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TATTOO CONSENT FORM

Let us do this part
Today's Date:
Sat Aug 2 2025 10:41
WAIVER, RELEASE AND CONSENT FOR TATTOO

Please read and be certain you understand the implications of signing


In consideration of receiving a Tattoo from (PLUG TATTOO) and (it’s employees, apprentice and agents, here and after collectively referred to as ‘’the Tattoo Studio’’), I agree to the following
Please read and answer
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-I ASSURE I AM 18 YEARS OR OLDER

(In California, it is illegal to tattoo anyone under the age of 18, even with parental consent.)
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-I WAIVE AND RELEASE to the fullest extent permitted by law the Artisit and the Tattoo Studio 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 the application of my tattoo whether caused by the negligence or fault of either the Artist or the Tattoo Studio, or otherwise.

-Both the Artist and the Tattoo Studio have given me the full opportunity to ask any and all questions about the application of my tattoo and all of my questions have been answered to my total satisfaction.

-The Artist and the Tattoo Studio will give 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.
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-I assure that I am not under the influence of alcohol or drugs, and I am voluntarily submitting to be tattooed or pierced by the Artist without duress or coercion.
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- I assure that I DO NOT HAVE diabetes, epilepsy, hemophilia, nickel allergy, a heart condition, hemophiliac (Bleeder) nor do I take blood thinning medication. I do not have any other medical or skin condition that may interfere with the application or healing of the tattoo. I am not the recipient of an organ or bone marrow transplant or, if I am, I have taken the prescribed prevention regimen of antibiotics that is required by my doctor in advance of any invasive procedure such as tattooing or piercing. I am not pregnant or nursing. I do not have any mental impairment that may affect my judgment in getting the tattoo.

-If I suffer from Hepatitis or any other communicable diseases, I have informed the Tattoo Artist of this fact and have been advised of any medications or procedures necessary to promote satisfactory healing of my tattoo.
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-I have advised the Tattoo Artist of any allergies to metals, latex, soaps, and medications. I acknowledge it is not possible for the Tattoo Artist to determine whether I might have an allergic reaction to the tattoo or process involved in the tattooing and further acknowledge that such a reaction is possible.
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-Neither the Artist nor the Tattoo Studio 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.
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-Variations in color and design may exist between the tattoo art I have selected and the actual tattoo applied to my body. I also understand that over time , the colors and the clarity of my tattoo will fade due to unprotected exposure to the sun and the naturally occurring dispersion of pigment under the skin.

-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 to its exact appearance before being tattooed.
Y
N
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-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 choose ( NO ) please advise the Tattoo Artist as well.
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-I agree to reimburse the Artist and the Tattoo Studio for any Attorney fees and cost incurred in any legal action I bring against either the Artist or the Tattoo Studio and in which either the Artist or the Tattoo Studio is the prevailing party. I agree that the courts of California in Contra Costa County shall have personal jurisdiction and venue over me and shall have exclusive jurisdiction for the purpose of litigating any dispute arising out of or related to this agreement.
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-I understand that the ink used have not been approved by the Federal Food Administration. (FDA) I also understand that the health consequence of these inks are unknown.
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-I acknowledge that I have been given adequate opportunity to read and understand this document, that it was not presented to me at the last minute, and I understand that I am signing a legal contract waving certain rights to recover against the Artist and the Tattoo Studio.
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.
Name:*
Date of birth:*
You must be 18 or older
Phone #:*
Email:
Signature:*


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