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I have read the contents of this consent form carefully and state that I am not aware of any medical condition, allergies, breathing or respiratory issue, or any other reason that would prohibit me from airbrush tanning. I have been given adequate instructions for the proper use of the sunless application with the tanning tips that Healthy Glow Airbrush Tanning/Sunless Inc. has instructed me to read on the website, text or emailed me. I am aware that the results of airbrush tanning vary and that no guarantee is offered or implied. If there is any discomfort during your session, your session will immediately stop. If necessary, Healthy Glow Airbrush Tanning/Sunless Inc.  will seek medical assistance on your behalf. I agree to release Healthy Glow Airbrush Tanning/Sunless Inc. , the owner and the property owners, operators, manufacturers from any damages that I might incur due to the use of this facility or service. I have been advised to discontinue use if any reaction occurs, understand the risks involved, and tan at my own risk. Refunds are at the discretion of Healthy Glow/Sunless Inc. It is the sole responsibility of the client to notify Healthy Glow/Sunless Inc. about any changes in allergies or medications. I have read and understand this waiver in its entirety as well as the tanning tips instructions. Healthy Glow/Sunless Inc. will provide a list of solution ingredients upon request, plant derivative DHA being the main ingredient. I do feel Susan Brand, owner and operator, has answered my questions and has provided me with all the appropriate information for my sunless airbrush tan. 

Healthy Glow/Sunless Inc. carries disposable: robes, thongs, shower caps, nose filters, face masks, eye covers, and lip balm.

FDA SPRAY TAN RECOMMENDATIONS

Precautionary Guidelines for spray tanning with DHA

The FDA has advised that all users of DHA spray tanning services avoid inhaling or ingesting DHA. When using all-over sunless tanning sprayscontaining DHA it may be difficult to avoid exposure to sensitive areas including eyes, lips, mucous membranes or internally.

The FDA recommends you take the following protective measures during your sunless tanning session:

• Use of Protective Undergarments• Using Protective Eyewear

• Use of Nose Filters

• Sealing Lips with Lip Balm

Please request the above items from your sunless technician.

If you have additional concerns, please consult with your health care provider. To understand the complete FDA stance on DHA please visit www.FDA.gov

The first set is supplied free upon your request. 

Retinol and also anti aging products are designed to exfoliate the skin and renew to reveal the skin underneath, so the results? Your sunless tan will fade faster and also get patchy. This also goes for AHA's, BHA's and any acne products

All precautions will be made to stop the spread of communicable diseases, however clients will enter the building 740 NE Jensen Beach Blvd, Jensen Beach, FL 34957 and be sprayed at their own risk.


Note: If you have already signed the waiver, you do not need to sign it again. Please direct any questions directly to Healthy Glow Airbrush Tanning

Today's Date: June 10, 2023

First Clients Name

First Name*

Last Name*

Phone*
First Clients Date of Birth*
First Clients Information
Gender:*

How did you hear about Healthy Glow Airbrush Tanning? Please be specific
Do you have any allergies or skin/breathing conditions? If you are on chemotherapy or medication that might effect the results of your customized tan, please let us know. If you would like to speak privately, please just let us know.*

If so, please state what they are.
Are you pregnant? If yes, first trimester is not accepted for a tan, and please check with your ob/gyn to make sure that they permit this sunless tan, you will be required to wear nose filters.*
Are you aware of the skin preparation, as well as the FDA Spray Tan recommendations located on the website?*
Have you airbrush tanned before with a handheld machine?*
Are you sunburned?*
Maintaining your airbrush tan will be up to you. Do you agree to properly take care of your tan?*
Have you or anyone close to you traveled out of state in the past 30 days?*

Please select the date of your service
Did you read our cancellation policy? If we are not contacted within 24 hrs to cancel, we will charge 100% of the fee as we are typically unable to fill that spot.*
First Clients Signature*
Second Clients Name

First Name*

Last Name*
Second Clients Date of Birth*
Second Clients Information
Gender:*

How did you hear about Healthy Glow Airbrush Tanning? Please be specific
Do you have any allergies or skin/breathing conditions? If you are on chemotherapy or medication that might effect the results of your customized tan, please let us know. If you would like to speak privately, please just let us know.*

If so, please state what they are.
Are you pregnant? If yes, first trimester is not accepted for a tan, and please check with your ob/gyn to make sure that they permit this sunless tan, you will be required to wear nose filters.*
Are you aware of the skin preparation, as well as the FDA Spray Tan recommendations located on the website?*
Have you airbrush tanned before with a handheld machine?*
Are you sunburned?*
Maintaining your airbrush tan will be up to you. Do you agree to properly take care of your tan?*
Have you or anyone close to you traveled out of state in the past 30 days?*

