←
Additional Client Release Form
Let us do this part
Today's Date:
Sat Aug 2 2025 11:41
Practitioner:
*
-- Select --
Anthony Papallo
Summer Ejnes
Brian Ferraiolo
Anthony Vieira
Jolie Matthews
Malory Moreno
Chris Koutsis
Pat MacCary
Ben Clarke
Other
Please read and answer
Decision
*
I have decided to ignore the artist’s recommended expertise for my tattoo.
Conditions
*
I understand that the tattoo I am receiving falls under the categories of being; too small, placed in an area prone to
blowouts, has hard to heal colors, or contains elements that may not heal properly.
Non-Action
*
I will not pursue any personal or legal action against Three Kings Tattoo or my artist who tried to best advise me on
the best possible execution of my tattoo.
Responsibility Acceptance
*
I accept full responsibility for the decision I am making in moving forward with my tattoo design, and hereby absolve
myself from leaving negative reviews, complaining post tattoo, or asking for a refund due to the nature of the final
product.
If any provision, section, subsection, clause or phrase of this release is found to be unenforceable or invalid, that portion shall be severed from this contract. The remainder of this contract will then be construed as though the unenforceable portion had never been contained in this document.
Client Information
I hereby declare that I am of legal age (with valid proof of age) and am competent to sign this Agreement.
Legal Name:
*
Chosen name:
Address:
Postcode:
Date of birth:
*
-Month-
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
-Day-
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
-Year-
1915
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
1916
You must be 18 or older
Phone #:
*
Email:
*
Sign up for our newsletter
Signature:
*
Sign above or type signature:
Parent/Legal Guardian
I, as custodial parent or legal guardian of the above minor under -18 years of age, hereby consent to the terms and conditions set forth in this release form and I attest that all documentation I have provided is true and accurate.
Guardian's Legal Name:
*
Signature:
*
Photo ID
*
Please take photo(s) of your government issued photo IDs and related paperwork.
Remove Photo