INFORMED CONSENT:
By selecting this section, I acknowledge that by completing and signing this form that I have been given full opportunity to ask any and all questions about obtaining my tattoo or piercing from an contractor at Moscow Tattoo Company, and all my questions have been answered to my full and total satisfaction. I specifically acknowledge that I have been advised of the facts and matters set forth below, and by my selection of items and initials, I understand and agree to the statements below.
OVER 18:
I have truthfully represented that I am over the age of eighteen (18) years or; I am a minor and that my parent or legal guardian.
HEALTH STATUS:
I have truthfully represented my health status by correctly (to the best of my knowledge) informing my artist, piercer, and Moscow Tattoo Company of any health conditions, allergies, and diseases/infections.
ALLERGIC REACTION
I acknowledge and understand that it is not reasonably possible for Moscow Tattoo Company representatives and artists or piercersto determine whether I might have an allergic reaction to the dyes, pigments, processes, or products used in my tattoo. I agree to accept the risk that such an allergic reaction is possible and do not hold my artist, piercer, and/orMoscow Tattoo Company responsible.
SKIN CONDITIONS:
I do not have a medical or skin condition that might interfere with desirable healing of my tattoo, such as acne, scarring condition (Keloidal) eczema, psoriasis, freckles, moles, sunburn in the area to be tattooed. I will inform my artist and/or piercer if I have any infection or rash anywhere on my body.
Please initial to acknowledge understanding and agreement with this section.
AFTERCARE:
I acknowledge that I will review written care instructions for tattoo aftercare (also available on the Moscow Tattoo Company website) and; I understand it is an absolute necessity to follow those instructions.
PERMANENT:
I acknowledge that a tattoos and piercing are considered permanent and that it can only be removed by surgical procedure, and that any removal may leave a permanent scar and disfigurement.
FREE WILL:
I acknowledge that obtaining my tattoo and/or is by my choice alone and; I consent to the application of the tattoo and/or. I provide consent to the location and procedures for receiving the tattoo and/or.
DRUGS AND ALCOHOL:
I acknowledge that I am not (nor will I be) under the influence of alcohol or drugs or any other intoxicating substance while obtaining my tattoo and/or piercing.
COPYRIGHT RELEASE:
I hereby give my artist or piercer and Moscow Tattoo Company permission to copyright and publish photographic portraits or pictures of me in which I may be included in whole or in part or reproduction thereof made through any media for art, advertising, or any other lawful purpose whatsoever. I waive any right I may have to inspect and approve the finished product or the use to which it may applied.
LIABILITY RELEASE:
I agree to release and forever discharge and hold harmless my artist, piercer, and Moscow Tattoo Company in which is my tattoo and/or piercing is applied from any and all claims, damages or legal actions arising from or connected in any way with my tattoo and or piercing, or the procedure and conduct used to apply my tattoo and/or piercing, or the processing or production of any said pictures.
CONTRACTOR STATUS:
I understand that my tattoo artist and piercer is an independent service provider and, although they lease space and equipment from Moscow Tattoo Company, my artist and/or piercier is not an employee of Moscow Tattoo Company.
TRANSLATION AND PROOFREADING:
If my tattoo is a symbol or something written in a language other than English, I acknowledge that the tattoo artist and Moscow Tattoo Company are not responsible for the meaning. If my tattoo includes text/writing, I acknowledge that I am fully responsible for the correct spelling, grammar, and punctuation. I have proofread/edited the text before it is applied as a tattoo and I do not hold the artist or Moscow Tattoo Company responsible.
TATTOO VARIATION:
I understand that variations in skin tones may influence the appearance of your tattoo. I acknowledge that variations in color and design exist between any tattoo as it is applied; the final product will vary as it is applied to my skin.
TATTOO/PIERCING APPEARANCE:
I accept responsibility for ensuring that my tattoo design is correctly drawn and tattoo or piercing is oriented to my specifications prior to procedures. I agree to allow for artist interpretation of the image.
TOUCH-UPS:
I acknowledge that Moscow Tattoo Company does not guarantee tattoos on Heads, Lips, Hands, Wrists or feet. I understand that they may need more than one touch up to keep their design or color. Touch ups resulting from not following aftercare instructions or after 3 months of the tattoo are subject to fees.
FAINTING:
I agree to IMMEDIATELY notify the artist or piercer if I feel ill, queasy, lightheaded, nauseated, and/or faint before, during or after the procedure. Failure to do so releases the Artist, Piercer,and Moscow Tattoo Company of all responsibility.
PAYMENT AND FEES:
I understand that payment is due in full at time of service. I understand that supply services fees may be assessed in addition to my tattoo fee or piercing fee. Fees will be discussed prior to beginning the tattoo or piercing and are non-negotiable once tattooing or piercing begins. I understand that fees are non-refundable. Rejected/returned payments are subject to surcharges. No-show will be assessed a fee and are subject to loss of deposit.
SIGNATURE:
I acknowledge that acceptance and execution of this Agreement shall be made by electronic acknowledgement, and agree that electronic acknowledgment of this Agreement with signatures shall be considered the equivalent of my written signature and initials.
SELECT CHECK-BOXES BELOW TO CONFIRM THAT YOU HAVE READ, UNDERSTAND, AND AGREE WITH EACH SECTION. WE ARE UNABLE TO PROCEED WITHOUT THIS ACKNOWLEDGEMENT.
INFORMED CONSENT
OVER 18
HEALTH STATUS
ALLERGIC REACTION
SKIN CONDITIONS
AFTERCARE
PERMANENT
FREE WILL
DRUGS AND ALCOHOL
COPYRIGHT RELEASE
TRANSLATION AND PROOFREADING
TATTOO VARIATION
TATTOO APPEARANCE
TOUCH-UPS
FAINTING
PAYMENT AND FEES
SIGNATURE
SIGNING THIS DOCUMENT INDICATES UNDERSTANDING AND AGREEMENT WITH ALL MATTER SET FORTH IN THIS DOCUMENT.
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