Tattoo Shop Waiver App - WaiverElectronic

Waiver, Release, and Consent to Tattoo Procedure

I acknowledge by signing this agreement that I have been given the full opportunity to ask any and all questions which I might have about the obtaining of a tattoo and that all of my questions have been answered to my full satisfaction. I specifically acknowledge I have been advised of the facts and matters set forth below and I agree as follows:

By checking this box, I agree that if I have any condition that might affect the healing of this tattoo, I will advise my tattooer. I am not pregnant or nursing. I am not under the influence of alcohol or drugs. * Please check it here.

By checking this box, I agree that I do not have medical or skin conditions such as but not limited to: acne, scarring (Keloid) eczema, psoriasis, freckles, moles or sunburn in the area to be tattooed that may interfere with said tattoo. If I have any type of infection or rash anywhere on my body, I will advise my tattooer. * Please check it here.

By checking this box, I acknowledge it is not reasonably possible for the representatives and employees of this tattoo shop to determine whether I might have an allergic reaction to the pigments or processes used in my tattoo, and I agree to accept the risk that such a reaction is possible. * Please check it here.

By checking this box, I acknowledge that infection is always possible as a result of the obtaining of a tattoo, particularly in the event that I do not take proper care of my tattoo. I have received aftercare instructions and I agree to follow them while my tattoo is healing. I agree that any touch-up work needed, due to my own negligence, will be done at my own expense. * Please check it here.

By checking this box, I realize that variations in color and design may exist between any tattoo as selected by me and as ultimately applied to my body. I understand that if my skin color is dark, the colors will not appear as bright as they do on light skin. * Please check it here.

By checking this box, I understand that receiving a tattoo may cause discomfort or pain during and after the proceedure. * Please check it here.

By checking this box, I understand that if I have any skin treatments, laser hair removal, plastic surgery or other skin altering procedures, it may result in adverse changes to my tattoo. * Please check it here.

By checking this box, I acknowledge that a tattoo is a permanent change to my appearance and that no representations have been made to me as to the ability to later change or remove my tattoo. To my knowledge, I do not have a physical, mental or medical impairment or disability which might affect my well being as a direct or indirect result of my decision to have a tattoo. * Please check it here.

By checking this box, I acknowledge that neither the tattoo artist, nor Zulu Tattoo Inc, is responsible for the meaning and/or spelling of the symbol or text that I have provided them or chosen for my tattoo. * Please check it here.

By checking this box, I acknowledge I am over the age of eighteen and that I have truthfully represented to my tattooer that the obtaining of a tattoo is by my choice alone. I consent to the application of the tattoo and to any actions or conduct of the representatives and employees of the tattoo shop reasonably necessary to perform the tattoo procedure. * Please check it here.

By checking this box, I release any and all rights to any photograph taken of me and/or my tattoo and give consent in advance to their reproduction in print or electronic form. (If you do not initial this provision, please remind your artist NOT to take any photographs!) Please check it here.

By checking this box, I acknowledge that I have been advised to properly cleanse the tattooed area, apply antibiotic ointment or cream, minimize sun exposure, use sterile bandages or sterile dressings when necessary and for at least 2 weeks to discourage swimming. * Please check it here.

By checking this box, I agree that I will consult a health care practitioner at the first sign of infection or an allergic reaction and to report any diagnosed infection, allergic reaction, or adverse reaction resulting from the application of the tattoo to the artist and to the department at 1-888-839-6676. * Please check it here.

By Signing this agreement, I represent and warrant that I have carefully read and fully understand this Agreement and its final binding effect, that I have been advised to and afforded sufficient time and opportunity to review this Agreement and had an opportunity to discuss and/or negotiate the terms of this Agreement, that I am fully competent to manage my own business affairs and to enter into this Agreement, and that I have signed this Agreement knowingly, freely, and voluntarily.

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