Fill this in before we start. Takes about two minutes. You'll get a signed copy and your aftercare by email.
3.1I am 18 years of age or older, or I am under 18 and my parent or legal guardian is with me and signs this form below. Wicked Inx does not tattoo or pierce anyone under 18 without a parent or legal guardian present and consenting in person.
3.2If Wicked Inx asks me for government-issued photo identification, I will provide it. If I am under 18 and do not hold photo ID, my parent or legal guardian provides theirs instead.
3.3Any identification I provide is valid, has not been altered, and belongs to the person named on it.
You don't have to upload anything. Staff can check your ID at the counter instead.
Tap to open your camera. Make sure the name and date of birth are readable.
Tell us if any of these apply to you:
4.1I have disclosed any medical or skin condition that could affect this procedure or my healing, including but not limited to those listed on this form.
4.2I am not under the influence of alcohol or drugs, and I have not consumed alcohol in the 24 hours before this appointment. I have eaten before my appointment.
4.3The information I have given is true and complete to the best of my knowledge. I understand that Wicked Inx is relying on it, and that withholding it puts my own health at risk.
4.4I understand that no one at Wicked Inx is a medical practitioner, that nothing said to me here is medical advice, and that I should speak to my doctor about any condition of mine before proceeding.
I have had the chance to ask every question I wanted to ask, and all of them have been answered to my satisfaction. I understand and accept that:
5.1Infection is possible, particularly if I do not follow the aftercare I have been given.
5.2An allergic reaction to inks, pigments, metals, jewellery, soaps or aftercare products is possible. It is not reasonable to expect the artist to predict whether I will react, and I accept that risk.
5.3Scarring, including keloid or hypertrophic scarring, swelling, bruising, bleeding, prolonged tenderness and changes in skin pigmentation are all possible outcomes.
5.4Healing time and healed appearance vary from person to person and cannot be guaranteed. My aftercare, skin, health and lifestyle all affect the result.
5.5A tattoo is permanent. It will fade and soften over time. Removal is expensive, painful, requires multiple sessions and may never be complete. Touch-ups may be needed and may be charged for.
5.6A piercing may reject, migrate, become embedded, or close if jewellery is removed. Oral and lip piercings carry a specific risk of damage to teeth, enamel and gums. Nerve damage and prolonged numbness are possible.
5.7I am choosing to go ahead with full knowledge of all of it.
6.1I have been given the written aftercare instructions for my procedure, I have read them, and I have had the chance to ask about anything I did not understand.
6.2Healing is my responsibility. I will follow the aftercare I have been given, and I will not hold Wicked Inx responsible for any outcome caused by my failing to.
6.3If I develop signs of infection — spreading redness, heat, swelling, pus, or fever — or if any problem lasts more than three days, I will call the shop at (905) 544-1209 and see a physician.
7.1I have reviewed the final design, including the spelling of every name, date, word and letter in it, and I approve it exactly as drawn. I have approved the size, the colours and the placement on my body. I understand Wicked Inx is not responsible for a spelling, date or wording error I have approved.
7.2I have been shown the jewellery to be used and I approve it, including its material and size. I understand that initial jewellery is chosen for healing and that changing it too early can cause problems.
7.3I understand that I am responsible for the fee for the work agreed today, and that deposits, where taken, are non-refundable.
8.1Wicked Inx operates as a personal service setting inspected by City of Hamilton Public Health Services. All needles and single-use items are sterile, used once, and disposed of after my procedure. Reusable equipment is sterilized between clients.
8.2If I have a concern about the cleanliness or safety of this premises, I may raise it with Wicked Inx directly or contact City of Hamilton Public Health Services.
9.1I give Wicked Inx permission to photograph the completed work and to use those photographs on its website, social media and promotional material, without payment to me.
9.2I understand I do not have to agree to this, that declining changes nothing else in this form, and that I can withdraw permission at any time by emailing info@wickedinx.ca — though images already published or shared may not be recoverable.
10.1In exchange for Wicked Inx performing this work, I release and discharge Wicked Inx, its owner, artists, piercers, employees and agents from all claims, demands, damages and causes of action arising from this procedure or its healing, except for any claim arising from their own negligence, gross negligence or wilful misconduct, which is not released and cannot be released.
10.2I agree to indemnify Wicked Inx against any claim brought by me or on my behalf that I have released under 10.1.
10.3This release binds my heirs, executors and estate.
10.4This agreement is governed by the laws of the Province of Ontario. If any part of it is found unenforceable, the rest continues in force.
11.1Wicked Inx collects the information and identification on this form to confirm my age and identity, to keep the client record required of a personal service setting, and to contact me about this procedure.
11.2This record, including my identification, is stored securely, is not published, and is not sold or shared with anyone except where the law requires it or a public health investigation demands it.
11.3The record is kept for two years from the date signed and is then permanently deleted.
11.4I may ask what Wicked Inx holds about me by emailing info@wickedinx.ca.
I am the parent or legal guardian of the client named above. I have read this form in full, I consent to this procedure being performed on them, and I accept every acknowledgement and release in it on their behalf and my own.
Signing electronically has the same effect as signing on paper. We record the time, your IP address and your device with the signature.