Email : contact@makabre.fr Address : 55 avenue des Templiers, 88000 Épinal Phone : 09 79 11 53 56 Opening hours : Tue-Sat: 10am - 6pm FR EN

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CONSENT FORM · MINOR

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The legal guardian must be present on the day of the appointment. Data kept for 3 years.

Legal guardian

Last name *

First name *

Relationship to child *

Email * (for the PDF)

Guardian's ID document (JPG/PNG/PDF)

The child concerned

Child's last name *

Child's first name *

Date of birth *

Address *

Postal code *

City *

Child's ID document (JPG/PNG/PDF)

📄 Copy of family record book * (page concerning the child) Take a photo or upload the page of the family record book proving your relationship with the child. Formats: JPG, PNG, PDF (max 10 MB).

Tattoo design * (style, placement, size...)

Health questionnaire

Child's known allergies

Has the child taken aspirin?

Yes No

Has the child consumed illicit substances?

Yes No

Has the child consumed alcohol?

Yes No

Does the child have any coagulation disorders?

Yes No

Is the child on any medication?

Yes No

Does the child have heart problems (pacemaker)?

Yes No

Legal guardian's agreements

As legal guardian, I agree with the design and its placement, and confirm I have been informed of the risks: permanent nature, pain, scarring, health risks, and changes over time.

I have read, understood and accept *

Additional fees may be required for touch-ups beyond 3 months.

Read and accepted *

Photo/video authorization

I authorize I do not authorize

Legal guardian's signature

Made at (city) *

Date

Signature * (draw below)

A PDF will be sent to your email. Data kept for 3 years.

Tattoo art in Épinal since 2020.
Blackwork · Semi-realism · Ornamental

Every tattoo is unique, custom-made to tell your story.

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55 Avenue des Templiers
88000 Épinal, France
09 79 11 53 56
contact@makabre.fr
Tue → Sat : 10am – 6pm Sun & Mon: closed
Appointment strongly advised

Guarantees

Sterile, single-use equipment Qualified & certified artists 100% custom designs Aftercare follow-up Studio in Épinal, Vosges, France

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