Test Tattoo Release form • Killer Silver Tattoo

Age Restriction

New York state law requires you to be 18 years of age. Sorry, we can't tattoo you this time.

Ask Front Desk what to enter

Today`s Date:

Wednesday, April 30 2025

Tattoo Artist:*

Placement of your tattoo (what bodypart): *

Please read and answer

Where did you hear about us? *

Medical Information*

I have diabetes, epilepsy, hepatitis, hemophilia, HIV-AIDS, tuberculosis or any other communicable disease, a heart condition or take medication that thins the blood. I am not pregnant or nursing. am not under the influence of drugs or alcohol. I do not have medical or skin conditions such as (but not limited to) acne, scarring (keloids), eczema, psoriasis, freckles, moles, or sunburn in the area to be tattooed that may interfere with said tattoo. If any of these apply, I will inform the Artist and Killer Silver Tattoo Studio prior to the application of my tattoo.

Risks *

I 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 o infections, scarring, difficulties in detecting melanoma, and allergic reactions to tattoo pigment, latex gloves, and/or soap. Having been informed of the potential risks, I still wish to proceed with the tattoo application and I freely accept and expressly assume any and all risks.

Waive *

TO WAIVE AND RELEASE to the fullest extent permitted by law each of the Artist and Killer Silver Tattoo 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 my tattoo, whether caused by the negligence of fault of either the Artist or Killer Silver Tattoo Studio or otherwise.

Longevity *

Variations in color/design may exist between the art I have selected and the actual tattoo. I also understand that over time, the colors and the clarity of my tattoo will fade due to the natural dispersion of pigment under the skin.

Spelling *

Neither the Artist nor Killer Silver Tattoo Studio is responsible for the meaning or spelling of the symbol or text that I have provided to or chosen from the flash (design) sheets.

Permanent *

A tattoo is a permanent change to my appearance and can only be removed by laser or surgical means, which can be disfiguring and /or costly and which in all likelihood will not result in the restoration of my skin.

Healing *

The Artist and Killer Silver Tattoo Studio have given me instructions on the care of my tattoo while it`s healing. I understand them and will follow them. I acknowledge that it is possible that the tattoo can become infected, particularly if I do not follow the aftercare instructions given to me. If any touch-up work to the tattoo is needed due to my own negligence, I agree that the work will be done at my own expense.

Questions *

I acknowledge that I have been given adequate opportunity to read and understand this document, that any and all of my questions have been answered, that it was not presented to me at the last minute, and I understand that I am signing a legal contract waiving certain rights to recover against the Artist and Killer Silver Tattoo Studio.

Social Media

If my photo is taken, I`d like to be tagged on social media!
My Instagram handle (@) is:

Photography

I release all rights to any photographs taken of me and the tattoo and give consent in advance to their reproduction in print or digital form. (If you do not checkmark this provision, please advise your Artist).

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.

Personal Info

I hereby declare that I am of legal age (with valid proof of age) and am competent to sign this Agreement.

First Name: *

Last Name: *

Address: *

City: *

State: *

Postcode: *

Date of birth: *

You must be 18 or older

Phone #: *

Email: *

Signature: *

Sign above or type signature:

Photo ID *

Please take photo(s) of your government issued photo IDs and related paperwork.

Age Restriction

Thank You,