Tattoo consent form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.In consideration of getting a tattoo from *Please select artistMark PennellEli PennellDan MurphyGuest Artist.Please select the artist your are booked in with.Guest artist name. *FirstLastFrom time to time we have guests from all over the world, just fill in their name here, a breast Date Clients Name *FirstLastPlease type your full name as on the bookingAddress *Address Line 1CityState / Province / RegionPostal CodeAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryName and address of the client:Contact Number *Email *Email addressAge declaration *I am 18 or overI hereby declare I am of legal age (18+) and have valid proof of age when asked. If you look under the age of 25 will ask proof of age documents.Date of birth *DD12345678910111213141516171819202122232425262728293031MM123456789101112YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Aftercare Instructions *Aftercare adviceThe artist will give me instructions on how to look after my fresh tattoo. We can provide you with a paper copy if you have not already received an emailed version. I agree to follow these instructions to the best of my ability. Unless it is clear that I have not properly looked after my tattoo during healing, touch ups are free of charge up to two months from your original date of appointment.Waive and release *WaiverTo waive and release the artist and studio of all liability whatsoever for any damages to my new tattoo. I understand that I must return to Serious Ink Studio with any issues concerning my tattoo.Spellings and writing *I have supplied the correct spellings dates and times.Not ApplicableThe artist is NOT responsible for time / dates / spellings of text that I have provided, you will be asked multiple times that what you have provided is correct.Natural ageing of the tattoo *I fully understand.I fully understand that the clarity of the tattoo may fade over time and due to unprotected exposure to UV rays (sun damage) and the natural dispersion of pigment under the skin. I understand that tattoos are permanent and can only be removed by laser treatment.Photographs and social media *No PhotographsYes, but please don't show my face or namePhotographs are fineI am happy for the artist and the studio to take photos during and after the tattoo. These may be included on the studios and the artists social media pages.Health and medications *I am not under the influenceI am NOT under the influence of any drugs or alcohol and I am voluntarily submitting to be tattooed by the artist without duress or coercion. Please note if we suspect that you are under the influence of any drugs or alcohol. We can and will refuse to tattoo you.Illnesses and medications *I confirm that I do notI can confirm that I doI do not suffer from any blood disorders, skin allergies or nervous complaints. I do not take blood thinning medications. I am not HIV positive.*Medications *Blood ThinnersSkin / Allergies / complaintsHIV non detectableOtherI've discussed with the artist and we are happy to proceed *I've discussed with the artist and we are happy to proceedPregnant or breast feeding. *I am not pregnant or Breast feeding. If I was unknowingly pregnant during the tattoo the artist and studio will not be held responsible.*Not applicableIllness *Covid 19 / Colds / Flu / SicknessI confirm that I am not or any person in my close contact is suffering any of the above.Acknowledgment *I acknowledge I have been given adequate opportunity to read and understand this form.How will my Information be used? *Please tick the box to agree.Privacy Notice for Serious Ink in accordance with the GDP Regulations. The following information we will collect and store on our secure computer/phone systems, collecting the data from your disclaimer form and/or computer/ email/phone/calendar as follows: Name, Date of Birth, telephone number, email address and postal address. We will use this information for the purpose of booking an appointment or consultation at the studio. If required we will contact you regarding confirmation of appointment, any queries in relation to aftercare and issues. We will not share your data with any third parties. If you require any further information. If, you require any further information please do not hesitate to contact the studio.Signature * Clear Signature Please signTodays dateSubmit