I acknowledge by signing this agreement that I have been given the full opportunity to ask and all questions which I might have about the obtaining of a tattoo and that all of my questions have been answered to my full satisfaction. I specifically acknowledge I have been advised of the facts and matters set forth below and I agree as follows:

1. If I have any condition that might affect the healing of this tattoo, I will advise my tattooer. I am not pregnant or nursing. I am not under the influence of alcohol or drugs.

2. I do not have medical or skin conditions such as but not limited to: acne, scarring, eczema, psoriasis, moles or sunburn in the area to be tattooed that may interfere with said tattoo. I also acknowledge that I do not have any communicable disease such as HIV-AIDS, HEP. A/B/C, or any other strains, etc. If l have any of the above or other infections or rashes anywhere on my body, I will advise my tattooer.

3. I will not hold Snake & Flower Tattoo Studio responsible for the work performed on me by any of the artists and acknowledge that this is the tattoo I have requested (I have seen the artwork and/ or the stencil when it was placed on my body and have acknowledged that all spelling is correct, this is the artwork I requested, I have asked any and all questions) and if I am not sure, I will say something to my artist.

4. I acknowledge that I do not have any physical, mental or medical impairment or disability which might affect my well being as a direct or indirect result of my decision to have a tattoo done at this time I understand that tattoos are permanent and cannot be removed.

5. I acknowledge it is not reasonably possible for the representatives and employees of this tattoo shop to determine whether I might have an allergic reaction to the pigments or processes used in my tattoo, and I agree to accept the risk that such a reaction is possible.

6. I acknowledge that infection is always possible as a result of the obtaining of a tattoo, particularly in the event that I do not take proper care of my tattoo. I have received aftercare instructions and I agree to follow them while my tattoo is healing. I agree that any touch-up work needed, due to my own negligence, will be done at my own expense.

7. I state that I am of age (19) to receive a tattoo. I acknowledge that I am of age, and Snake & Flower Tattoo is not responsible for further identification. If I lie about my age, Snake & Flower Tattoo Studio is not responsible for my well being. If I sign and I am not the stated age, Snake & Flower Tattoo Studio has the right to legally pursue action against me. The below signature release staff and associated parties from any legal responsibility re: age.