WAIVER, RELEASE, AND CONSENT TO TATTOO
In consideration of receiving a tattoo from
and Gnostic Tattoo, LLC (and its employees, apprentices and agents), I agree to the following:
PLEASE CHECK EACH PROVISION AFTER READING TO SHOW THAT YOU UNDERSTAND EACH PROVISION
I have been fully informed of the inherent risks, associated with getting a tattoo. I fully understand these risks can lead to injury, including but no limited to infection, scarring, 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 and I freely accept and expressly assume and all risks that may arise from tattooing.
I waive and release, to the fullest extent permitted by law, each of the Artist and Tattoo Studio from all liability whatsoever, for any and claims or causes of action that I, my estate, heirs, exectutors or assigns may have for personal injury of otherwise, including any direct and/or consequential damages, which result or arise from the application of my tattoo.
Both the Artist and Tattoo Studio have give 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.
The Artist and the Tattoo Studio have given me the instructions on the care of my tattoo while it's healing, and I understand them and will follow them. I acknowledge that it is possible that the tattoo can become infect, 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 am not under the influence of alcohol or drugs, and I am voluntarily submitting to be tattooed by the Artist without duress or coercion.
I do not have diabetes, epilepsy, hemophilia, 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 judgement in getting the tattoo.
Neither the Artist of the Tattoo Studio is responsible for the meaning or the spelling of the symbol or text that I have provided for them or chose from the flash (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 clarity of the 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 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 tattoo and give consent in advance to their reproduction in print or electronic form. (If you do not check this provision, please advise and remind your Artist and the Tattoo Studio not to take any pictures of you and your completed tattoo).
I agree to reimburse each of the Artist and Tattoo Studio for any attorney's fees and costs incurred in any legal action I bring against either the Artist or the Tattoo Studio and in which either the Artist or the Tattoo Studio is the prevailing party. I agree that the courts of Brooklyn in Kings County shall have personal jurisdiction and venue over me and 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 not presented to me last minute, and I understand that I am signing a legal contract waiving certain rights to recover against the Artist and the Tattoo Studio.
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.
Date of Birth
PHOTO ID (you can take a picture of it with your phone)
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1089 Flushing Ave. Brooklyn NY 11237
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