This is to certify that I, the undersigned person, today gave my correct name, date of birth and address when asked to do so by Bournemouth Tattoo Ltd " ta Jynx Tattoo & Piercing" located at 3 Lansdowne Crescent, Bournemouth, BH1 1RX.

I. Confirm that I must be at least 18 years to obtain a tattoo, this is to certify that the above named and undersigned, does give consent to be tattooed at their own free will, are fully aware of the process involved and understand the importance of daily aftercare. I agree to follow the aftercare instructions given to me by the tattoo artist. If you have signed and suffer or have suffered from any of the conditions above you should your GP before proceeding.

I confirm that I am not under the influence of drugs or alcohol. I understand that Bournemouth Tattoo Ltd " ta Jynx Tattoo & Piercing" are not responsible for any allergic reactions to the ink/pigments. I understand that I am responsible for checking the designs, print out and stencil application before the tattoo process begins. " including but not restricted to placement, symmetry, direction, translation mistakes, spelling, grammatical errors". I understood the importance of the aftercare provided to me by the tattoo artist and the studio. I understand that bleeding, swelling, peeling and ichtness are a part of the tattoo healing process and I hereby declare that I will not rub, pick or scratch the tattoo. I understand that I am entitled to a free touch up within 45 days of having my tattoo. Any further touch ups after the 45 days will require a further charge.