Atomic Tattoos & Body Piercing                      
Corporate: 9041 Ulmerton Rd, Largo, FL 33771
Studio # & Location: ____________________
Addres: ______________________________
City: _____________ State: ___ Zip: _______
Phone:_______________________________

Atomic Tattoos does not perform tattooing on any minor without the written notarized consent of the parent or legal guardian.  Atomic Tattoos does not tattoo anyone under the age of 16 years unless a parent or legal guardian accompanies the minor.  Atomic Tattoos and/or contractors may refuse service to any minor and therefore this does not constitute a right or contract to receive service.


I,_________________________, give legal permission for my child/ward, ____________________, to  have a ____________   tattoo at Atomic Tattoos.

Parent/Legal Guardian signature______________________ Date_______________
Identification type and number____________________________

Notary Signature
The foregoing instrument was acknowledged before me this_____
day of_______________, 20____, by______________________, who is(  ) personally know to me or (   ) who has produced _______________________ as identification and who did not take an oath.

Notary Public/State of Florida
Name:______________________
Commission No.______________
Commission Expires:__________

This section is to be filled out at the time of the tattoo if the minor is under age 16.
I,_____________________ the parent/legal guardian of________________________ was present at the time of the tattoo.

Parent/Legal Guardian signature____________________________
Tattoo Artist’s signature___________________________________