PARENTAL CONSENT AND RELEASE FORM FOR MEDICAL TATTOOING (CAMOUFLAGE PROCEDURE)

PARENTAL CONSENT AND RELEASE FORM FOR MEDICAL TATTOOING (CAMOUFLAGE PROCEDURE)

I, the undersigned, hereby confirm that I am the legal parent or court-appointed guardian of the minor listed above. I give my full consent for LMS Aesthetic LLC to perform a medical tattooing procedure (also known as camouflage tattooing) on my child.

I affirm the following:

1. The minor is at least 16 years old, in accordance with Florida Statute § 381.00787 and Orange County ordinances.

2. I will provide a notarized consent form, along with valid government-issued photo IDs for both myself and the minor.

3. I understand the procedure is medical-aesthetic in nature, not decorative, and may require multiple sessions.

4. I have been informed of the risks, purpose, and expected outcomes of the procedure.

5. I voluntarily authorize this treatment and certify that all my questions have been addressed.

6. I understand and agree that results may vary depending on the skin, healing process, and other factors beyond the technician’s control.

7. I acknowledge and agree that LMS Aesthetic LLC and its representatives are not liable for any dissatisfaction with the outcome or for any unforeseen complications that may arise.

8. I hereby waive, release, and discharge LMS Aesthetic LLC, its owners, staff, affiliates, and contractors from any and all present or future claims, demands, or causes of action, including but not limited to claims for negligence, damages, injury, scarring, dissatisfaction, or financial loss related to this procedure.

9. This release is binding upon me, the minor, and our respective heirs, executors, legal representatives, and assigns.

By checking the box below, I affirm that I have read and fully understood this authorization and release. I consent voluntarily and without reservation.