Please select the date of your service
Did you read our cancellation policy? If we are not contacted within 24 hrs to cancel, we will charge 100% of the fee as we are typically unable to fill that spot.*
Third Clients Name

First Name*

Last Name*
Third Clients Date of Birth*
Third Clients Information
Gender:*

How did you hear about Healthy Glow Airbrush Tanning? Please be specific
Do you have any allergies or skin/breathing conditions? If you are on chemotherapy or medication that might effect the results of your customized tan, please let us know. If you would like to speak privately, please just let us know.*

If so, please state what they are.
Are you pregnant? If yes, first trimester is not accepted for a tan, and please check with your ob/gyn to make sure that they permit this sunless tan, you will be required to wear nose filters.*
Are you aware of the skin preparation, as well as the FDA Spray Tan recommendations located on the website?*
Have you airbrush tanned before with a handheld machine?*
Are you sunburned?*
Maintaining your airbrush tan will be up to you. Do you agree to properly take care of your tan?*
Have you or anyone close to you traveled out of state in the past 30 days?*

Please select the date of your service
Did you read our cancellation policy? If we are not contacted within 24 hrs to cancel, we will charge 100% of the fee as we are typically unable to fill that spot.*
Fourth Clients Name

First Name*

Last Name*
Fourth Clients Date of Birth*
Fourth Clients Information
Gender:*

How did you hear about Healthy Glow Airbrush Tanning? Please be specific
Do you have any allergies or skin/breathing conditions? If you are on chemotherapy or medication that might effect the results of your customized tan, please let us know. If you would like to speak privately, please just let us know.*

If so, please state what they are.
Are you pregnant? If yes, first trimester is not accepted for a tan, and please check with your ob/gyn to make sure that they permit this sunless tan, you will be required to wear nose filters.*
Are you aware of the skin preparation, as well as the FDA Spray Tan recommendations located on the website?*
Have you airbrush tanned before with a handheld machine?*
Are you sunburned?*
Maintaining your airbrush tan will be up to you. Do you agree to properly take care of your tan?*
Have you or anyone close to you traveled out of state in the past 30 days?*

Please select the date of your service
Did you read our cancellation policy? If we are not contacted within 24 hrs to cancel, we will charge 100% of the fee as we are typically unable to fill that spot.*
Fifth Clients Name

First Name*

Last Name*
Fifth Clients Date of Birth*
Fifth Clients Information
Gender:*

How did you hear about Healthy Glow Airbrush Tanning? Please be specific
Do you have any allergies or skin/breathing conditions? If you are on chemotherapy or medication that might effect the results of your customized tan, please let us know. If you would like to speak privately, please just let us know.*

If so, please state what they are.
Are you pregnant? If yes, first trimester is not accepted for a tan, and please check with your ob/gyn to make sure that they permit this sunless tan, you will be required to wear nose filters.*
Are you aware of the skin preparation, as well as the FDA Spray Tan recommendations located on the website?*
Have you airbrush tanned before with a handheld machine?*
Are you sunburned?*
Maintaining your airbrush tan will be up to you. Do you agree to properly take care of your tan?*
Have you or anyone close to you traveled out of state in the past 30 days?*

Please select the date of your service
Did you read our cancellation policy? If we are not contacted within 24 hrs to cancel, we will charge 100% of the fee as we are typically unable to fill that spot.*
Sixth Clients Name

First Name*

Last Name*
Sixth Clients Date of Birth*
Sixth Clients Information
Gender:*

How did you hear about Healthy Glow Airbrush Tanning? Please be specific
Do you have any allergies or skin/breathing conditions? If you are on chemotherapy or medication that might effect the results of your customized tan, please let us know. If you would like to speak privately, please just let us know.*

If so, please state what they are.
Are you pregnant? If yes, first trimester is not accepted for a tan, and please check with your ob/gyn to make sure that they permit this sunless tan, you will be required to wear nose filters.*
Are you aware of the skin preparation, as well as the FDA Spray Tan recommendations located on the website?*
Have you airbrush tanned before with a handheld machine?*
Are you sunburned?*
Maintaining your airbrush tan will be up to you. Do you agree to properly take care of your tan?*
Have you or anyone close to you traveled out of state in the past 30 days?*

Please select the date of your service
Did you read our cancellation policy? If we are not contacted within 24 hrs to cancel, we will charge 100% of the fee as we are typically unable to fill that spot.*
Seventh Clients Name

First Name*

Last Name*
Seventh Clients Date of Birth*
Seventh Clients Information
Gender:*

How did you hear about Healthy Glow Airbrush Tanning? Please be specific
Do you have any allergies or skin/breathing conditions? If you are on chemotherapy or medication that might effect the results of your customized tan, please let us know. If you would like to speak privately, please just let us know.*

