Please read, understand and sign the following.

1. Caution – Pregnant or nursing women should consult their physician before their session. 2. Warning – The spray tan ingredient DHA (Dihydroxyacetone) has been approved only for external application and should not be inhaled or ingested internally. 3. Warning – This product does not contain a 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. 4. Spray tanning is accomplished in part by application of a solution containing the active ingredient DHA. According to the FDA (Food and Drug Administration), DHA is a color additive for use in imparting color to the human body. However, its use in cosmetics -- including sunless "tanning" products -- is restricted to external application.

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:

d. Using protective undergarments

You may bring your own protective items, or you may borrow / use items that we provide for this

6. The spraying process will take approximately thirty (30) minutes. After spraying, you will dry approximately eight (8) minutes before putting your clothes back on, and you should not shower, bathe or sweat excessively for six (6) hours. 7. The bronzing and tanning solutions used during your session have the potential to stain clothing. We recommend that you wear something dark in color that can be stained without concern. Cotton clothing is less likely to stain. After your tanning session, you should wear dark, loose fitting clothes.

8. It is also possible that the tanning solution may transfer to other clothing, furniture or car seats after your session. Washing or dry-cleaning will usually, but not always, remove the color. We suggest bringing a towel to cover your car seat. Beaute Speciale is not responsible for potential stains to clothing or upholstery. Please be careful.

9. 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. 10. Be advised that a small percentage of people have skin that does not react favorably to spray tanning. For this reason, we do NOT advise being sprayed for the first time when your

appearance is critical; e.g., wedding, special occasion, photographic session, modeling assignment, etc.

This process has been explained to me and I hereby agree to allow an employee of Beaute

Speciale, 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 Beaute Speciale

and its employees 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 Beaute Speciale and its employees 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

I acknowledge that 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 has been discussed with me.

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 Beaute Speciale and their employees 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 have read and completely understand this consent form, and agree to the above waivers of liability.

PARENT / GUARDIAN CONSENT (if client is under the age of 18) Because the spray tan client is under the age of 18, a parent or legal guardian must also read and understand the above information and provide their consent and approval for the tanning session with a signature below. All information is required. Beaute Speciale reserves the right to refuse service if the person signing below cannot be contacted prior to my session.

As Parent/Legal Guardian of the above listed Client, I grant permission for Beaute Speciale to apply a spray tan to the above listed Client. I acknowledge that I have read and completely understand this consent form, and agree to the above waivers of liability, recommendations and terms.