Consent Form

Full Name *

Phone *

Email Address *

Date Of Birth *

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Day

Year

Address

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ID Photo (Driver license - Passport) *

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I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.

Emergency Contact

Emergency Contact Name *

Emergency contact phone *

Tattoo Session Information

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Tatoo Description *

Health Information

Legal information

By completing and signing this form, I acknowledge that I have been given the full opportunity to ask any and all questions which I might have about obtaining a tattoo from Garden Ink Inc (Garden Ink NY) and that all of 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, and I agree as follows:

I have truthfully represented to Garden Ink Inc (Garden Ink NY) that I am over eighteen (18) years of age. *Acknowledge

I acknowledge and agree to following any and all instructions provided to me regarding the maintenance of a sanitary environment while I am being tattooed. *Acknowledge

I acknowledge that it is not reasonably possible for the representatives and employees of Garden Ink Inc (Garden Ink NY) to determine whether I might have an allergic reaction to the dyes, pigments or processes used in my tattoo, and I agree to accept the risk that such a reaction is possible. *Acknowledge

I acknowledge the decision for obtaining my tattoo is my own free will and choice. I consent to the location of the tattoo and the performance of the tattoo procedure. *Acknowledge

I acknowledge that infection is always possible as a result of obtaining 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. This includes sun and ultraviolet frequency damage. *Acknowledge

I acknowledge that I have advised my tattoo artist of any condition that might affect the healing of this tattoo. I do not have medical or skin conditions such as but not 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 the tattooer. *Acknowledge

I acknowledge that variations in color and design may exist between any tattoo as selected by me and as ultimately applied to my body. I understand that if my skin color is dark, the colors will not appear as bright as they do on light skin. I also understand that overtime, the colors and the clarity of my tattoo will fade due to unprotected exposure to the sun and the naturally occurring dispersion of pigment under the skin. *Acknowledge

I acknowledge that a tattoo is a permanent change to my appearance and that no representations have been made to me as to the ability to later change or remove my tattoo. To my knowledge, I do not have physical, mental or medical impairment or disability which might affect my well being as a direct or indirect result of my decision to have a tattoo. *Acknowledge

I acknowledge that if my tattoo includes text that I am responsible for the correct spelling, grammar and punctuation. I have proofed the text before it is applied as a tattoo. *Acknowledge

I acknowledge that if my tattoo is a symbol, or something written in a language other than English, the tattoo artist and the owner of this business are not responsible for what it may or may not mean. *Acknowledge

I agree to IMMEDIATELY notify the artist if I feel lightheaded, dizzy and/or faint before, during or after the procedure. Failure to do so releases Inknation Studio and my tattoo artist of all responsibility. *Acknowledge

I am NOT under the influence of alcohol or drugs. *Acknowledge

I do not have diabetes, epilepsy, hemophilia, a heart condition, nor do I take blood thinning medication. I do not have any other medical or skin condition that may interfere with the application or healing of the tattoo. I am not the recipient of an organ or bone marrow transplant or, if I am, i have taken the prescribed preventive regimen of anti-biotic that is required by my doctor in advance of any invasive procedure such as tattooing. I am not pregnant or nursing. I do not have a mental impairment that may affect my judgement in getting tattoo. *Acknowledge

TO WAIVE AND RELEASE to the fullest extent permitted by law each of the artist and Inknation Studio 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 the application of my tattoo, whether caused by the negligence or fault of either the Artist or Garden Ink NY, or otherwise. *Acknowledge

I agree to allow for artist interpretation of the image. *Acknowledge

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. *Acknowledge

I agree to reimburse each of the artist and 'Garden Ink Inc' (Garden Ink NY) for any attorneys fees and cost incurred and any legal action I bring against either the artist or 'Garden Ink Inc' (Garden Ink NY) and in which either the artist or the tattoo studio is the prevailing party. I agree that the courts of New York in New York county 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. *Acknowledge

I release all rights to any photographs taken to me and the tattoo and give consent in advance to their reproduction in print or electronic form. (If you do not initial this provision, please advice and remind your artist and the Garden Ink Inc (Garden Ink NY) not to take any pictures of you and your completed tattoo. *Acknowledge

COVID-19 Safety Measures: * For the purpose of protecting our clients and employees, it is essential we practice safe social distancing and the provided CDC guidelines as instructed by your artist. *Acknowledge

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