Release form

Tattoo waiver

Please read each section and tick to initial it, then sign at the bottom. Your signed copy is stored securely at the studio.

This document is three pages (or two, two-sided). Ticking each box below is the same as initialling that provision and shows that you understand it.

About you

at Pushing Inc. Tattoo Emporium (together with its employees, apprentices, guest artists and agents, the “Tattoo Studio”), I agree to the following:

That I, (your name), have been fully 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, gloves, soap, cleansers, ointments and/or any other product used prior, during or after the procedure. Having been informed of the potential risks associated with getting a tattoo, I still wish to proceed and I freely accept and expressly assume any and all risks that may arise from tattooing.

Please check the following if they apply to you

Tick each provision to initial it

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.

I hereby declare that I am of legal age (and have provided valid proof of age) and am competent to sign this Agreement or, if not, that my parent or legal guardian shall sign on my behalf, and that my parent or legal guardian is in complete understanding and concurrence with this agreement.

I HAVE READ THIS AGREEMENT, I UNDERSTAND IT, I AGREE TO BE BOUND BY IT.

Sign

Signed on today · Your waiver is sent securely to Pushing Inc. and is not shared.