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WAIVER & RELEASE OF LIABILITY

Please read, understand, and sign the following in the section below:

- Caution – The effect of the spray tan ingredient DHA (Dihydroxyacetone) on pregnant or nursing mothers and their babies is unknown. Pregnant or nursing women should therefore consult their physician before their session. Bronze Beauty Lounge will not tan pregnant women unless there is a note from the client's Doctor.
- Warning – The spray tan ingredient DHA (Dihydroxyacetone) has been approved only for external application and should not be inhaled or ingested internally.
- 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.
- 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 solution used at Bronze Beauty Lounge is made with only FDA-approved ingredients, is hypoallergenic, and is all-natural; therefore an allergic reaction is highly unlikely. However, you do assume that there is a very small risk for a reaction to the solution and waive Bronze Beauty Lounge of any liability relating to such a reaction.

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
- Wearing nose filters
- Sealing lips with lip balm
- Using protective undergarments

Nose filters will be offered as part of your spray tan session. Male clients are requested to wear undergarments. Female clients may wear whatever they feel comfortable with. You may receive protective undergarments for no additional fee. You may also bring/use your own protective items. The appointment will take approximately twenty to thirty minutes. After the spray tan is applied, you will dry briefly before putting your clothes back on, and you should not shower, bathe or sweat excessively for at least six (6) hours, or less if using a rapid rinse formula. You will receive instructions dependent upon formula chosen. 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. 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. Bronze Beauty Lounge is not responsible for potential stains to clothing or upholstery. Please be careful.

 I have read and completely understand this consent form, and agree to the above waivers of liability.

Dated: February 22, 2019

First Client's Name

First Name*

Middle Name

Last Name*

Phone*
First Client's Date of Birth*
First Client's Signature*
Second Client's Name

First Name*

Middle Name

Last Name*
Second Client's Date of Birth*
Third Client's Name

First Name*

Middle Name

Last Name*
Third Client's Date of Birth*
Fourth Client's Name

First Name*

Middle Name

Last Name*
Fourth Client's Date of Birth*
Fifth Client's Name

First Name*

Middle Name

Last Name*
Fifth Client's Date of Birth*
Sixth Client's Name

First Name*

Middle Name

Last Name*
Sixth Client's Date of Birth*
Seventh Client's Name

First Name*

Middle Name

Last Name*
Seventh Client's Date of Birth*
Eighth Client's Name

First Name*

Middle Name

Last Name*
Eighth Client's Date of Birth*
Ninth Client's Name

First Name*

Middle Name

Last Name*
Ninth Client's Date of Birth*
Tenth Client's Name

First Name*

Middle Name

Last Name*
Tenth Client's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
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.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
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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