PLEASE READ AND CHECK THE BOXES WHEN YOU ARE CERTAIN YOU UNDERSTAND THE IMPLICATIONS OF SIGNING.

In consideration of receiving a Tattoo from DH Tattooing (together with its artists, associates, employees, apprentices, and agents, hereinafter referred to as “DH Tattooing”) located at 4326 Las Positas Rd Suite 120, Livermore, CA 94551 (the “Premises”) I confirm and agree to the following by initialing each applicable item:

NOTICE:

TATTOO INKS, DYES, AND PIGMENTS THAT HAVE NOT BEEN APPROVED BY THE FEDERAL FOOD AND DRUG ADMINISTRATION MAY HAVE HEALTH CONSEQUENCES THAT ARE UNKNOWN.

DH Tattooing has given me the full opportunity to ask any questions about the procedure and application of my tattoo and all of my questions, if any, have been answered to my total satisfaction. I have been fully informed of the inherent risks associated with getting a tattoo. Therefore, I fully understand that these risks, known and unknown, can lead to injury including but not limited to: infection, scarring, difficulties in the detection of melanoma and allergic reactions to tattoo pigment, latex gloves and/or soap. Having been informed of the potential risks associated with getting a tattoo I wish to proceed with the tattoo procedure and application and freely accept and expressly assume any and all risks that may arise from tattooing. Furthermore, I am voluntarily submitting to be tattooed by DH Tattooing without duress or coercion.

If I have diabetes, epilepsy, hepatitis, HIV-AIDS or any other communicable disease,, heart condition(s) or take blood thinning medication I have informed DH Tattooing and my tattoo artist. I do not have any other medical or skin condition that may interfere with the procedure, application, or healing of the tattoo. I am not the recipient of an organ or bone marrow transplant or, if I am, I have consulted my physician and have adhered to any and all prescribed preventative regimen that is required by my doctor in advance of any invasive procedure such as tattooing. I am not pregnant or nursing. I do not have a mental impairment that may affect my judgement in getting the tattoo. I understand that I may be asked to attain a physician’s release prior to receiving a tattoo under certain circumstances and agree to do so upon request by DH Tattooing prior to receiving a tattoo. I agree to keep DH Tattooing updated as to any and all changes in my medical profile prior to the start of tattoo application appointment and shall indemnify and hold DH Tattooing harmless should I fail to do so.

I understand that I am solely responsible for the tattoo design and placement I choose to receive. I agree to fully communicate, describe, show, and present all images, drawings, documentation, and the like required by DH Tattooing and my tattoo artist prior to tattoo application. If I fail to submit reference photos AND a detailed description of the tattoo to DH Tattooing at least 48 hours prior to the appointment time booked, I understand that the designing/drawing of my tattoo artwork will take place DURING my scheduled appointment, and I agree to pay for any and all additional time needed to complete the tattoo design and tattoo application. DH Tattooing is not responsible for the meaning or spelling of the symbol or text that I have provided to them or chosen. I understand that variations in color and design may exist between the tattoo art I have selected and the actual tattoo when it is applied to my body. I also understand that over time, the colors and the clarity of my tattoo will fade due to unprotected exposure to the sun and the naturally occurring dispersion of the pigment under the skin.

I understand that 48-hour advance notice is required when canceling a scheduled appointment with DH Tattooing. This allows the opportunity for someone else to schedule an appointment. Since all services are by appointment only, a major credit card is required to hold an appointment. I understand that I will not be charged until services are rendered unless I fail to cancel 48 hours or more prior to the scheduled appointment start time. I further understand if I am unable to give DH Tattooing 48 hours advance notice I will be charged half the price of the service booked. I understand that if I fail to attend a scheduled appointment and do not provide 48 hours cancellation notice, I will be considered a “no-show” and will be charged the full amount for the service booked.

I authorize DH Tattooing to keep my credit card on file for any future transactions. I authorize the Business to charge my credit card on file for any and all Services rendered, late cancellation fees, products I purchase, and any other transactions I initiate through DH Tattooing. Additionally, I authorize DH Tattooing to charge my credit card on file in lieu of presenting it. I understand that the terms of this authorization will remain in effect until I request that they be terminated. I acknowledge that I am responsible for making this request in writing.

I understand that any statement(s) or action(s) made or taken by me that is, without limitation, illicit, sexually suggestive, racist, xenophobic, aggressive, violent, or the like will result in one or more of the following; i) immediate termination of any Service being performed; ii) my removal from the Premises; iii) forfeiture of any and all money paid to DH Tattooing for current or future services; iv) immediate full payment required for any service being performed; v) denial of any future services to be provided by DH Tattooing; vi) my being trespassed from the Premises; vii) actions as DH Tattooing sees fit.