James River Tattoo LLC

15042 Carrollton Blvd., Suite K, Carrollton, VA 23314
JamesRiverTattoo757@gmail.com
JamesRiverTattoo.com
(757) 745-7135

Consent to Tattoo Waiver

To be completed on the day of your tattoo appointment and not before.

I acknowledge by signing this agreement that I have been given the full opportunity to ask any and all questions that I might have about obtaining 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:

• I understand that James River Tattoo LLC does not tattoo minors, even with parental consent. I hereby state that I am 18 years of age or older.
• If I have diabetes, epilepsy, hepatitis, hemophilia, HIV-AIDS, or any other communicable disease, heart condition, or take medicine that thins the blood, I have advised my tattoo artist. I am not pregnant or nursing. I am not under the influence of alcohol or drugs.
• I do not have medical or skin conditions, such as but not limited to: acne, scarring (Keloid), Eczema, psoriasis, rash, infection, lesion, freckles, warts, moles, or sunburn in the area to be tattooed that may interfere with said tattoo. If I have any type of infection, rash, or lesion anywhere on my body, I will advise my tattooist.
• I acknowledge it is not reasonably possible for the representatives, independent contractors, and employees of James River Tattoo LLC 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 acknowledge that infection is always possible as a result of obtaining a tattoo, particularly if 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 or failure to follow such instructions, will be done at my own expense.
• I realize 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 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 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 a physical, mental, or medical impairment or disability that might affect my well-being as a direct or indirect result of my decision to have a tattoo.
• I acknowledge I am eighteen (18) years of age or older and that I have truthfully represented to my tattooist that the obtaining of a tattoo is by my choice alone. I consent to the application of the tattoo and to any actions or conduct of the representatives, independent contractors, and employees of James River Tattoo LLC reasonably necessary to perform the tattoo procedure.

I understand tattoos usually take two (2) weeks or longer to heal. I hereby release and forever discharge and hold harmless James River Tattoo LLC, the tattoo artist, and all affiliates, owners, managers, independent contractors, and employees from any and all claims, damages, or legal actions arising from or connected in any way with my tattoo or the procedure and conduct used in the application of my tattoo, to the fullest extent allowed by law.

By completing this waiver and booking an appointment, I am confirming that I have completely read this Consent to Tattoo Waiver provided by James River Tattoo LLC and understand and fully agree to its terms.