Shinra Electric Tattoo

Let us do this part

Today's Date:

Sat Jun 21 2025 04:42

I induce the tattooer to tattoo my body and in consideration of his/her/their doing so, I hear-by release the tattoo artist, tattoo studio and it's agents, from all manner of liabilities, claims, actions, and demands, in law or equity, which I or my heirs might have now or hereafter by reason of complying with my request to be tattooed.

Please read and answer

I FULLY UNDERSTAND THAT ANY EMPLOYEE OR AGENT of the studio when performing a tattoo does not act in the capacity of a medical professional.
The suggestions made by any employee or agent of this studio are just suggestions, they are not to be constructed or substituted for advice from a medical professional

I UNDERSTAND THAT I WILL BE TATTOOED USING THE APPROPRIATE INSTRUMENTS AND TECHNIQUES to ensure proper healing of my tattoo, I agree to follow the guidelines given to me by my tattoo artist until the healing is complete. I understand that the tattoo takes up to 2 weeks or longer to heal.

I WILLINGLY SUBMIT TO THESE PROCEDURES with full understanding of possible complications such as, but not limited to, infections, allergic reactions, or rejection of the ink. Neither the artist or the studio is responsible for the meaning or the spelling of the symbol I have provided to them, chosen from the flash designs, requested to be part of my drawing, or provided within my design.

I TAKE FULL RESPONSIBILITY OF THE HEALING OF MY TATTOO. Including the aftercare and cleanliness. I understand by having this tattoo performed that I am making a permanent change to my body and no claims have been made regarding the ability to undo the changes I have made.

I AM IN FULL HEALTH and take full responsibility that I am prepared to be tattooed and not suffering from any illness or poor health that would impact the process of getting tattooed or the healing of my tattoo.

I RELEASE ALL RIGHTS TO ANY PHOTOGRAPHS TAKEN OF ME AND THE TATTOO and give consent in advance to the reproduction in prints or electronic form.

I FULLY UNDERSTAND I MAY BE ASKED TO REMOVE ITEMS OF CLOTHING OR SIT IN AWKWARD POSITIONS. For the tattoo to be applied correctly and proficiently, I acknowledge that I may be asked to remove certain items of clothing (within reason) so that tattoo can be performed by the artist to the best of their abilities. I may also be asked to stretch, sit, or lay in different positions for the tattoo to be applied with ease.

I have eaten in the last 4 hours.*

Have you had any illicit drugs or alcohol in the last 8 hours?*

Are you prone to fainting?*

Are you prone to heavy bleeding?*

Have you taken aspirin, ibuprofen or any bloody thinners in the last 24 hours?*

Details:

Do you have a Latex allergy?*

Do you have any other allergies?*

If yes, please list what allergies you have

Details:

Are you pregnant or breastfeeding?*

Do you have any other conditions that may effect the process of getting this tattoo or it's healing?*

If yes, please explain.

Details:

As a studio, we strive to create a comfortable, safe and friendly environment for all clients to be tattooed in. If at any point during the tattoo process you may feel uncomfortable; whether it be regarding the tattoo itself, the position you're in, another client or artist in the studio etc, please do not hesitate to tell your artist/another artist within the studio how you are feeling so as we can better accomodate you to help you feel more comfortable.

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:*

Pronoun:

Chosen name:

Address:*

Postcode:*

Date of birth:*

You must be 18 or older

Gender:

Phone #:*

Email:*

Signature:*

Sign above or type signature:

Emergency Contact

If something happens, your emergency contact might need to explain your medical history, allergies, or medications.

Name:

Phone #: