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@stainedskintattoo Tattoo Consent and Liability Form

Its an honor you chose to get a tattoo from me :)

Please fill this out honestly and to the best of your knowledge.

This Liability Waiver and Release Form acknowledges that I agree to get a tattoo from Devin Riley (@stainedskintattoo).

Participant information

Full legal name

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Date of birth

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Email

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Phone

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Address

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Untitled checkboxes field

I confirm that I am at least 18 years old and have a valid government issued ID

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Emergency contact

Contact name

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Contact phone

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Medical information & authorization

Relevant medical conditions or allergies

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I acknowledge that I have listed any medical conditions that may affect the application or outcome of the tattoo.

Media release (optional)

I grant permission for photos/videos taken during activities to be used for promotional purposes.

Tattoo Description

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Tattoo Placement

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I have reviewed and approved of the final design, placement and size.

Risk Acknowledgement

I understand the risks involved with getting a tattoo such as: Infection, Allergic Reactions, Scarring, Fading ink or Spreading.

I understand no guarantees are made regarding the end result of the tattoo and the end result of healing.

Aftercare Agreement

I agree to follow all aftercare instructions provided

I understand improper aftercare can affect the healing and results

Liability Release:

I release the artist and BlackworkTattoo LLC from liability for complications, infections

I confirm that I am not under the influence of drugs or alcohol.

I understand that this tattoo is permanent and difficult to remove.

Upload a Picture of your ID or Drivers License.

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Size limit: 10 MB

Date signed

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Signature

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Signature