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Name
*
First Name
Last Name
Personal Details
D.O.B. / PROOF OF AGE / CONTACT INFO
What is your date of birth & your AGE ?
*
Proof of Age PHOTO ID
*
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Do you have any of the below health conditions below ?
*
Kidney Issues
Hepatitis
Dermatitus
HIV
Sunburn
Jaundis
Heart conditions
Pregnant
N/A : I am in Top Form
OTHER : please share with your Artist, SAFETY FIRST
How did you find out about Sydney GHETTO Ink ?
*
Recommendation
Passing By
Google Search
Social Network
Other
so know how to reach you again
DATE
*
-
Year
-
Month
Day
Date
Please Read “Our Duty of Care Promise", answer ‘YES’ below if you understand or ‘NO’ if you would like your Artist to explain in more detail, "Our Duty of Care Promise”
Can we please have your AUTOGRAPH ?
*
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