Please only fill this form out ONCE (for your first appointment) OR if your information has changed.

If you are under the age of 18, you must have parental/guardian sign & consent for any spray tan services. See signature box at the bottom.

Caution: Pregnant or nursing women should consult their physician before their session. 

Warning: This product does not contain sunscreen and does not protect against sunburn. Repeated exposure to the sun of unprotected skin while sun tanning may increase the risk of skin aging, skin cancer and other harmful effects to the skin even if you do not burn. Spraying over a sun burn is NOT advised. 

The FDA advises that spray tan users should avoid inhaling or ingesting DHA or letting the spray get into your eyes. When using DHA-containing products as an all-over spray or mist, it may be difficult to avoid exposure in a manner for which DHA is not approved, including the area of the eyes, lips, or mucous membrane, or internally. Therefore, it is recommended that you take protective measures to eliminate eye contact, inhalation or ingestion during your spray tan session, such as:
      - Using protective eyewear/keeping eyes closed. 
      - Wearing nose filters
      - Sealing lips with lip balm
      - Using protective undergarments

These will be available at no cost during your session.

The spraying process will take approximately 10-15 minutes. After spraying, and you should all water and sweating before your rinse time.

The bronzing and tanning solutions used during your session have the potential to transfer and stain clothing, furniture, car seats etc. After your tanning session, you should wear dark, loose fitting clothes. Washing or dry-cleaning will usually, but not always, remove the color. I suggest bringing a towel to cover your car seat. Glow and Go LLC / Ashley Sedberry is not responsible for potential stains to clothing or upholstery. Please be careful.

Some individuals in certain circumstances may be allergic to one or more ingredients in the spray tan solution. In such a case, please discontinue use immediately and consult a physician.

For this reason, I do NOT advise being sprayed for the first time when your appearance is critical; e.g., wedding, special occasion, photographic session, modeling assignment, etc. I suggest a trial tan.

I hereby agree to allow Glow and Go LLC / Ashley Sedberry to apply spray tan solution to my skin. To my knowledge, I have no medical condition or allergy which would preclude me from having this procedure done. I agree to hold Glow and Go LLC / Ashley Sedberry harmless of any and all liability for medical complications that may arise from exposure to the spray tan solution. I have been advised to discontinue use if any reaction occurs. I agree to hold Glow and Go LLC / Ashley Sedberry harmless of any and all liability for pregnancy-related medical complications that may arise from exposure to the spray tan solution. I acknowledge that I have been advised to consult with a physician who can properly assess the pregnancy-related risk and complications potentially involved through exposure to spray tanning and DHA while pregnant.

I acknowledge the importance of wearing protective items to limit / prevent inhalation or ingestion of DHA in the area of the eyes, lips, or mucous membrane, or internally. I also acknowledge that I have been given the opportunity to wear my own protective items and that protective items have been made available to me free of charge. 

Furthermore, I agree to release Glow and Go LLC / Ashley Sedberry from any liability in the event of stains to clothing, car and furniture upholstery, jewelry and accessories, and any other objects my body might come into contact with.

I acknowledge that Glow and Go LLC / Ashley Sedberry is not responsible for any lost, stolen, or damaged property, personal injury of any kind, or death. I release Glow and Go LLC / Ashley Sedberry from any liability should any of these events take place in regards to myself or any minor that I choose to bring with me. I acknowledge that any minor that I choose to bring with me is 100% my responsibility. I acknowledge that I chose to come to the address that Glow and Go LLC / Ashley Sedberry provided (in order to receive a spray tan) and therefore release Glow and Go LLC / Ashley Sedberry from any and all liability and waive my right to sue for any reason whatsoever. 

Address:

3 Brecknock Lane

Bella Vista, AR 72714

*please note: make sure your GPS reads LANE*

Again, you are coming to a home studio. This is why the address is shared after appointments are booked.

Phone:

479-601-4576

I implement a 50% fee for cancellations and rescheduling within 24 hours of scheduled service time.

‘No shows’ will be charged the full price of their scheduled service.

Please note: if you are more than 10 minutes late to your appointment - without prior communication- you will be charged and required to reschedule  

As I understand that things come up, having policies in place helps business run smoothly. It is not easy to fill appointment times after the 24 hour cut off.

Thank you for understanding!

I, the undersigned, being the legal guardian do hereby acknowledge, agree and consent to them receiving spray tanning services or treatments. I hereby waive any and all claims or rights on behalf of my child as a result of any service rendered and release and forever discharge Glow & Go, LLC / Ashley Sedberry from any and all claims, responsibilities or cause of action arising from the rendering of spray tanning services and or treatments to my child. I have read and completely understaing this consent form.