I HEREBY RELEASE AND FOREVER DISCHARGE FUNHOUSE TATTOOS PB, LLC; DRIPPIN' IN INK, LLC d/b/a FUNHOUSE TATTOOS; FLORIDA GULF COAST TATTOO EXPO; AND THE 11:11 FUND, LLC; THEIR EMPLOYEES, AND THEIR AGENTS FROM ANY AND ALL MANNER AND TYPE OF NEGLIGENCE, LIABILITY, CLAIM, ACTION, DEMAND, AND COMPENSATION, IN LAW AND IN EQUITY, WHICH I HAVE OR MIGHT HAVE, NOW OR HEREAFTER, BY REASON OF MY REQUEST TO BE TATTOOED.

I ALSO SPECIFICALLY RELEASE AND FOREVER DISCHARGE AND RELIEVE FUNHOUSE TATTOOS PB, LLC; DRIPPIN' IN INK, LLC d/b/a FUNHOUSE TATTOOS; FLORIDA GULF COAST TATTOO EXPO; AND THE 11:11 FUND, LLC; THEIR EMPLOYEES, AND THEIR AGENTS, FOR ANY AND ALL LOSS OR DAMAGE ON ACCOUNT OF INJURY TO MY PERSON OR PROPERTY CAUSED BY THEIR EMPLOYEES, OR AGENTS OR NEGLIGENCE OR OTHERWISE, BY REASON OF MY REQUEST TO BE TATTOOED.

I REALIZE THAT MISREPRESENTATION OR FALSIFICATION OF INFORMATION PROVIDED BY ME IS A CRIME AND IS SUBJECT TO PROSECUTION. I FURTHER CERTIFY THAT I AM OVER THE AGE OF EIGHTEEN AND AM NOT INTOXICATED OR UNDER THE INFLUENCE OF ANY NARCOTIC SUBSTANCE, AND MAKE THIS STATEMENT ENTIRELY OF FREE WILL AND SOUND MIND. THIS IS A LEGALLY BINDING CONTRACT.

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