ROYAL KIDD

TATTOO PROCEDURE CONSENT FORM 817 Dickinson Avenue

Greenville NC 27858

(252)-364-2294

I ACKNOWLEDGE BY SIGNING THIS AGREEMENT THAT I HAVE BEEN GIVEN THE OPPORTUNITY TO INQUIRE AND ASK ALL QUESTIONS ABOUT THE PROCESS OF THE TATTOO PROCEDURE AND THAT ALL QUESTIONS HAVE BEEN ANSWERED TO MY SATISFACTION. FURTHERMORE I HAVE BEEN ADVISED OF AND UNDERSTAND THE FOLLOWING INFORMATION:

• I AM RESPONSIBLE FOR INFORMING MY TATTOO ARTIST OF ANY SKIN CONDITION THAT MAY AFFECT THE TATTOO PROCESS OR PROCEDURE.

• I DO NOT HAVE ANY SKIN CONDITIONS SUCH AS ACNE, SCARRING, KELOIDS, ECZEMA, PSORIASIS, FRECKLES, MOLES. OR SUNBURN IN THE AREA OF SKIN WHERE THE TATTOOING PROCEDURE WILL OCCUR.

• I AM NOT UNDER THE INFLUENCE OF DRUGS OR ALCOHOL.

• I AM NOT PREGNANT OR NURSING.

• IT IS MY RESPONSIBILITY TO INFORM THE TATTOOIST OF ANY RASH OR INFECTION OF THE SKIN PRESENTLY ON MY BODY.

• DIABETICS MUST INFORM THE ARTIST OF THIS CONDITION AND BE AWARE THAT THE HEALING TIMES ARE LONGER AND MAY PRESENT COMPLICATIONS.

• I ACKNOWLEDGE THAT IT IS NOT REASONABLE FOR THE OWNER, EMPLOYEE, OR ANY AUTHORIZED AGENT OF ROYAL KIDD TO DETERMINE THE POSSIBLE ALLERGIC REACTIONS AS A RESULT OF RECEIVING A TATTOO, AND I AGREE I ACCEPT ALL RISK AND ACKNOWLEDGE THAT SUCH RISK IS POSSIBLE.

• I ACKNOWLEDGE THAT INFECTION IS ALWAYS A POSSIBILITY OF GETTING A TATTOO.

• I ACKNOWLEDGE THAT I HAVE RECEIVED AFTERCARE INSTRUCTIONS (AND THAT THEY ARE AVAILABLE ONLINE) AND I AGREE TO FOLLOW THEM. I ALSO ACKNOWLEDGE THAT NOT FOLLOWING MY AFTERCARE INSTRUCTIONS PROPERLY MAY RESULT IN INFECTION OR HEALING COMPLICATIONS.

• I AGREE THAT ANY TOUCH-UP WORK TO BE DONE THAT IS A RESULT OF NOT PROPERLY TAKING CARE OF MY TATTOO WILL BE DONE AT MY OWN EXPENSE.

• I HAVE BEEN MADE AWARE THAT IF MY SKIN IS DARKER IN COMPLEXION THAT SOME COLORS WILL NOT APPEAR VIBRANT AS OPPOSED TO HAVING A LIGHTER SKIN TONE.

• I ACKNOWLEDGE THAT A TATTOO IS A PERMANENT CHANGE TO MY APPEARANCE. I ACKNOWLEDGE THAT ALTERING TO THE SKIN INCLUDING BUT NOT LIMITED TO TATTOO REMOVAL AND PLASTIC SURGERY MAY AFFECT THE APPEARANCE OF MY TATTOO.

• I AFFIRM THAT I HAVE NO PHYSICAL, MENTAL, OR MEDICAL IMPAIRMENT OR DISABILITY THAT COULD AFFECT OVERALL WELL-BEING AS AN INDIRECT OR DIRECT DECISION TO GET A TATTOO.

• I ACKNOWLEDGE THAT I AM EIGHTEEN YEARS OF AGE OR OLDER AND THAT I HAVE TRUTHFULLY PROVIDED A GOVERNMENT-ISSUED PHOTO ID TO ROYAL KIDD EMPLOYEES OR AUTHORIZED AGENTS. ALSO THAT THERE IS A $5 CREDIT/DEBIT CARD COURTESY FEE.

• I CONSENT TO THE APPLICATION OF THE TATTOO AND TO ANY ACTIONS OR CONDUCT OF THE EMPLOYEES OR OWNER OF ROYAL KIDD AND A THE TERM OF THIS CONSENT FORM AS IT PERTAINS TO THE TATTOO PROCEDURE.

• I CONSENT TO COVID-19 SCREENING, AND ACKNOWLEDGE THAT I AM NOT EXHIBITING ANY OF THE SYMPTOMS PRESENTED WITH THE ILLNESS.