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Tattoo Release Form

Let us do this part
Today's Date:
Sat Aug 2 2025 11:43
Practitioner:*
Tattoo Location (where on body):*
Please read and answer
 
How did you hear about us?
 
Medical Information*
If any of the conditions listed below apply to me, I will inform the Artist and Three Kings Tattoo prior to the application of my tattoo including: diabetes, epilepsy, hepatitis, hemophilia, HIV-AIDS, tuberculosis or any other communicable disease, a heart condition, or take medication which thins the blood. I am not pregnant or nursing. I am not under the influence of drugs or alcohol. I do not have medical or skin conditions such as (but not limited to) acne,
scarring (keloids), eczema, psoriasis, freckles, moles or sunburn in the area to be tattooed that may
interfere with said tattoo.
Risks*
That I have been fully informed of the inherent risks, associated with getting a tattoo. I fully understand that these risks, known and unknown, can lead to injury, including but not limited to infection, scarring, difficulties in detecting melanoma and allergic reactions to tattoo pigment, latex gloves, and/or soap. Having been informed of the potential risks, I still wish to proceed with the tattoo application and I freely accept and expressly assume any and all risks.
Waive*
TO WAIVE AND RELEASE to the fullest extent permitted by law each of the Artist and Three Kings Tattoo 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 and/or consequential damages, which result or arise from my tattoo, whether caused by the negligence or fault of either the Artist or Three Kings Tattoo, or otherwise.
Fading*
Variations in colour/design may exist between the art I have selected and the actual tattoo. I also understand that over time, the colors and the clarity of my tattoo will fade due to natural dispersion of pigment under the skin.
Spelling*
Neither the Artist nor Three Kings Tattoo is responsible for the meaning or spelling of the symbol or text that I have provided to them or chosen from the flash (design) sheets.
Permanent*
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.
Healing*
The Artist and Three Kings Tattoo have given me 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 infected, 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.
Questions*
I acknowledge that I have been given adequate opportunity to read and understand this document, that any and all of my questions have been answered, that it was not presented to me at the last minute, and I understand that I am signing a legal contract waiving certain rights to recover against the Artist and Three Kings Tattoo.
Y
N
Photography*
I release all rights to any photographs taken of me and the tattoo and give consent in advance to their reproduction in print or electronic form. (If you do not tick this provision, please advise your Artist).
 
Social Media
If my photo is taken, I’d like to be tagged on social media!
My Instagram handle is:
 
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:*
You must be 18 or older
Phone #:*
Email:*
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Signature:*


Photo ID*
Please take photo(s) of your government issued photo IDs and related paperwork.