Name *

First Name

Last Name

Phone

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Who is your artist today? *

Heather

Sol

Lindsey

Kimmy

Sibel

Molly

Toro

Andy

Oddie

Jessie

Other

*

I acknowledge by signing this release form that I have been given the full opportunity to ask any and all questions I might have about obtaining a tattoo from Slowside Tattoo Studio. I specifically acknowledge that I have been advised of the facts and matters set forth below, and I agree as follows.

*

I am not under the influence of alcohol or drugs.

*

I do not have acne, freckles, moles, or sunburn in the area to be tattooed that might be agitated by the tattoo process.

*

I have looked over my design, checked the spelling if applicable, and give my full consent to the application of my tattoo.

*

I acknowledge that I am not pregnant.

*

I acknowledge that I am over eighteen (18) years of age.

*

I acknowledge that it is not reasonably possible for my artist to determine whether I might have an allergic reaction to the pigments, materials, or processes used in my tattoo and agree to accept that such risks are possible.

*

I acknowledge that infection is always possible as a result of obtaining a tattoo, particularly in the even that I do not follow the aftercare instructions communicated to me by my artist.

*

I acknowledge receipt of written aftercare instructions advising me of proper care of my tattoo and recognize the absolute necessity of following those written instructions (also found on slowside.studio).

*

I acknowledge that variations in colour and design may exist between any tattoos selected by me and ultimately applied to my body.

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I acknowledge that tattooing is a permanent change to my appearance and that no representations have been made to me as to the ability to later change, alter, or remove my tattoo.

*

I acknowledge that the obtaining of my tattoo is my choice alone and I consent to the application of the tattoo and any actions of my artist that are reasonable and necessary to perform the tattoo procedure.

*

I agree to release and forever discharge and forever hold harmless Slowside Tattoo Studio and its artists, associates, and agents from any and all claims, damages, or legal actions arising from or connected in any way with my tattoo or the procedures and conduct used to apply my tattoo and any and all tattoos applied by Slowside Tattoo Studio and its artists, associates, agents, and representatives in the future.

*

I acknowledge that there is a chance I might feel lightheaded, dizzy during or after being tattooed. I agree to immediately notify the artist in the even I feel lightheaded, dizzy, and/or faint before, during, or after the procedure.

*

I have been fully informed of the risks of tattooing including but not limited to infection, scarring, difficulties in detecting melanoma, and allergic reactions to tattoo pigment, nitrile gloves, and antiseptics. Having been informed of the potential risks associated with getting a tattoo, I still wish to proceed with the tattoo application and I assume any and all risks that may arise from tattooing.

Date

MM

DD

YYYY