Body Art Release Release Form
Let us do this part
Today's Date:
Fri Aug 14 2020 05:42
Artist:*
Artist signature:*


Utah’s Premier Body Art Studio
Please read & answer
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Have you been tattooed before?
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Are you pregnant? If not please mark no
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Are you on any medication? If so please list them to the best of your knowledge.
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Do you have any allergies?
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Do you have a heart condition, bleeding disorder, diabetes, or have ever had a seizure?
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I have eaten within one hour prior to the start of this session
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I am not under the influence of drugs or alcohol.
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I understand and agree that if I have had alcohol or illegal drugs in my system in the last 48 hours you can directly affect the healing of my tattoo.
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I understand that the tattoo may vary in appearance, color, design from the image the design is based off and the placement of the tattoo and/skin tones.
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I am aware that this tattoo is permanent, and it can only be removed via laser, which can produce scaring.
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Do you have any blood borne illnesses or communicable diseases such as hepatitis, HIV or AIDS? Or any infections, bacteria, or fungus, that are not bleeding being treated? Are you on medication for them if so what kind? If yes please explain.
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I am aware there are no refunds on tattoo deposits and costs and all funds are non-transferable but the end cost of the tattoo will vary for many reasons and exact cost cannot be given at all times
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Are you currently experiencing any flu type symptoms
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Have you had to be tested for Covid 19
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If previous answer was yes, have you completed a 14 day quarantine.
I agree to pay for any and all damages and/or injuries to any persons in Black Art Society.
I confirm that all information above is true.
I understand that pictures taken of me/my tattoos can be posted on social media and other platforms.
I agreed to hold harmless from all damages, actions,, clean judgments, course of litigation, attorneys fees and other costs of expenses which might arise from my decision to have any tattoo work done at the Black Art Society.
I hereby release any and all employees, agents, or persons representing the Black Art Society from all responsibility and agree not to sue in connection with any and all damages, claims, demands, rights and causes of actions of any nature based upon injuries or property damages to or death of myself or any other persons arising from my decisions to have a tattoo done at this time.

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.
Personal Info
I hereby declare that I am of legal age (with valid proof of age) and am competent to sign this Agreement.
Name:*
Address:
Date of birth:*
You must be 18 or older
Gender:
Phone #:*
Email:*
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Signature:*


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