Consent to Tattoo

Step 3 of 5

Representations and disclosures

Section 1 of the Agreement, in full. By ticking a box the Client represents, warrants and affirms that the statement beside it is true as of today, the date of signature. Each is a separate representation, and every one is required.

Section 1.1(a)1.1(a)The Client represents and warrants that they are at least 18 years of age.Section 1.1(b)1.1(b)The Client represents and warrants that, at the time of the tattoo procedure, they are not pregnant, nursing, or under the influence of any intoxicating substances.Section 1.2(i)1.2(i)The Client covenants to fully and accurately disclose any and all medical conditions, including but not limited to, allergies, or skin disorders that may affect or be affected by the tattoo procedure. The Client acknowledges that tattoo pigments and related products are not approved by any regulatory authority for long-term human application.Section 1.2(ii) first1.2(ii)I am free of any close proximity, skin to skin or blood-borne transmissible diseases.Section 1.2(ii) second1.2(ii)I do not have any medical or skin conditions that will agitate the skin nor interfere with the tattooing process. If I do have any, I will notify the tattoo artist before the tattooing process.Section 1.2(ii) third1.2(ii)There is a chance I might feel lightheaded/dizzy before, during or after being tattooed. I agree to immediately notify the tattoo artist or staff if it does happen.Section 1.2(ii) fourth1.2(ii)Necessary precautions are taken but it is not possible for the tattoo artist and/or staff to determine if I may have an allergic reaction to dyes, pigments, or any other materials used in my tattoo and I agree to accept that as such risks are possible.Section 1.2(iii)1.2(iii)In the event that it has been revealed or disclosed that Client has a medical condition, disease, etc., that may affect the tattoo procedure, Client must provide the Artist with a primary medical physician's written approval or a medical professional's written approval to undergo the tattoo procedure.Section 1.31.3The Client acknowledges that the Artist is required to verify that the Client is at least 18 years of age prior to the tattoo procedure, and consents to the Artist inspecting valid government-issued photographic identification for that purpose, whether by secure upload or by presentation in person. The Client represents that any identification provided is genuine and belongs to the Client.

Your disclosure under 1.2(i) - any medical condition, allergy or skin disorder

Under 1.2(iii), if you disclose a condition or disease that may affect the procedure, you must give Maddie written approval from a physician or other medical professional before she can tattoo you.

Please confirm every statement above.

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Step 4 of 5

The agreement

Sections 2 to 9 of the Agreement, in full and exactly as drafted. Read them in the box below, then confirm each section underneath. Each section stands on its own.

This Tattoo Consent, Release, and Waiver Agreement (hereinafter referred to as "Agreement") is executed by and between the undersigned Client named and signing below (hereinafter referred to as "Client") and Maddie Reid (legal name Madison Reid), doing business as Madd Inkz (hereinafter referred to as the "Artist"). By executing this Agreement, the Client acknowledges full understanding of the inherent risks in the tattoo procedure and consents to be bound by its terms.

1. Representations and Disclosures

1.1 Client's Age and Condition. (a) The Client represents and warrants that they are at least 18 years of age. (b) The Client represents and warrants that, at the time of the tattoo procedure, they are not pregnant, nursing, or under the influence of any intoxicating substances.

1.2 Health Disclosure. (i) The Client covenants to fully and accurately disclose any and all medical conditions, including but not limited to, allergies, or skin disorders that may affect or be affected by the tattoo procedure. The Client acknowledges that tattoo pigments and related products are not approved by any regulatory authority for long-term human application. (ii) The Client further acknowledges and agrees to the following: I am free of any close proximity, skin to skin or blood-borne transmissible diseases. I do not have any medical or skin conditions that will agitate the skin nor interfere with the tattooing process. If I do have any, I will notify the tattoo artist before the tattooing process. There is a chance I might feel lightheaded/dizzy before, during or after being tattooed. I agree to immediately notify the tattoo artist or staff if it does happen. Necessary precautions are taken but it is not possible for the tattoo artist and/or staff to determine if I may have an allergic reaction to dyes, pigments, or any other materials used in my tattoo and I agree to accept that as such risks are possible. (iii) In the event that it has been revealed or disclosed that Client has a medical condition, disease, etc., that may affect the tattoo procedure, Client must provide the Artist with a primary medical physician's written approval or a medical professional's written approval to undergo the tattoo procedure.

