Dear Summer Tanning Consent Form

Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Date of Birth

Date

Gender

Were you referred by an individual to our salon? If yes, please indicate in the field.

Where did you learn about our Tanning Salon?

Is this your first spray tanning?

If no, then please indicate when did you last perform spray tanning?

E.g. two months ago, a year ago, or exact date

What is your skin type?

Do you have allergies? If yes, please indicate them in the field.

Did you undergo any surgery within the last 6 months?

Are you pregnant or breastfeeding? (Female only)

Are you currently taking any medications?

I consent to being photographed/filmed (no nudity) for social media advertising?

What is your desired skin color for tanning?

• All people are different. All ingredients used in this procedure are intended for cosmetic use and generally regarded as safe. There are, however, occasions where individuals may be allergic to one or more ingredients in the spray tan solution. Please read the ingredients list if you have any known
allergies.
• Be advised there is a small percentage of people whose skin may not react favorably to spray tanning. For this reason, we do NOT advise being sprayed for the first time when your appearance is critical; (wedding/special occasion)
• Caution – Pregnant or nursing women should consult their physician before using.
• Warning – This product does not contain a sunscreen and does not protect against sunburn. Repeated exposure of unprotected skin to U.V. Light may increase the risk of skin aging, skin cancer and other harmful effects to the skin even if you do not burn.

I have been provided with spray tan care instructions, which I have read and understand completely. To my knowledge, I have no medical condition or allergy which would preclude me from having this procedure done. I have been honest and accurate about the information that I have provided on this waiver. I take sole responsibility of any reaction I may have, staining of clothing and/or personal belongings.

Client's Signature

Date Signed

Date

Salon Attendant

First NameLast Name

Salon Attendant Signature

Dear Summer Tanning

Consent Agreement