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First Name *
Last Name *

Phone Number *

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I acknowledge by signing this agreement that I have been given the full opportunity to ask any and all questions which I might have about the obtaining of a tattoo and that all of my questions have been answered to my full satisfaction. I specifically acknowledge I have been advised of the facts and matters set forth below and I agree as follows:

If I have any condition that might affect the healing of this tattoo, I will advise my tattooer. I am not pregnant or nursing. I am not under the influence of alcohol or drugs.

I understand *

I do not have medical or skin conditions such as but no limited to: acne, scarring (keloid), eczema, psoriasis, freckles, moles or sunburn in the area to be tattooed that may interfere with said tattoo. If I have any type of infection or rash ANYWHERE on my body, I will advise my tattooer.

I agree *

I acknowledge it is not reasonably possible for the representatives and employees of this tattoo shop to determine whether I might have an allergic reaction to the pigments or processes used in my tattoo, and I agree to accept the risk that such a reaction is possible.

I accept *

I acknowledge that infection is always possible as a result of the obtaining of a tattoo, particularly in the event that I do not take proper care of my tattoo. I have received aftercare instructions and I agree to follow them while my tattoo is healing. I agree that any touch-up work needed, due to my own negligence, will be done at my own expense.

I acknowledge *

I realize that variations in color and design may exist between any tattoo selected by me and as ultimately applied to my body. I understand that if my skin color is dark, the color will not appear as bright as they do on light skin.

I understand this *

I understand that if I have any skin treatments, laser hair removal, plastic surgery or other skin altering procedures, it may result in adverse changes to my tattoo.

I accept this *

I acknowledge that a tattoo is a permanent change to my appearance and that I am of clear and sound mind to make my own decision to get a tattoo. I am not impaired in any way mentally, physically or medically which might affect my well being as a direct or indirect result of getting a tattoo.

Yes *

I acknowledge I am over the age of 18 and that I have truthfully represented to my tattooer that this tattoo is my choice alone. I consent to the application of the tattoo and to any actions or conduct of the representatives and employees of the tattoo shop necessary to perform the tattoo procedure.

I consent *

I acknowledge that I may have video or pictures of me taken at this event and give TattooCharity.com permission to use any footage or content with my likeness or exactness as they see fit, in perpetuity, in any content they create.

I consent to this *