1.3 Identity Verification. The Client acknowledges that the Artist is required to verify that the Client is at least 18 years of age prior to the tattoo procedure, and consents to the Artist inspecting valid government-issued photographic identification for that purpose, whether by secure upload or by presentation in person. The Client represents that any identification provided is genuine and belongs to the Client.

2. Assumption of Risk

2.1 Acknowledgment of Risks. The Client acknowledges that the tattoo procedure carries risks, including but not limited to, infection, allergic reaction, scarring, and other complications which may occur during or after the procedure.

2.2 Voluntary Assumption. The Client expressly or impliedly assumes all risks, during or after, associated with the tattoo procedure, including but not limited to those resulting from the acts or omissions of the Artist, except that this assumption does not affect the Client's right to assert any claims arising solely from the Artist's gross negligence or willful misconduct.

2.3 Disclaimer. Client acknowledges it is normal that there may be slight changes in the color pigment and how the tattoo looks as it ages over long periods of time. Client agrees that if any touchup work is needed, it will be done at the Client's own expense.

3. Consent to Tattoo Procedure

The Client hereby consents, of their own free will, to the performance of the tattoo procedure and any preparatory or ancillary measures reasonably necessary for its proper execution by the Artist.

4. Release and Waiver

4.1 General Release. To the maximum extent permitted by law, the Client does hereby irrevocably, unconditionally, and forever release and discharge the Artist, including her representatives, agents, and affiliates, from any and all claims, actions, demands, or causes of action, whether known or unknown, arising out of or in any way connected with the tattoo procedure.

4.2 Exception for Gross Negligence. Notwithstanding the foregoing, this release shall not apply to any claims arising solely from the Artist's gross negligence or willful misconduct.

4.3 Additional Waiver Provision. In further consideration, the Client waives and releases to the fullest extent permitted by law the Artist from all liability whatsoever for any and all claims or causes of action that I, my heirs, executors, or assigns may have for personal injury or otherwise, including any direct and/or consequential damages, arising out of or related to the tattoo procedure, whether such claims are based on negligence or fault of the Artist, except that this release shall not apply to claims arising solely from the Artist's gross negligence or willful misconduct.

4.4 Design Waiver. The Artist is not responsible for the meaning of a symbol or spelling of any text that I have provided to them or chosen from the Flash (design) Sheets. I acknowledge that I have been given adequate opportunity to modify the design, placement, stencil and/or tattoo. I understand that once I approve the final design, the Artist will proceed with the tattooing process, and no further changes can be made.

5. Indemnification

5.1 Client's Indemnity. The Client shall indemnify, defend, and hold harmless the Artist, her heirs, executors, assigns, representatives, agents, and affiliates (each, an "Indemnified Party") from and against any and all losses, liabilities, claims, damages, costs, and expenses, including reasonable attorneys' fees, arising out of or in connection with: (i) any misrepresentation or failure by the Client to disclose pertinent health information; (ii) any materials or representations provided by the Client; and (iii) any acts or omissions of the Client in connection with the tattoo services provided under this Agreement, including any failure to follow aftercare instructions provided by the Artist. This indemnification specifically includes, but is not limited to, claims relating to alleged copyright infringement, defamation, products liability, any deceptive acts or practices, fraud, or any negligent or grossly negligent acts or omissions of the Client or its representatives.

5.2 Survival. The indemnification obligations set forth herein shall survive the termination of this Agreement.

5.3 Reimbursement of Legal Fees. In addition, the Client agrees to reimburse the Artist for any attorneys' fees and costs incurred in any legal action or proceeding brought by either party in connection with claims arising out of or related to this Agreement, provided that such legal actions are not based solely on claims of gross negligence or willful misconduct by the Artist.

6. Limitation on Liability

6.1 Monetary Limitation. Except for liability arising from gross negligence or willful misconduct, the total aggregate liability of the Artist arising out of or related to the tattoo procedure shall in no event exceed the total amount paid by the Client for the tattoo procedure.

