Aftercare

Lucky 7 Tattoo  Release Form

PLEASE PRINT

Client Name: __________________________ Phone: __________________________

Address: _____________________________ City: ____________________________

Postal Code: __________________________ Artist’s Name: ____________________

Tattoo Description: ______________________________________________________

CLIENT ID NO. ________________________ CONFIRMED D.O.B. ____/____/_____

I agree and state that I am in proper physical condition to obtain the tattoo and I am (a)aware that a tattoo is permanent, and (b) obtaining the tattoo could, in some circumstances, result in physical injury.  I acknowledge that obtaining a tattoo is inherently dangerous and agree to assume such hazards and risks associated with obtaining the tattoo and do thereby discharge, waive, and release Lucky 7 Tattoo from all claims, demands, and liabilities for any and all damage or injury arising out of my decision to obtain tattoo.

I agree that any art that forms part or all of the tattoo that is designed, modified, enhanced, altered, or created in any way by Lucky 7 Tattoo, including any and all intellectual property rights in and to the Art. I hereby irrevocably convey, assign, and transfer any and all rights, title, and interest in and to the Art and the intellectual property therein to Lucky 7 Tattoo unconditionally.

In the event that I have brought in or created art that is intended to sort some or all of the tattoo (the “client art”) I hereby certify and agree that (a) I am the owner or licensee or the Client Art, and have full permission and ability to use the Client Art, (b) I am solely responsible for obtaining any license or permission required to use the Client Art, and (c) I hereby indemnify, release, and hold harmless Lucky 7 Tattoo from any and all claims with respect to the Client Art.

I have read this Waiver and Release, fully understand its terms, understand that I have given up rights by signing it and have signed it freely and without inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability of Lucky 7 Tattoo.

Where did you hear about Lucky 7 Tattoo? __________________________________________

Facebook/ Instagram/ Friend/ Family/ Google or Other (please specify)

Client Signature: __________________________________ Date: _______/_______/_______

        OR

Parental Consent (for Clients under 18 years of age)

Parent 1 Signature :________________________________ Date: ______/_______/________

Parent 2 Signature: ________________________________ Date: ______/_______/_______

Lucky 7 Tattoo Release Form 

In the instance that an artist injures themselves with equipment contaminated with my bodily fluids I consent to blood testing and/or treatment.                                                                                                 Initial: _________

I acknowledge that it is not reasonable for the Artists of Lucky 7 Tattoo to determine whether i might have an allergic reaction to the dyes, pigments, and/or processes used in administering my tattoo, and I accept the risk that a reaction is possible.                                                                                                                  Initial: _________

I acknowledge and understand that tattooing has inherent risks and hereby voluntarily assume all risk of injury, harm, and/or damage resulting from, or connected with, receiving a tattoo.                               Initial: _________

I acknowledge that upon completion of my tattoo, I will receive written/oral instructions advising me of the proper care of my tattoo and I recognize the absolute necessity to follow these instructions.                 Initial: ________

I acknowledge that variations in colour and design may exist between my tattoo and my tattoo as selected by myself and as ultimately applied to my body.                                                                                Initial:_________

I acknowledge that a tattoo is permanent change to my appearance and that no representations have been made to me as to the ability to later change or remove my tattoo.                                                           Initial:_________

I acknowledge that i have truthfully represented to the Artists of Lucky 7 Tattoo, that I am eighteen (18) years of age or have parental consent (both parents must fill out and sign these release forms)                       Initial: _________                                                                           

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 conducts of the Artists of Lucky 7 Tattoo, reasonably necessary to perform the tattoo procedure.                                                                                                                                      Initial:________

I do waive, release, and discharge the Artists of Lucky 7 Tattoo, from any and all liability and/or damages whatsoever.                                                                                                                                     Initial:________

I agree to take full responsibility for checking over the spelling of my tattoo prior to the tattoo procedure and release my artist of the responsibility of ensuring correct spelling of my tattoo.                                          Initial:________

I acknowledge that my tattoo session may be photographed for the website, if you would not like to be photographed please let the artist and front desk be aware of this.                             Please circle  YES   or    NO

PLEASE ANSWER THE FOLLOWING:

- Do you have epilepsy?                                                                   YES _____   NO_____

Have you ever been diagnosed with Hepatitis?                             YES _____   NO _____

Have you ever tested positive for HIV?                                          YES _____  NO _____

Do you have any heart problems, seizures or blood disorders?     YES _____  NO _____

Are you diabetic or have diabetes in your family?                           YES _____  NO _____

Are you currently taking medications?                                             YES _____  NO _____

FEMALES: Are you pregnant?                                                         YES _____  NO _____

In reading this waiver; I am aware that Lucky 7 Tattoo charges an hourly rate of $150.00 + GST and a minimum of $100.00 +GST for a half hour and under. Or otherwise specified.  YES _____ NO _____

In reading this waiver; I am aware that Lucky 7 Tattoo adds on an additional 2% on payments made wit VISA and MASTER CARDS.                                                                           YES ______  NO _______

I acknowledge by signing this form that I now have the full opportunity to ask any and all questions which I might have about acquiring a tattoo from the Artist of my choice at Lucky 7 Tattoo. I declare, under penalty of perjury under the laws of the Province of Saskatchewan and the country of Canada, that the foregoing is true and correct: 

Signature: ____________________________________________ Today’s Date _____/______/_______    OR

Parental Consent:    Signature Parent 1:________________________________ Today’s Date ____/____/______

(for clients under 18) Signature Parent 2:_______________________________Today’s Date ___/____/_