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Waiver and Release <br /> Int. 1.To my knowledge,I do not have any mental or medical impairment or disability <br /> which might affect my well-being as a direct or indirect result of my decision to have any tat:)o <br /> anct r piercing procedure done at this time. <br /> Int. 2. I agree to follow all instructions concerning the care of my tattoo and/or p-ewing <br /> whlk IT's healing. I agree that any touch up work,due to my negligence,will be done at my oiam <br /> expense. <br /> Int. 3. I understand that if my skin color is dark,the colors will not appear as brig-t as <br /> they do on li;hter skin.Additionally,I understand that the finished tattoo may vary somewhat in <br /> appearanc,-,color and/or design from the paper or other drawing or photographic image which the <br /> tattoo design is based. <br /> Int. 4.All questions about the procedure have been answered to my satisfaction,and I <br /> have been given written aftercare instructions for the procedure I am about to receive. <br /> Int. 5.I am the person on the I.D.presented as proof I am at least 18 years of age. <br /> Int. 6.1 have been advised that the tattoo will be permanent and that it can only be <br /> removed with a surgical procedure,and that any effective removal will leave permanent scarring <br /> and d-srigurement.This cautionary notice is required to be provided to me by the health <br /> deparanent and I hereby acknowledge receipt of this formal notice. <br /> Int. 7.I understand there is a risk of an allergic reaction and agree not to hold Colcrful <br /> Addictions responsible for any allergic reactions. <br /> Int. 8. I am not under the influence of drugs or alcohol and that I am voluntarily <br /> sub-nitting tc be tattooed without distress or coercion. <br /> lat. 9. I understand tattoo inks are not FDA approved and health consequences are <br /> unktx-An. <br /> lat. 10. I swear or affirm and agree that the above information is true and correct. <br /> i have been provided with information describing the tattoo and/or piercing <br /> pro=diurc to be preformed and instructions on after care. I understand it is my <br /> resp-insiblity to take care of my new tattoo and/or piercing site according to the <br /> insir.ictions provided both verbally and in writing. I have been fully informed of the risks <br /> of tattooing including but not limited to infection, scarring, difficulties in detecting <br /> mekntnna, and allergic reaction to tattoo pigments, latex gloves and antibiotics. <br /> Following the tattoo the tattoo area may be sore and have some redness.Also during <br /> healing may experience some itching and peeling. If any indication of infection such as <br /> feve_, puss or extreme pain please seek medical attention. Having been informed of all <br /> p:)te-itial risks associated with getting a tattoo, I still wish to proceed with the tattoo <br /> procedure and I assume any and all risks that may arise from tattooing. <br /> C.istamer S-gesture Date <br /> DO NOT WRITE BELOW THIS LINE <br /> Tatoo R&rmatiDn <br /> DesaVtian of tEwo Exact spelling of names or <br /> ,xotdts <br /> La.atio-i on body Price of tattoo <br /> Artier NEme Artists <br /> S anatse <br />