Page 1

NAME: ______________________________

DOB: ______________________

ADDRESS: _______________________ CITY/STATE: _________________ ZIP: _____________

EMAIL: __________________________PHONE: ______________ CELL: ________________

PLEASE READ THE FOLLOWING INFORMATION AND ACKNOWLEDGE THAT YOU UNDERSTAND AND ACCEPT ALL PROVISIONS BY SIGNING BELOW WE RESEVE THE RIGHT TO REFUSE SERVICE TO ANYONE AT ANY TIME. 1. We recommend sensible, moderate and responsible exposure to ultraviolent radiation (UVR). Sunburns can significantly increase the risk of skin cancer/melanoma. I understand that it is unadvisable and against policy to tan in more than one indoor tanning salon in one day. OVEREXPOSURE CAN CAUSE ERYTHIEMA (SUNBURN!) IF YOU DO NOT DEVELOP A TAN IN THE SUN, YOU ARE UNLIKELY TO TAN FROM THE USE OF THE TANNING DEVICE AT THIS TANNING SALON. 2. PLEASE FOLLOW ALL INSTRUCTIONS regarding the operation of all tanning equipment. The proper procedure to follow in the tanning room will be clearly explained by the specially trained instructor. Please feel free to ask any questions or to voice any concerns that you might have before you starting to tan. 3. AVOID OVEREXPOSURE. As with natural sunlight, overexposure can cause eye and skin injury and allergic reactions. Repeated overexposure may cause photo aging of the skin, dryness, wrinkling and (sometimes fatal) skin cancer. We recommend that you do not tan outdoors on days you are tanning indoors, do not tan if you have sunburn and tan no more often than every other day. 4. WEAR PROTECTIVE EYEWEAR. Failure to wear protective eye wear may result in severe burns or long term injury to the eyes. We recommend that you remove contact lenses before tanning. 5. I WILL NOT SHARE MY SESSION CARD. Unless you have had both of the people fill out a consent form and notified us, there are no exceptions. This is for your safety. PRECAUTUONS ARE NECESSARY FOR SAFE TANNING. I, AGREE THAT I WILL COMLY WITH ALL INSTRUCTIONS ON THE TANNING SYSTEM, AND THAT I AM USING THESE SERVICES AT MY OWN


RISK, AND PRTECTION MY VISION BY USING PRTECTIVE EYE WEAR. I HAVE READ THE CONTENTS OF THIS CONSENT FORM CAREFULLY AND STATE THAT I AM NOT AWARE OF ANY MEDICALY CONDITION OR OTHER REASON THAT WOULD PROHIBIT ME FROM TANNING. I UNDERSTAND THAT WHILE I WILL NOT ALLOWED TO EXCEED THE MAXIMUS ALLOWABLE TIME POSTED ON THE SUNBED, MY SKIN PHOTOTYPE/SUBTYPE, TANNING HISTORY AND LEVEL OF EXISTING BASE TAN MAY ALLOW ME TO TAN LONGER THAN THE POSTED SCHEDULE AND I DO SO AT MY OWN RISK. I HAVE BEEN GIVEN ADEQUATE INSTRUCTIONS FOR THE PROPER USE OF THE TANNING EQUIPMENT, UNDERSTAND THE RISKS INVOLED AND DO SO AT MY OWN RISK. I HERBY AGREE TO THE RELEASE THE OWNERS, OPERATORS, MANUFACTURERS, DISTRIBUTORS, AND ANY GOVERNMENTAL AGENCY FROM ANY DAMAGES THAT I MIGHT INCURE DUE TO THE USE OF THIS TANNING FACILITY. WE, SUN KISSED AND HAIR BOUTIQUE, ARE NOT LIABLE FOR ANY INJURY TO THE PERSON OR PROPERTY CAUSED IN ANY WAY OF IT’S SERVICES OR IT PREMISES. ALSO, WE ARE NOT LIABLE FOR THE LOSS OR THEFT OF ANY PERSONAL PROPERTY. EACH PERSON IS RESPONSIBLE FOR SAFEGAURDING HIS OR HER OWN PROPERTY. NO REFUNDS. PLEASE WRITE “I HAVE READ THE ABOVE” ON THE LINE BELOW.

__________________________________________________________

__________________________________________________________ Date: Signature

__________________________________________________________ Witness (Employee) Signature

PARENTAL CONSENT REQUIRED IF UNDER 18: I hereby give my permission as parent or guardian of ________________ who is ________ years of age and is my ___________________ to tan at this tanning salon. I have read and understand this Client Release and Informed Consent Form and agree and accept all of its provisions. Signed ____________________________________________ Date:

Sun Kissed consent form  

You can print this off and fill it out to save time. You must fill it out at some point.

Sun Kissed consent form  

You can print this off and fill it out to save time. You must fill it out at some point.