If so, please state what they are.
Are you pregnant? If yes, first trimester is not accepted for a tan, and please check with your ob/gyn to make sure that they permit this sunless tan, you will be required to wear nose filters.*
Are you aware of the skin preparation, as well as the FDA Spray Tan recommendations located on the website?*
Have you airbrush tanned before with a handheld machine?*
Are you sunburned?*
Maintaining your airbrush tan will be up to you. Do you agree to properly take care of your tan?*
Have you or anyone close to you traveled out of state in the past 30 days?*

Please select the date of your service
Did you read our cancellation policy? If we are not contacted within 24 hrs to cancel, we will charge 100% of the fee as we are typically unable to fill that spot.*
Eighth Clients Name

First Name*

Last Name*
Eighth Clients Date of Birth*
Eighth Clients Information
Gender:*

How did you hear about Healthy Glow Airbrush Tanning? Please be specific
Do you have any allergies or skin/breathing conditions? If you are on chemotherapy or medication that might effect the results of your customized tan, please let us know. If you would like to speak privately, please just let us know.*

If so, please state what they are.
Are you pregnant? If yes, first trimester is not accepted for a tan, and please check with your ob/gyn to make sure that they permit this sunless tan, you will be required to wear nose filters.*
Are you aware of the skin preparation, as well as the FDA Spray Tan recommendations located on the website?*
Have you airbrush tanned before with a handheld machine?*
Are you sunburned?*
Maintaining your airbrush tan will be up to you. Do you agree to properly take care of your tan?*
Have you or anyone close to you traveled out of state in the past 30 days?*

Please select the date of your service
Did you read our cancellation policy? If we are not contacted within 24 hrs to cancel, we will charge 100% of the fee as we are typically unable to fill that spot.*
Ninth Clients Name

First Name*

Last Name*
Ninth Clients Date of Birth*
Ninth Clients Information
Gender:*

How did you hear about Healthy Glow Airbrush Tanning? Please be specific
Do you have any allergies or skin/breathing conditions? If you are on chemotherapy or medication that might effect the results of your customized tan, please let us know. If you would like to speak privately, please just let us know.*

If so, please state what they are.
Are you pregnant? If yes, first trimester is not accepted for a tan, and please check with your ob/gyn to make sure that they permit this sunless tan, you will be required to wear nose filters.*
Are you aware of the skin preparation, as well as the FDA Spray Tan recommendations located on the website?*
Have you airbrush tanned before with a handheld machine?*
Are you sunburned?*
Maintaining your airbrush tan will be up to you. Do you agree to properly take care of your tan?*
Have you or anyone close to you traveled out of state in the past 30 days?*

Please select the date of your service
Did you read our cancellation policy? If we are not contacted within 24 hrs to cancel, we will charge 100% of the fee as we are typically unable to fill that spot.*
Tenth Clients Name

First Name*

Last Name*
Tenth Clients Date of Birth*
Tenth Clients Information
Gender:*

How did you hear about Healthy Glow Airbrush Tanning? Please be specific
Do you have any allergies or skin/breathing conditions? If you are on chemotherapy or medication that might effect the results of your customized tan, please let us know. If you would like to speak privately, please just let us know.*

If so, please state what they are.
Are you pregnant? If yes, first trimester is not accepted for a tan, and please check with your ob/gyn to make sure that they permit this sunless tan, you will be required to wear nose filters.*
Are you aware of the skin preparation, as well as the FDA Spray Tan recommendations located on the website?*
Have you airbrush tanned before with a handheld machine?*
Are you sunburned?*
Maintaining your airbrush tan will be up to you. Do you agree to properly take care of your tan?*
Have you or anyone close to you traveled out of state in the past 30 days?*

Please select the date of your service
Did you read our cancellation policy? If we are not contacted within 24 hrs to cancel, we will charge 100% of the fee as we are typically unable to fill that spot.*
Parent or Guardian's Email Address

Email*
A signed copy of this waiver will be sent to the email address you provide.
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
Gender:*

How did you hear about Healthy Glow Airbrush Tanning? Please be specific
Do you have any allergies or skin/breathing conditions? If you are on chemotherapy or medication that might effect the results of your customized tan, please let us know. If you would like to speak privately, please just let us know.*

If so, please state what they are.
Are you pregnant? If yes, first trimester is not accepted for a tan, and please check with your ob/gyn to make sure that they permit this sunless tan, you will be required to wear nose filters.*
Are you aware of the skin preparation, as well as the FDA Spray Tan recommendations located on the website?*
Have you airbrush tanned before with a handheld machine?*
Are you sunburned?*
Maintaining your airbrush tan will be up to you. Do you agree to properly take care of your tan?*
Have you or anyone close to you traveled out of state in the past 30 days?*

Please select the date of your service
Did you read our cancellation policy? If we are not contacted within 24 hrs to cancel, we will charge 100% of the fee as we are typically unable to fill that spot.*
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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