Authorization Form

Orland Tattoo LLC

2114 Palm Ave, Hialeah, FL, 33010

Personal Details

THE CLIENT ACKNOWLEDGES HAVING RECEIVED INFORMATION AND WRITTEN INSTRUCTIONS REGARDING HEALING AND PRECAUTIONS, AND HAS BEEN ADVISED THAT IN CASE OF COMPLICATIONS, THEY SHOULD CONSULT WITH THEIR PHYSICIAN AND GRANTS CONSENT FOR THE APPLICATION :

I, an adult over 18 years of age, acknowledge that I have voluntarily decided to have my body tattooed at Orland Tattoo LLC. I understand that tattooing involves a process of inserting pigment under the surface of the skin by pricking with a needle or otherwise, so as to produce an indelible mark or visible figure through the skin. I am voluntarily participating in this activity with knowledge of the risks involved, which include infections or other injuries. I understand that any tattoo design I may choose may have a different appearance when printed on my skin. I also understand that the tattoo artist is an "independent contractor" and not a direct employee of Orland Tattoo LLC or any of its agents, employees, affiliated organizations, licensors, or lessors in relation to this decision.

With full knowledge of the dangers and risks involved, I hereby agree to accept any and all risks of any kind or nature. In consideration for being allowed to enter and use the facilities at this event, I hereby agree that I, my assignees, heirs, and legal representatives will not make a claim, sue, or otherwise attempt to hold Orland Tattoo LLC or any of its employees liable for injury or damage resulting from the negligence or other actions, regardless of the cause, of any person or entity as a result of my participation in tattooing and piercing activities.

THERE ARE NO DEPOSIT REFUNDS

AS THEIR LEGAL REPRESENTATIVE, AUTHORIZES THE APLICATION OF: TATTOO - PIERCING THE AREA:

IF THE SIGNATORY PERSON CANNOT ATTEND, A SIGNED COPY OF THE LEGAL GUADIAN'S LICENSE WOULD BE REQUIRED.