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Treze release form
Date
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Practitioner
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Tattoo Location
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COVID-19 - Have you experienced any symptoms of COVID-19 within the last 14 days, such as a high temperature, cough, or a loss or change to your sense of smell or taste?
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COVID-19 - Have you been in close contact with someone who has COVID-19 or has displayed symptoms of COVID-19 within the past 14 days?
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Have you eaten in the past 4 hours? It's a good idea to eat beforehand to increase your blood sugar levels.
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PREGNANT/NURSING? Are you currently pregnant or breastfeeding? If you have recently given birth, or finished nursing, we recommend waiting for a period of at least 3 months before having a procedure such as tattooing done. This is for your and your child's health and safety.
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BLOODBORNE PATHOGENS? Do you have any bloodborne pathogens, transmissible diseases or recent illness? (It's okay if you do, we just want to know for ours and others' safety.)
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HEALTH? Do you have diabetes, epilepsy, haemophilia or a heart condition? Do you take blood thinning medication? Do you have any other condition that may interfere with the application or healing of the tattoo? Are you the recipient of an organ or bone marrow transplant? If so, have you taken the preventative antibiotics? Are you pregnant or nursing? Do you have a mental impairment that may affect your judgement?
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ALLERGIES? Do you have any known allergies (latex, micropore tape, etc)?
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Please read and tick each statement to confirm you agree
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RISKS: I confirm 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 injury, including but not limited to infection, scarring, difficulties in detecting melanoma and allergic reactions to tattoo pigment, latex gloves, and/or soap. Having been informed of the potential risks, I still wish to proceed with the tattoo application and I freely accept and expressly assume any and all risks.
WAIVE: To waive and release to the fullest extent permitted by law each of the artist and Treze Ink Tattoo Ltd 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 this tattoo. Whether caused by the negligence or fault of either the artist or Treze Ink Tattoo Ltd, or otherwise.
LEGAL ACTION: I agree to reimburse each of the artists and Treze Ink Tattoo Ltd for any attorneys' fees and costs incurred in any legal action I bring against either the artist or Treze Ink Tattoo Ltd and in which either the artist or Treze Ink Tattoo Ltd is the prevailing party. I agree that the courts of the UK 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.
UNDER THE INFLUENCE: 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.
FADING: Variations in colour/design may exist between the art I have selected and the actual tattoo. I also understand that over time, the colours and the clarity of my tattoo will fade due to natural dispersion of pigment under the skin.
SPELLING: Neither the artist nor Treze Ink Tattoo Ltd 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.
PERMANENT: 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.
HEALING: The artist and Treze Ink Tattoo Ltd have given me the 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.
FINGER, HAND AND SIDE OF FOOT TATTOOS: I understand that these areas will most likely not hold ink well and usually tend to heal very poorly. Treze Ink Tattoo Ltd does not guarantee these tattoos, and cannot guarantee how they heal. The tattoo may also heal poorly beyond repair, and if repair is possible, there will be an additional charge for the repair/touch up of the tattoo.
QUESTIONS: I acknowledge that I have been given adequate opportunity to read and understand this document, that any and all of my questions have been answered, that it was not presented to me at the last minute, and I understand that I am signing a legal contract waiving certain rights to recover against the artist and Treze Ink Tattoo Ltd.
PHOTOGRAPHY: 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 select no, please advise your artist of your decision.)
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Data protection and agreement
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THE GENERAL DATA PROTECTION REGULATION (GDPR): GDPR is designed to give you more choice in how you're contacted and how your data (for example, your name, address) is used. To comply with GDPR, please confirm that we can retain your details.
GDPR CONTINUED: I consent to my personal information being used to contact me in the future. This could be physically or electronically.
THIS DOCUMENT: 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.
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.
Legal Name
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Preferred Name
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Address
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Birth Date
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Phone
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Email
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Submit