Declaration of consent

The following contract is concluded between the company My Story and the above-mentioned customer.
I permit My Story to store my data and use them for advertising purposes.
NoYes

Are you under 21 years of age?
NoYes

If so, I am the guardian:

Knowledge

- I am aware that there is a risk and that there will be bodily injury and changes.
- I am aware that deviations from the original design are possible.
- The tattoo process has been explained to me in detail.
- The aftercare for the tattoo has been explained to me thoroughly and in detail and I have understood everything.
- Spelling and grammar will be checked by me immediately before the tattooing starts.
- At the moment when the tattoo artist starts to work, permission is assumed to be given.
- I know that the tattoo session has to be paid in full if the session has to be stopped because of insufferable pain, and that a new date has to be agreed upon with additional cost.
- If some action by the customer makes it impossible for the artist to work undisturbed, the session will be stopped, but has to be paid in full.
- I understand that touch-up by the same artist will be free of charge only within 3 months.
- My Story advises against tattoos on hands, feet, head or lips. Therefore, I understand that there is a charge for touch-ups in these areas.
- It is possible that the old tattoo is still visible after a cover-up tattoo. Everybody’s skin is different, and therefore it is not
possible to predict to what degree the new tattoo will cover the old one. The customer confirms that he is aware of this fact.
- My Story is not liable for follow-up problems caused by incorrect aftercare, use of inappropriate cream, inappropriate sun-screen or similar causes.
- By closing the contract the customer agrees to the GTCS

Body

At this time I use blood thinning drugs?
NoYes:

I have allergies which may repel the ink or lead to inflammation or worse
NoYes:

I have heart or circulatory problems?
NoYes

I am pregnant or nursing a baby.
NoYes

I have skin diseases.
NoYes:

If there are blood diseases or other reasons that impair the natural ability to see and control the patient.
NoYes

Epilepsy or similar symptoms?
NoYes

Have surgical procedures or radiation been performed in the area which is to be tattooed?
NoYes

Has there already been a laser treatment in the area which is to be tattooed?
NoYes

I am or have been a very short time ago under the influence of alcohol or other drugs.
NoYes

I confirm with my signature that all my answers are true, that I have understood all the information above and that.
I agree to the procedure. Liability of and claims for damages against the tattoo artist and My Story for any type of complication and damages in consequence thereof are hereby excluded.
I confirm this with my signature.

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