Thank you for working with us at Icon Tattoo Studio. Please read and be certain that you understand the implications of signing. If you have absolutely any questions, please ask. It is important for you to be fully informed about this process.
In consideration of receiving a tattoo from Willis Van Pelt BAPTA10163904 of Icon Tattoo Studio, I agree to the following:
I, have been fully informed of the inherent health risks associated with getting a tattoo. 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 from tattooing.
I hereby agree to waive and release, to the fullest extent permitted by law, both Icon Tattoo Studio and Willis Van Pelt 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 any other damages or causes of action, including any direct and/or consequential damages, which result of arise from the application of my tattoo, whether caused by negligence or fault of either Icon Tattoo Studio or Willis Van Pelt.
Willis Van Pelt and Icon Tattoo will give me written and/or verbal instructions on the care of my tattoo while it’s healing, and I understand these instructions and will follow them carefully. I also acknowledge that I am aware that I can contact Icon Tattoo Studio for additional, follow-up care information at any time. 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 understand that if I have certain medical conditions, the healing time for my tattoo may take longer due to my condition. If I have such a condition, I have disclosed this to Willis Van Pelt and Icon Tattoo Studio.
I am not under the influence of alcohol or drugs, and I am voluntarily submitting to be tattooed by Willis Van Pelt without duress or coercion.
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. If I have such a condition, I have disclosed this to Willis Van Pelt and Icon Tattoo Studio.
I do not have a mental impairment that may affect my judgment in getting the tattoo
Icon Tattoo Studio and Willis Van Pelt have 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 satisfaction.
Neither Icon Tattoo Studio nor Willis Van Pelt are responsible for the accuracy or meaning or spelling or the symbol or text that I have provided to them or chosen from the design sheets.
Variations in color 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 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.
I understand that a tattoo is a permanent change to my appearance and can only be removed, or attempted to be removed, by laser or surgical means, which can be disfiguring and/or costly and may not result in the restoration of my skin to its exact appearance before being tattooed.
I release all rights to any photographs taken of my body 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 advise and remind Willis and Icon “NOT” to take any pictures of you and your completed tattoo). I acknowledge that, once this permission is granted, I will have no future approval rights over any uses of any such images, of any kind, in the future.
I agree to reimburse Icon Tattoo Studio and Willis Van Pelt for any attorneys’ fees and costs incurred in any legal action I bring against either Icon Tattoo Studio or Willis Van Pelt.
I agree that the courts of Multnomah County shall have personal jurisdiction and venue over Icon Tattoo Studios provision of services and the state and federal courts of Multnomah County, Oregon, shall have exclusive jurisdiction for the purpose of litigating any dispute arising out of, or related to, this agreement.
I acknowledge that I have been given adequate opportunity to read and understand this document, that it was presented to me prior to the tattoo session.
If any provision section, subsection, clause or phrase of this release is found to be unenforceable or invalid, that portion shall be stricken from this contract. The remainder of this contract will then be construed as though the unenforceable portion had never been in this document.
