Consent Form * Consent Form * Consent Form * Date of Birth * MM DD YYYY Name * First Name Last Name Email * Phone (###) ### #### PLEASE READ AND BE CERTAIN YOU UNDERSTAND THE IMPLICATIONS OF SIGNING In relation to receiving a tattoo from any of the artists at Township Tattoo I agree to the following: That I, Have been informed of the inherent risks associated with getting a tattoo. I fully understand that these risks, known and unknown, can lead to injuries including (but not limited to) infection, scarring, difficulties in detecting melanoma and allergic reactions to tattoo pigment, latex gloves, and soap etc. Having been informed of the potential risks associated with getting a tattoo. * YES NO That 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. * YES NO I am not under the influence of alcohol or drugs, and I am voluntarily submitting to be tattooed by the Artist without duress or coercion, and I have not consumed excessive units of alcohol within the last 24 hours (in excess of 6 units) * YES NO I am not recovering from any illness, surgery or other medically related condition, and I am not taking any medication including but not limited to antibiotics, paracetamol and other over the counter treatments). * YES NO I have disclosed any health issues such as diabetes, epilepsy, haemophilia, a heart condition etc. and whether 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 1 am, I have taken the prescribed preventive regimen of antibiotics that is required by my doctor in advance of any invasive procedure such as tattooing or piercing. * YES NO I am not pregnant or nursing a baby (including expressing) up to the age of 12 months. * YES NO 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 artist's designs. * YES NO Variations in colour and design may exist between the tattoo art I have selected and the actual tattoo when it is applied to my body. I also understand that over time, the colours 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 related to the ageing process of the human body. * YES NO The Artist and the Tattoo Studio have given me instructions on the care of my tattoo while it is 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, l agree that the work will be done at my own expense. * YES NO I acknowledge that I have been given adequate opportunity to read and understand this document, and I understand that I am signing a legal contract waiving certain rights to recover against the Artist and the Tattoo Studio. * YES NO Not all artists are happy to use numbing cream, however if they agree to then the client takes full responsibility for sourcing, and applying the cream as well as carrying out a patch test prior to using it. The client also accepts liability for any adverse reactions and healing complications that the cream may cause. * YES NO I hereby declare that I am of legal age (and have provided valid proof of age as required) and am competent to sign this Agreement. I have read this document and wish to proceed with the tattoo application and I freely accept and expressly assume any and all risks that may arise as a result. I HAVE READ THIS AGREEMENT, I UNDERSTAND IT, I AGREE TO BE BOUND BY IT. * YES NO Date * Please input today’s date to complete your digital signature. MM DD YYYY Signature * Input your full name, as spelt above, to form a digital signature. Thanks for filling out your consent form!You're all set for your session.On completion of your tattoo, your Artist will run through the Aftercare process and answer and question you might have.Or feel free to check out our Aftercare Guide to know exactly what to expect and how to keep your new ink looking its best. If you have any question please speak to your Artist who will be happy to help.
