I confirm by my signature overleaf that I have read this consent form, that I understand it and that all statements in it are true. I confirm that I am not under the influence of alcohol or drugs and that I consider myself to be healthy enough to undergo the tattooing procedure. I authorize an agent of Black Hat Tattoo a pre-determined design on my body, to which I have given adequate fore-thought as to type and placement. Furthermore, I understand that this process is irreversible, whereby indelible inks are injected under the skin. I confirm that I have been given the aftercare procedure in writing, that it has been fully and clearly explained to me and that I understand it. I also confirm that I will follow the aftercare procedure until the healing is complete. I understand that the tattooing will be carried out under hygienic conditions using the appropriate sterile instruments and techniques. I also understand that no form of anesthetic will be used in this procedure. I confirm that I am not taking any other medication or suffering from any other illness, condition or allergy which a reasonable person should be aware of, which may cause me to react adversely to, or be aggravated by tattooing. I understand that a new tattoo is susceptible to an infection until healed and that proper aftercare of the tattoo, once I leave the studio, is fully my responsibility. I understand that notwithstanding the hygienic conditions, sterile instruments and techniques used by this tattooing Establishment, there are associated risks with tattooing which include infection, scarring, allergy reactions, localized swelling, fall out and fading. In giving this consent I release this tattooing establishment and its employees from all liabilities, actions and demands which I may have now or in the future for any loss or damage suffered howsoever caused as result of my tattoo (e.g. as a result of a fraudulent miss-statement by me, or in respect of personal injury caused by myself, negligence and or failure on my part to follow the aftercare procedures). I hereby release and hold blameless Black Hat tattoo and its agents of all responsibility and/or culpability for any adverse effects arising directly or indirectly from this procedure now or in the future.