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Tattoo Release - Poca
Let us do this part
Today's Date:
Wed Oct 7 2026 11:57
Practitioner:*
Tattoo Location:*
Please read and answer
Dynamic TBK XXX Black #92026220
Dynamic TWD XXX White #92021330
Dynamic RD1 Fire Red #82024150
Dynamic 80 Greywash #82020370
Dynamic 60 Greywash #82021370
Dynamic 40 Greywash #82021080
Dynamic 20 Greywash #82025080
Intenze Zuper Black #SS345
Nocturnal Super Black #P121025
Nocturnal Lining & Shading #P12105
Dynamic BDI Blue #82020310
Dynamic ELB Electric Blue #72027280
Dynamic SKB Sky Blue #82021120
Dynamic TEA Teal #72024290
Dynamic GDI Green #82028070
Dynamic TRQ Turquoise #82027160
Dynamic LYM Lime Green #82022210
Dynamic LFG Leaf Green #82020170
Dynamic YD2 Lemon Yellow #72023040
Dynamic YD4 Canary Yellow #82023160
Dynamic Platinum Nude #-NUD-020924-DP
Dynamic BRN Brown #82026110
Dynamic TRP Tropical Purple #82026050
Dynamic MDI Magenta #82029050
Dynamic RD6 Wine Red #82029120
Dynamic RD4 Burgundy Red #82020250
Dynamic RD2 Chinese Red #82022150
Eternal Ink Cotton Candy #N091924

I acknowledge by signing this release that I have been given the full opportunity to ask any and all questions I might have about obtaining a tattoo from Dandyland, hereafter referred to as the studio. I acknowledge that I have been advised of the facts and matters set forth below, and I agree as follows:

The possibility of discomfort or pain.
The risk of infection, (particularly in the event I do not take proper care of my tattoo).
The possibility of allergic reaction to the pigments or other materials used.

I acknowledge that I am not pregnant.

I acknowledge that variations in color and design may exist between any tattoo selected by me and as ultimately applied to my body.

I acknowledge that tattooing is a permanent change to my appearance and 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 by my choice alone and I consent to the application of the tattoo and to any actions or conduct of the associates, agents, or representatives of the studio reasonably necessary to perform the tattoo procedure.

I am not under the influence of alcohol or drugs, and am making this decision of my own free will, under no duress.

I acknowledge the receipt of written, digital or internet link to instructions advising me of proper care of my tattoo and recognize the absolute necessity of following the written instructions.

I agree to release and forever discharge and forever hold harmless DANDYLAND, its associates, agents, officers, and shareholders from any and all claims, damages, or legal actions arising from or connected in any way with my tattoo or the procedures and conduct used to apply my tattoo.

I acknowledge that I have truthfully represented to the associated, agents, and representatives of this studio that I am 18 years of age or older.

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).

I acknowledge that I have read and agree to Dandyland's touch up policy as follows:
Your tattoo should heal within 2-4 weeks. If you need a touch up, you may schedule 1 free touch up appointment after one month, but no longer than four months from the date the tattoo was originally done. Any other touch ups will be paid appointments.
**Face, ear, hand, finger and feet tattoos are not guaranteed and will always be paid touch ups**
Call or stop by to make an appointment.

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:*
Pronouns:
Chosen name:
Address:
Postcode:
Date of birth:*
 
You must be 18 or older
Age: 
Phone #:*
Email:
Signature:*

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