Health
The following contains a waiver ("Waiver") for your review and signature. By signing this Waiver, you attest that you have: (1) read and fully understand the terms contained hereunder; (2) responded truthfully to the representations you made to Ganga Tattoo Studio and complied with your responsibilities hereunder; and (3) waived Ganga Tattoo Studio's potential or actual liability for any harm that may occur through the services provided.
This Waiver must be reviewed, understood, and signed for Ganga Tattoo Studio or any of its employees, agents, contractors, and representatives (collectively "Ganga's Providers") to provide any services to you. A refusal to sign this Waiver shall preclude you from receiving any services. Accordingly, you hereby represent the following:
1. I am not allergic to any component or material used in or for tattoos, piercings, or micropigmentation, and I have had the opportunity to, and have, consulted with my personal physician regarding my risks and any underlying health conditions in relation to receiving a tattoo. (Please initial each statement below).
2. I do not suffer from any infectious illness, disease, or any health condition that may increase my risk of injury, illness, or death (“Health Conditions”). Examples of such Health Conditions include, but are not limited to, hemophilia, cutaneous skin disease, herpes, epilepsy, diabetes, heart disease, or high blood pressure. To the extent I suffer from any such Health Conditions, I accept all risk and responsibility for complications that may arise due to such Health Conditions, and I shall and do hold Ganga Tattoo Studio blameless and harmless for any associated harm that may occur.
3. I do not have any other physical, mental, or medical impairment or disability (“Impairments”) which might affect my wellbeing as a direct or indirect result of my decision to receive a tattoo. To the extent I have any such Impairments, I accept all risk and responsibility, and I shall and do hold Ganga Tattoo Studio blameless and harmless for any associated harm that may occur.
4. I am not being treated with any antibiotic medication.
5. I am at least eighteen (18) years of age as of today’s date listed above.
6. I acknowledge, understand, and have been advised that tattoo inks, dyes, and pigments have not be approved by the United States Food and Drug Administration (FDA), and the health consequences of using such products are unknown. I hereby accept the risk for such unknown consequences.
7. I acknowledge and understand that Ganga Tattoo Studio and Ganga’s Providers cannot provide a medical opinion related to a possible allergic reaction to the dyes, pigments, or other products and procedures involved with the tattoo process. I will not rely upon any opinions provided by Ganga Tattoo Studio regarding potential or actual adverse health conditions in any form or the safety of any procedure. I further acknowledge that Ganga Tattoo Studio and Ganga’s Providers are relying upon my statements regarding my health and wellness contained herein.
8. I have informed my tattoo artist of any condition that might affect the placement, procedure, or healing of the tattoo. I expressly assert that I do not have any such medical or skin conditions, or, in the alternative, I accept the risks associated and the full responsibility for any and all complications that may be caused by such medical conditions. Examples of such conditions include, but are not limited to, acne, scarring (keloid), eczema, psoriasis, freckles, moles, or sunburn in the area to be tattooed. I understand that these conditions may interfere with the tattoo regardless of the care provided by Ganga’s Providers.
9. I am not pregnant or nursing.
10. I am not under the influence of drugs or alcohol or any other substance that may impair my judgment.
11. I acknowledge that I have received, or will receive, instructions on how to properly care for my tattoo during the healing process. I understand that infection is a known and assumed risk of receiving a tattoo, and I will not hold Ganga Tattoo Studio or Ganga’s Providers liable for any infections caused as a result of receiving a tattoo.
12. I acknowledge and understand that a variety of factors may contribute to a tattoo fading or otherwise becoming less legible including, but not limited to, improper care during the healing process and exposure to UV light and the sun. I agree that any touch-up work will be done at my expense unless otherwise agreed upon.
13. I acknowledge and understand that guest artists serve and are available to Ganga Tattoo Studio’s clients for a limited time. If I receive a tattoo from a guest artist and would like touch-ups but the guest artist is no longer providing services for Ganga Tattoo Studio, I may schedule a touch-up session with a different artist at my own expense.
