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DECLARATION

I acknowledge by signing this Consent and Declaration Form, I have been given the full opportunity to ask all questions and clear any and all doubts which I might have about obtaining a tattoo from the Tattoo Artists at Murukoo Studio and that all of my questions and doubts have been answered to my full satisfaction. I specifically acknowledge I have been advised of the facts and matters set forth below and I declare and agree as follows:

  1. I state that I do not have any medical condition that prevents me from getting a tattoo nor do I have any medical condition that prevents or hampers the healing process. If I do have any of the above-mentioned medical conditions, I will inform the tattoo artist at Murukoo Studio during the Consultation Session prior to the Tattoo Appointment.

  2. I state that I do not have any 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 do have any of the above-mentioned skin conditions/rashes/communicable diseases or other infections anywhere on my body, I will inform the Tattoo Artist at Murukoo Studio during the Consultation Session prior to the Tattoo Appointment.

  3. I confirm that the design for the scheduled tattoo is according to my instructions and wishes. I further state that the above-mentioned tattoo is being obtained by me under my free will and without any coercion. I state that I cannot and do not hold Murukoo Studio or the Tattoo Artists at Murukoo Studio liable for any consequences that may arise from the work performed on me. I further confirm that I have seen the artwork prior to my Tattoo Appointment and I have also seen the stencil as and when it was placed on the agreed-upon area of my body and acknowledge that the above-mentioned design is the one I requested, including but not limited to the accompanying words, spellings, shapes, colours, etc.

  4. I state that I do not have any physical, mental or medical impairment or disability which might affect my physical or mental well-being as a direct or indirect result of my decision to have a tattoo done at this time. I understand that the tattoo I am obtaining from the Tattoo Artists at Murukoo Studio is permanent which cannot be removed by the Tattoo Artists at Murukoo Studio, once given. I acknowledge that neither Murukoo Studio nor the Tattoo Artists at Murukoo Studio are liable for any tattoo removal procedure, once the tattoo is obtained by me. Any tattoo removal procedure will be done at my own wishes and expenditure, not holding Murukoo Studio or the Tattoo Artists at Murukoo Studio liable for the same.

  5. I acknowledge it is not reasonably possible for the Tattoo Artists at Murukoo Studio to foresee and determine before-hand whether I might have an allergic reaction to the pigments or processes used to obtain the above-mentioned tattoo, and I agree to accept the risk that such a reaction is possible. I state that I will not hold Murukoo Studio or the Tattoo Artists at Murukoo Studio liable for any consequences or expenditure that may arise out of such a reaction.

  6. I acknowledge that infection is a possible consequence as a result of the obtaining of the above-mentioned tattoo, particularly in the event that I do not take proper care of my tattoo. I state that I have received aftercare instructions and I agree to follow the same while my tattoo is healing. I state that I do not hold Murukoo Studio or the Tattoo Artists at Murukoo Studio liable for any infection that may arise as a consequence of obtaining the above-mentioned tattoo.

  7. I agree that if any touch-up work is required to be done on the above-mentioned tattoo, as a result of my own negligence or not properly following the above-mentioned aftercare instructions, will be done at my own expense. I state that I will not hold Murukoo Studio or the Tattoo Artists at Murukoo Studio liable for the same.

  8. I state that I am an adult (18+). I acknowledge that I am of age, and Murukoo Studio is not responsible for further verification of the same.

  9. I state that I am neither pregnant nor nursing. I further state that I am not currently under the influence of alcohol or narcotics or psychotropic substances.

  10. I consent to the application of the tattoo and to any actions or conduct of the Tattoo Artists at Murukoo Studio which is reasonably necessary to perform the tattoo application procedure. I acknowledge that a new and fresh needle/s which is to be used in pursuance of the application of my tattoo has been opened by the Tattoo Artist/s at Murukoo Studio, in my presence and upon informing me of the same.

  11. I consent that this agreement and any dispute that arises from it shall fall within the jurisdiction of the courts in Bangalore, India. I consent that any dispute that arises from this agreement will first be resolved by both parties entering into a good faith negotiation discussion. In case the dispute is not resolved by negotiation within 60 days, I consent that the dispute will be referred to Mediation at any mutually agreed upon facility that provides Mediation services. In case the dispute is not resolved through Mediation within 90 days, I consent that the dispute shall be referred to a sole arbitrator, mutually appointed by both parties, whose proceedings shall be governed by the provisions of the Arbitration and Conciliation Act, 1996. The proceedings shall be held in Bangalore and shall be conducted in English.

Date of Birth
Day
Month
Year
Are you okay with pictures/videos of the tattoo being recorded during your session?
YES
NO
Is this your first tattoo?
NO
YES
Have you eaten in the past 2 hours?
NO
YES
Do you have high blood pressure, diabetes, bleeding disorders, heart problems, cold/flu, etc.?
NO
YES
Do you have HIV, AIDS, Hepatitis (any strain), or any other blood-borne illness?
NO
YES
Are you pregnant and/or nursing?
NO
YES
Do you have any allergies that could affect the tattoo process?
NO
YES
Date Signed
Day
Month
Year
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