469-334-0469

Consent

I acknowledge by signing this agreement that I have been given the 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:

Full Name(Required)

First Last

Email(Required)

Phone(Required)

Date of Birth(Required)

PLEASE UPLOAD A PICUTRE OF YOUR VALID DRIVERS LICENSE OR PASSPORT(Required)

Max. file size: 32 MB.

I understand that there is a possibility for discomfort or pain.(Required)

Yes

Do you have a condition that might affect the healing of this tattoo.(Required)

Yes

Are you pregnant or nursing.(Required)