Contact 1 — Rye Lanez

Consent Form

Please read and fill out ALL sections of the form.
Once all sections are complete, please read the terms & conditions attached. By signing your name and clicking complete, you agree to all T&C’s.

Terms and Conditions

Name

First Name

Last Name

Phone Number

Age

Artist

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Are you under the influence of drugs/alcohol?

Do you have communicable disease?

Skin conditions (e.g. rashes, eczema, infection, psoriasis, freckles, etc.)

Medical History

(e.g. Diabetes, cardiovascular disease, epilepsy, hepatitis A, B or C, or any other blood-related disease etc.)

Allergies?

(penicillin, ink pigments, bandages etc.)

Have you read the T&C's?

Yes

Sign

By signing this with your first initial and last name, you agree that all information provided is correct and T&C's have been read and adhered to.