Flash Consent Form

Thanks for participating iN Our flash event!

please make sure to read the following rules:

•YOU ARE ALLOWED TO BRING ONE (1) GUEST WITH YOU TO YOUR APPOINTMENT (NO PETS ALLOWED)
•ARTIST WILL BE ASSIGNED, NOT CHOSEN
•TATTOOS WILL ONLY BE PLACED IN EASY TO reach LOCATIONS
•APPROPRIATE CLOTHING MUST BE WORN FOR THE DESIRED PLACEMENT (DON’T WEAR PANTS IF IT’S GOING ON YOUR THIGH)

PLEASE FILL OUT THE CONSENT FORM BELOW AS TO STREAMLINE THE PROCESS ON FRIDAY! MAKE SURE TO BRING YOUR VALID GOVERNMENT ISSUED ID AS WELL.

STUDIO INFO

837 TRACTION AVE, LOS ANGELES CA 90013

CALLBOX INPUT IS #4927

ELEVATOR TO 2ND FLOOR

UNIT 203

IT’S LOS ANGELES SO PARKING IS NOT GUARANTEED
PLEASE SHOW UP EARLY AS TO NOT BE LATE DUE TO PARKING

Name

First Name

Last Name

Instagram Username

TIME SLOT

CONSENT RELEASE

-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 (healing excluded) -I acknowledge that I am not pregnant or nursing -I acknowledge that I am free of communicable disease -I acknowledge that I DO NOT have diabetes, epilepsy, hemophilia, a heart condition, nor do I take blood thinning medication. I do not have any other 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 preventative antibiotics -I acknowledge that I DO NOT have a mental impairment that may affect my judgment in getting a tattoo -I acknowledge that I have truthfully represented to the artist that I am over eighteen (18) years of age -I have looked over my design, checked the spelling if applicable, and given my full consent to the application of my tattoo. I understand that the artist is not responsible for the meaning or spelling of the design or text that I have provided to them or chosen from any flash/design sheets -I acknowledge that it is not reasonably possible for the artist to determine whether I might have an allergic reaction to the dyes, pigments, or processes used in my tattoo and I 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 event that I do not take proper care of my tattoo, and I have been advised of the signs and symptoms of infection that indicate a need to seek medical care -I acknowledge receipt of written instructions advising me of proper care of my tattoo and recognize the absolute necessity of following those written instructions. All questions about the body art procedure have been answered to my satisfaction -I acknowledge that variations in color and design may exist between any tattoos as selected by me and as ultimately applied to my body -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 to any actions or conduct of the artist that are reasonably necessary to perform the tattoo procedure -I agree to waive and release to the fullest extent permitted by law, each the artist and associates 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 andor consequential damages, which result or arise from my tattoo, whether caused by negligence or fault of either the artist or associates -I acknowledge that tattoo inks, dyes, and pigments have not been approved by the federal Food and Drug Administration and the health consequences of using these products are unknown -I acknowledge that there is a chance that I might feel lightheaded, dizzy during or after being tattooed and agree to immediately notify the artist in the event I feel lightheaded, dizzy, and/or faint before, during, or after the procedure -I agree to follow all instructions concerning the care of my tattoo, and that any touch-ups needed because of my own negligence will be done at my own expense -I agree to grant permission and give my consent to the artist and associates for the use of any photographs, videos, or any other electronic media images of my tattoo and/or the tattooing process for the presentation under any legal use -I have read and have complied with any pre-tattooing instructions, if any, as outlined by my artist. -I have read this release form and confirm that all the information I have given is correct. I understand that this is a release form and I agree to be legally bound by it. -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 pigments, latex gloves, and antibiotics. Having been informed of the potential risks associated with getting a tattoo, I still wish to proceed with tattoo application and I assume any and all risks that may arise from tattooing.

I HAVE READ AND AGREE WITH ALL ABOVE STATEMENTS

E-SIGNATURE

BY SIGNING, YOU AGREE TO HAVE READ THIS RELEASE FORM AND CONFIRM THAT ALL THE INFORMATION GIVEN IS CORRECT. THIS E-SIGNATURE WILL SERVE, FOR ALL INTENTS AND PURPOSES AND AS NECESSARY, AS YOUR SIGNATURE. THIS IS A RELEASE FORM AND YOU AGREE TO BE LEGALLY BOUND BY IT.