LUNAFOX INK

Technicians make no attempt to, or claim to, practice medicine. Some individuals will have complications related to permanent make-up applications. These complications are usually mild and last only a few days. However, extreme complications are always a possibility. If you are healthy and there are no visible reasons for restricting you from receiving a tattoo, you must approve of the procedure and the color before the application of your permanent make-up.

• I confirm that all information given in this form is true, complete, and accurate. 

• I released this organization for any responsibility in case of accident, illness, or injury. 

• I understand that with time the pigment can fade and will change according to metabolism, skin type, medication, age, smoking, alcohol, sun exposure, Retin-A and Glycolic acids. 

• I understand that the process used to apply color is not a one step process and may require subsequent visits to achieve desired results. I further understand that the fee includes my first visit and one touch-up visit within two months of first appointment and the result of the procedure will be a permanent change 

•  I understand the nature of the procedure and possible complications, reactions or adverse effects that may occur as a result of the applied pigments. I fully understand this is a tattooing process, and have discussed any medical conditions

• I acknowledge that no assurance was offered about the outcome. 

• I have read through the Frequently Asked Questions on the Lunafox Ink website and agree to strictly adhere to such instructions. 

• I understand that taking before and after pictures may be required and allow Lunafox Ink to use the photos for marketing or promotional services. 
  
  

• I acknowledge by signing below, that I have been given the full opportunity to ask any and all questions which I might have about obtaining this procedure(s) from, Shea jackson. I also acknowledge that all of my questions have been answered below to my full and total satisfaction. I specifically acknowledge that I have been advised of the fact and matters set below, and I agree as follows. 

I have read and understand the contents of each paragraph above. I acknowledge this is a contract and that I have received no warranties or guarantees with respect to the benefits to be realized from, or consequences of, the aforementioned procedure(s). I further acknowledge that at the time of signing this consent to this procedure(s), I was of sound mind and capable of making independent decisions for myself.

WAIVER, RELEASE OF LIABILITY AND INDEMNITY

Shea Jackson shall perform permanent application of dyes to the skin of the releaser. Whereas releaser has been informed as to the methods and procedures concerning the result of such treatments, a scratch test will also be performed prior to the procedure, if requested by the client, to detect any signs of allergies.  

I, inconsideration of Shea Jackson At Lunafox ink. completing the procedure(s) mentioned below, hereby release and further agree not to make any claim or demand, or commence legal action against Lunafox ink for damages, compensation, loss or any relief whatsoever in respect of any cause or matter relating to the procedure(s). I further agree that this Agreement shall operate conclusively as an estoppel in the event any such claim, action or proceeding and may be pleaded accordingly.

I confirm that all information given in this form is true, complete, and accurate.
I released this organization for any responsibility in case of accident, illness, or injury.
I understand that with time the pigment can fade and will change according to metabolism, skin type, medication, age, smoking, alcohol, sun exposure, Retin-A and Glycolic acids. I understand that the process used to apply color is not a one step process and may require subsequent visits to achieve desired results. I further understand that the fee includes my first visit and one touch-up visit within two months of first appointment and the result of the procedure will be a permanent change. I understand the nature of the procedure and possible complications, reactions or adverse effects that may occur as a result of the applied pigments. I fully understand this is a tattooing process, and have discussed any medical conditions. I acknowledge that no assurance was offered about the outcome. I have read through the Frequently Asked Questions on the Lunafox Ink website and agree to strictly adhere to such instructions.I understand that taking before and after pictures may be required and allow Lunafox Ink to use the photos for marketing or promotional services.

I acknowledge by signing below, that I have been given the full opportunity to ask any and all questions which I might have about obtaining this procedure(s) from, Mariah Feser. I also acknowledge that all of my questions have been answered below to my full and total satisfaction. I specifically acknowledge that I have been advised of the fact and matters set below, and I agree as follows. 

I accept full responsibility for and indemnify and hold Lunafox ink., and any of its employees and/or contractors, harmless and without liability of any kind whatsoever for the responses to products used for Microblading- Lunafox ink and its employees will not be held responsponsible for any injury or damage that may occur due to Microblading.

I further agree to hold Lunafox ink. nameless and harmless from any and all damages. I release Shea jackson. from any responsibility for pre-existing conditions I have not revealed, or any consequential change to those conditions that arises after the procedure. I understand I am responsible for any medical treatment I may need to receive because of getting this procedure. I accept full responsibility for these and any other complications, which may arise or resulting of getting this procedure(s), which are to be performed at my request.

Having read the above, I acknowledge that all of procedures contemplated and consented to herein have been fully explained and I fully understand the nature, scope and potential risks of the procedure(s) I am consenting to being performed and accept full responsibility for any and all results of the said procedure.

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to be spread mainly from person-to-person contact. As a a result provincial and federal health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups and people. 

Lunafox Ink has put in place preventative measures to reduce the spread of COVID-19 with strict cleaning measures and mandatory masks during appointments. Further, attending to appointments in the studio could increase your risk of contracting COVID-19.

By signing this agreement, I acknowledge the contagious nature of COVID-19 by attending the appointment and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed or infected by COVID-19 at MicroBeauty Studio may result from the actions, omissions, or negligence of myself and others, including, but not limited to, employees, volunteers, and program participants and their families. 

I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself (including but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my family may experience or incur in connection with my attendance at The Fix Studio Ltd.