6.2 Exclusion of Damages. In no event shall the Artist be liable for any consequential, incidental, indirect, or punitive damages.

7. Media Release

7.1 Consent to Use. The Client consents to the capturing of photographic and/or video images before, during, or after the tattoo procedure by the Artist for purposes of advertising, promotion, or portfolio display.

7.2 Waiver of Further Claims. The Client hereby expressly waives any right to compensation for the use of any photographic and/or video images before, during, or after the tattoo procedure by the Artist for purposes of advertising, promotion, or portfolio display.

7.3 Withdrawal of Consent. The Client may withdraw the consent granted in Section 7.1 at any time by providing written notice to the Artist. Withdrawal takes effect prospectively only: upon receipt, the Artist will cease new uses of the Client's images within a reasonable period. The Client acknowledges that the Artist is not required to recall, retract, or remove images already published, printed, or distributed before the notice was received.

8. Governing Law, Venue, and Compliance with Local Regulations

8.1 Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of New York. Notwithstanding the foregoing, the Artist does not intend to waive, limit, or modify any mandatory consumer rights or protections imposed by the law of the jurisdiction in which the tattoo procedure is performed. In the event of any conflict between this Agreement and any non-waivable local right, the non-waivable right shall prevail.

8.2 Exclusive Venue. Notwithstanding any mandatory local rights, the parties agree that any dispute, claim, or controversy arising out of or relating to this Agreement or the tattoo procedure shall be exclusively resolved in the state or federal courts located in New York County, New York, or, if agreed, by binding arbitration conducted in Manhattan, New York. The Client hereby irrevocably consents to the jurisdiction and venue of such courts or arbitration forums and waives any right to a trial by jury and to participate in any class action.

9. Entire Agreement and Severability

9.1 Entire Agreement. This Agreement constitutes the entire agreement between the parties regarding the subject matter hereof and supersedes all prior agreements, representations, or understandings, whether oral or written.

9.2 Amendment. No amendment or modification of this Agreement shall be effective unless in writing and duly executed by both parties.

9.3 Severability. If any provision of this Agreement is found to be invalid or unenforceable, the remaining provisions shall remain in full force and effect.

9.4 Incorporation of the Terms of Service. The Artist's Terms of Service, published at maddinkz.com/terms, are incorporated into this Agreement by reference and govern booking, deposits, payment, cancellation and studio policies. The Client acknowledges having had the opportunity to read them before executing this Agreement. In the event of a conflict between this Agreement and the Terms of Service in respect of the tattoo procedure itself, this Agreement shall prevail.

Accepts Section 2I have read, understand and agree to be bound by Section 2 (Assumption of Risk) in its entirety.Accepts touch-up cost2.3 Disclaimer. Client acknowledges it is normal that there may be slight changes in the color pigment and how the tattoo looks as it ages over long periods of time. Client agrees that if any touchup work is needed, it will be done at the Client's own expense.Accepts Section 3I have read, understand and agree to be bound by Section 3 (Consent to Tattoo Procedure) in its entirety.Accepts Section 4I have read, understand and agree to be bound by Section 4 (Release and Waiver) in its entirety, including the Design Waiver at 4.4.Accepts Section 5I have read, understand and agree to be bound by Section 5 (Indemnification) in its entirety.Accepts Section 6I have read, understand and agree to be bound by Section 6 (Limitation on Liability) in its entirety.

Accepts Section 7I have read, understand and agree to be bound by Section 7 (Media Release) in its entirety, including the consent to the use of my images at 7.1, the waiver of any right to compensation at 7.2, and the withdrawal procedure at 7.3.

You may withdraw the consent given in 7.1 at any time by writing to Maddie. Withdrawal applies going forward only: she will stop new uses of your images within a reasonable period, but is not required to recall or remove images already published before she received your notice.

Accepts Section 8I have read, understand and agree to be bound by Section 8 (Governing Law, Venue, and Compliance with Local Regulations) in its entirety, including the waiver of trial by jury and of participation in any class action at 8.2.Accepts Section 9I have read, understand and agree to be bound by Section 9 (Entire Agreement and Severability) in its entirety, including the severability of each provision at 9.3 and the incorporation of the Terms of Service at 9.4.