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CLIENT WAIVER FORM

PERSONAL INFORMATION

TATTOO INFORMATION

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EMERGENCY CONTACT

HEALTH & MEDICAL

ARE YOU PREGNANT OR NURSING?
DO YO HAVE ANY SKIN PROBLEMS THAT MAY INTERFERE WITH THE TATTOO?
DO YO HAVE ANY OF THE FOLLOWING HEALTH CONDITIONS?

CONSENT

I UNDERSTAND THERE IS A RISK OF AN ALLERGIC REACTION THAT IS BEYOND THE ARTISTS' CONTROL, AS WELL AS THE POSSIBILITY OF INFECTION DUE TO POOR AFTERCARE OR HYGIENE. I AGREE TO FOLLOW ALL INSTRUCTIONS GIVEN TO ME BY BLACK PETAL TATTOO LTD CONCERNING THE CRUCIAL AFTERCARE OF MY TATTOO. I UNDERSTAND THAT AFTER GETTING A TATTOO THERE IS ALWAYS A RISK OF ME GETTING A SERIOUS INFECTION, THEREFORE BY SIGNING THIS, I ALSO COMMIT TO ENSURING MY TATTOO IS SERIOUSLY CARED FOR AND IS NOT SUBJECTED TO NON-HYGENIC ENVIRONMENTS SO I CAN REDUCE THE CHANCES OF INFECTIONS AND POOR HEALING. I UNDERSTAND THAT THERE IS A CHANCE THAT I MIGHT FEEL LIGHT-HEADED, DIZZY, AND/OR FAINT DURING THE SESSION. I UNDERSTAND THE PERMANENCY  OF TATTOOS I AM RECEIVING AT BLACK PETAL TATTOO LTD. I HEREBY RELEASE BLACK PETAL TATTOO LTD OF  ALL RESPONSIBILTY AND LIABILITY AND FORFEIT MY RIGHT TO PURSUE ANY FORMS OF LITIGATION RESULTING FROM MY DECISION TO GET A TATTOO AND THE RESULTS OF MY AFTERCARE. I UNDERSTAND THAT I WILL BE TATTOOED WITH STERILE INSTRUMENTS AND I AM SATISFIED THAT BLACK PETAL TATOTO LTD FOLLOWS CROSS-CONTAMINATION, HEALTH AND SAFETY PROCEDURES ISSUED UNDER THE PROVINCE OF BRITISH COLUMBIA. I UNDERSTAND THAT BLACK PETAL TATTOO LTD HAS A NO REFUND POLICY.

I UNDERSTAND THAT PHOTOGRAPHS AND VIDEOS OF THE TATTOO AND ITS PROCESS MAY BE TAKEN AND USED ONLINE AND/OR FOR PRINT MARKETING AND ADVERTISING PURPOSES. I HEREBY GRANT PERMISSION FOR BLACK PETAL TATTOO LTD TO USE SAID PHOTOS AND VIDEOS OF MYSELF, MY TATTOO AND  THE PROCESS ONLINE, IN PRINT AND IN OTHER COMMUNICATIONS RELATED TO MARKETING AND ADVERTISING.

GOVERMENT ISSUED IDENTIFICATION

PLEASE HAVE A PIECE OF PHOTO IDENTIFICATION READY TO HAVE A PICTURE OF IT FOR OUR RECORDS

THANKS FOR SUBMITTING!