Laserfiche WebLink
Amok <br />V 0 <br />111, 1, 1 <br />7ZPV1VM9-:�J,1 <br />U011111 0 101 s] Z MLOGM Lei 0 110 <br />In consideration of receiving a tattoo from (thlz <br />"Artist") and Loyalty Tattoo, (and its employees, apprentices and agents, <br />here and after collectively referred to as "Loyalty Tattoo"), I agree to the <br />following: <br />1, (clearly PRINT your name) have been fully informed <br />of the inherent risks, associated with getting a tattoo. I fully understand that these risks, <br />known and unknown can lead to injury, including but not limited to infection, scarring, <br />difficulties in detecting melanoma and allergic reactions to tattoo pigment, latex gloves, <br />and/or soap. Having been informed of the potential risks associated with getting a tattoo, I <br />still wish to proceed with the tattoo application and I freely accept and expressly assume <br />any and all risks that may arise from tattooing. <br />All questions about the tattoo 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 />The tattoo described or shown on the client record form is correctly placed to my <br />speccations. <br />I understand any touch up needed will be done at my own expenses. <br />I understand that tattooing is permanent and that if I choose to have it removed, it may <br />re expensive and leave scars. <br />I am the person on the legal ID presented as proof that I am at least 18 years of age. <br />I am not under the influence of alcohol or drugs and that I am voluntarily submitting <br />to be tattooed without duress or coercion. <br />I agree to let the artist take pictures of my tattoo for the purpose of sample work in the <br />artist portfolio. (Please notify artist if you do not wish to have '.1 taken.) <br />I understand there is a possibility of getting an infection and or a possibility of an aller <br />reaction. <br />I agree to follow all instructions concerning the care of my tattoo, and that any touch• <br />- <br />needed due to my own negligence will be done at my own expense. <br />I understand that there is a chance I might feel lightheaded, dizzy during or after being <br />tattooed. <br />I am not pregnant or nursing. (Please notify artist if you are.) <br />Signed Date <br />