14. I acknowledge and understand that a tattoo is a permanent change to my appearance and that no representations have been made by Ganga Tattoo Studio or Ganga’s Providers regarding any ability to change or remove the tattoo once the tattooing process begins.
15. I acknowledge and understand that Ganga Tattoo Studio and Ganga’s Providers are not responsible for any meaning, mistaken or otherwise, that may be assigned to my tattoo. This includes, but is not limited to, any and all symbols and foreign characters.
16. I have reviewed and approved the tattoo concept prior to receiving the tattoo. I acknowledge and understand that I am solely responsible for the correct and desired spelling, grammar, interpretation, and punctuation of any tattoo I receive. I explicitly affirm that Ganga Tattoo Studio and Ganga’s Providers are not responsible for any misspellings or mistakes.
17. I affirm that the tattoo design is correctly drawn to my specifications. I grant Ganga Tattoo Studio and Ganga’s Providers artistic license to interpret the tattoo design for the final tattoo.
18. I acknowledge and understand that variations in color and design may exist between an approved tattoo concept and the final tattoo. I further understand that the visibility of tattoos will vary depending on skin tone and complexion.
19. I have made the decision to obtain this tattoo under my own free will and choice free from impairment, external pressure, extenuating circumstance, or duress.
20. I consent to: (1) the location of the tattoo on my body; (2) the price for the tattoo; and (3) the procedure required to receive a tattoo.
21. I agree to follow all instructions provided to me regarding the maintenance of a sanitary environment during all interactions with Ganga Tattoo Studio and Ganga’s Providers. I understand that failure to comply with a request regarding sanitary standards and maintenance may result in a refusal (without reimbursement) from Ganga Tattoo Studio or Ganga’s Providers to provide or complete any services.
22. I will immediately notify my tattoo artist if I feel lightheaded, dizzy, or faint before, during, or after the procedure.
23. I hereby consent to receive any medical treatment deemed necessary if I am injured or require medical attention while at the Ganga Tattoo Studio. I understand and agree that I am solely responsible for all costs related to such medical treatment and any related medical transportation and/or evacuation. I hereby release, forever discharge, and hold harmless Ganga Tattoo Studio and Ganga’s Providers from any claim based on such treatment or other medical services and related costs.
24. I hereby irrevocably permit, authorize, grant, and license Ganga Tattoo Studio, and any of its assigns, the rights to display, publicly perform, exhibit, transmit, broadcast, reproduce, record, photograph, digitize, modify, alter, edit, adapt, create derivative works, exploit, sell, rent, license, otherwise use, and permit others to use my name, image, likeness, appearance, voice, and other personal characteristics, and all materials created by or on behalf of Ganga Tattoo Studio that incorporate any of the foregoing in perpetuity throughout the universe in any medium or format whatsoever now existing or hereafter created for any purpose, including but not limited to advertising, public relations, publicity, packaging, and promotion of Ganga Tattoo Studio and its business, products, and services, without further notice, consent from or royalty, payment, or other compensation to me.
25. By completing and signing this form, I acknowledge that I have been given the full opportunity to ask any and all questions which I might have about receiving a tattoo from Ganga Tattoo Studio and that all of my questions have been answered to my full and total satisfaction. I specifically acknowledge and attest that I have been advised of the facts and matters set forth herein, have responded truthfully, and understand that Ganga Tattoo Studio will rely upon my responses to determine if services may be provided.
By signing below, I acknowledge and agree that I have reviewed and understand the terms contained in this waiver and agree that the terms are binding and enforceable. I further understand that Ganga Tattoo Studio and Ganga's Providers are relying upon the representations I have made herein and would not otherwise provide me with any services. Review the entire form and make sure you have answered all the questions. By clicking 'Submit' you are accepting Ganga Tattoo Studio LLC's
