUST BE PAID IN CASH. IF YOU CHOOSE TO USE A CARD, THERE WILL BE A <br /> $25 fee added to do so. <br />