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Disclaimer And Waiver Release
Including Consent To Tattoo.
Please Read, Fully Understand
And Acknowledge The Following, Prior To Completing A Signed Declaration, Which Will Enable TATTOO
ARTIST Calvin Carville To Proceed And Administer This Tattoo.
I, ______________________________ (Clearly Print Your Name) Have Been
Fully Informed Of The Inherent Risks, Associated With Being Tattooed, And The Tattoo Process. I
Fully Understand That These Risks, Known And Unknown, Can Lead To Injury, Including But Not Limited
To Infection, Scarring, Difficulties In Detecting Melanoma And Allergic Reactions To Tattoo
Pigment, Latex Gloves, And/Or Soap. Having Been Informed Of The Potential Risks Associated With
Getting A Tattoo, I Still Wish To Proceed With The Tattoo Application And I Freely Accept And
Expressly Assume Any And All Risks That May Arise.
I Waive And Release To The Fullest Extent Permitted By Law The Tattoo
Artist Calvin Carville, From All Liability Whatsoever, For Any And All Claims Or Causes Of Action
That I, My Estate, Heirs, Executors Or Assigns May Have For Personal Injury Or Otherwise, Including
Any Direct And/Or Consequential Damages, Which Result Or Arise From The Application Of My Tattoo Or
The Process Involved, Whether Caused By The Negligence Or Fault Of The Tattoo Artist, Directly Or
Otherwise.
The Tattoo Artist Has Given Me The Full Opportunity To Ask Any And All
Questions About The Application Of My Tattoo, And All Of My Questions Have Been Answered To My
Total Satisfaction.
The Tattoo Artist Has Given Me Clear Instructions On How To Care For
My Tattoo During The Healing Process, I Understand Them And I Will Follow Them. I Acknowledge That
It Is Possible That The Tattoo Can Become Infected, Particularly If I Do Not Follow The
Instructions Given To Me. If Any Touch-Up Work To The Tattoo Is Needed Due To My Own Negligence, I
Agree That The Work Will Be Done At My Own Expense. I Fully Understand, And Will Follow The
Aftercare Instructions Which Have Been Given To Me.
I Am Not Under The Influence Of Alcohol Or Drugs, And I Am Voluntarily
Submitting To Be Tattooed By The Tattoo Artist Without Duress Or Coercion. I Am Present Through My
Own Freewill And Personal Choice.
I Do Not Have Diabetes, Epilepsy, Haemophilia, A Heart Condition, Nor
Do I Take Blood Thinning Medication. I Do Not Have Any Other Medical Or Skin Condition That May
Interfere With The Application Or Healing Of The Tattoo. I Am Not The Recipient Of An Organ Or Bone
Marrow Transplant Or, If I 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. There Are NO Present Medical Reason(s) To Prevent My Tattoo Application.
Variations In Colour And Design May Exist Between The Tattoo Art I
Have Selected And The Actual Tattoo When It Is Applied To My Body. I Also Understand That Over
Time, The Colours 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/May Only Be
Removed By Laser Or Surgical Means, Which Can Be Disfiguring And/or Costly 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 Tattoo And
Give Consent In Advance To Their Reproduction In Print Or Electronic Form. (If You Do Not Agree To
This Provision, Please Advice And Remind The Tattoo Artist Not To Take Any Pictures Of You And Your
Completed Tattoo!).
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 That
I Am Signing A Legal Contract Waiving Certain Rights To Recover Against The Tattoo
Artist.
I Hereby Declare That I Am Of Legal Age (And Have Provided Valid Proof
Of Age) And Am Competent To Sign This Agreement
I Have Read This Agreement, I Understand It, I Agree To Be Bound By
It.
I Understand That No Form Of Anaesthetic Will Be Used In The
Procedure.
I Understand That Every Care Will Be Taken To Ensure That The
Procedure Is Carried Out In A Hygienic Way, Which Includes The Use Of Disposable Or Pre-Sterilised
Equipment.
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Print Full Name:
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Date of Birth:
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Address:
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Telephone:
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Signature of Client:
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Signature of Artist:
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Date and
Time:
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