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Tanning Solution: Active Ingredient

DHA is listed in the regulations as 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 (21 CFR 73.2150). According to the CFR, "externally applied" cosmetics are those "applied only to external parts of the body and not to the lips or any body surface covered by mucous membrane" (21 CFR 70.3v). The industry has not provided safety data to FDA in order for the agency to consider approving it for use on these exposure routes, including "misting" from tanning booths.

Additional Tanning Disclosures:

Spray tan solutions nor DHA protect skin from UV rays from the sun and should not be thought of or treated as sunscreen or similar sun protector.

I have been given pre-tanning/prepartion instructions as well as post-tanning procedures by the airbrush technician at this business.

I understand and agree that this release of liability is perpetual and ongoing and it is my responsibility to notify this business if any information in my customer profile changes.

I have read the contents of this consent form carefully and state that I am not aware of any medical condition, allergies, or any other reason that would prohibit me from sunless tanning. I have been given adequate instructions for the proper use of the sunless application, understand the risks involved, and use it at my own risk. I hereby agree to release the owners, operators, and manufacturers from any damages that I might incur due to the use of this service, product, and/or facility.

First Participant's Name

First Name*

Last Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

Email*

Confirm Email*
Have you been out of the country in the last 6 weeks?
No
Yes
Have you tested positive or been exposed to anyone that has tested positive for Covid-19?
No
Yes, I tested positive.
Yes, I was exposed.

If yes, when were you exposed or tested positive?
Have you ever had a spray tan?*
No
Yes
Do you have any known allergies?*
No
Yes

If yes, please list.
Are you pregnant?
No
Yes

If yes, which trimester are you in?
Do you tan easily?
No
Yes
Have you had a sunburn or any sun damage in the past 6 weeks?
No
Yes

If yes, when were you exposed?
Do you agree to inform your technician of any sun damage prior to any future appointments?
No
Yes
Do you have any skin conditions (acne, eczema, psoriasis, vitiligo, scarring)?
No
Yes

If yes, please list.
Do you consent to have photos posted on Mistified's social media?
No
Yes
Have you read and consent to Mistified's cancellation policy?
No
Yes
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*

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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