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The Bronzery Release Form For 1st Time Customers

Please read, understand and sign the following.

The ingredients in spray tanning solutions have been safely used in cosmetics and nutritional products for decades and have been proven safe for the skin. If you had adverse effects utilizing self tanning products in the past, you may experience similar affects with spray tanning. There are occasions where individuals may be allergic to one or more ingredients in the spray tan solution. Please discuss this with the technician before proceeding.

Spray tanning is accomplished by application of a solution containing the active ingredient: DHA (Dihydroxyacetone). DHA is considered to be safe and has been FDA approved. DHA reacts with the skin’s amino acids resulting in a “tan” similar to that of the sun. The darker you can tan naturally, the darker you can tan with a spray tan.

Every person has a unique skin chemistry and amino acid makeup, which will make every tan unique, and specific to you. The color, shade, and appearance will be unique to you, and no two tans, will look identical, even when using the exact same product. Many things may affect the final color and how a tan works on you, with your individual skin chemistry. Skins pigment level, health, normal color tone, porosity, oiliness, your age and life style habits, diet, medications used, hormonal fluctuations, hormonal based medications and supplements, menstruation, pregnancy, and breast feeding, menopause as well as other factors can all change the outcome of your tan color, and how well it develops and wears.

Our product does not contain a sunscreen and does not protect against sunburn.

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.

I have read and completely understand this consent form.

May 28, 2022

First Client Name

First Name*

Last Name*

Phone*
First Client Date of Birth*
First Client Information
Have you ever had a spray tan?*
No
Yes
Spray Booth
Self Tanner
Are you tanning for a special occasion? If yes, please list below.*
No
Yes
Have you ever had any adverse reaction to any type of sunless tanning products? If yes, please describe below.*
No
Yes
What's Your Skin Type? *
Normal
Combination
Oily
Dry
Very Dry
What is your natural skin tone?*
Type 1 (always burns, never tans)
Type 2 (usually burns, tans with difficulty)
Type 3 (sometimes mild burn, gradually tans)
Type 4 (rarely burns, tans with ease)
Type 5 (very rarely burns, tans very easily)
Type 6 (never burns, tans very easily)
What color would you like to achieve today?*
Light
Medium
Dark
Very dark
Not sure
Do you have any skin concerns? *
Skin Sensitivity
Breaks out easily
Eczema/Psoriasis
Vitiligo
None
Other

If yes, please list
Have you had a sunburn in the last 6 weeks?*
Yes
No
Do you have tan lines that need to be blended? If Yes, Please explain below.*
No
Yes
We ask that you look over the prep instructions prior to your appointment, even if you have had a spray tans with other artists. All instructions are not the same, ours caters to our tanning solution. You will be sent prep instructions, but can also find the information on our website and social media.*
Ok, got it. I want the best tan possible!
How did you hear about us?*

We have an amazing referral program! If someone referred you, be sure to list their name below so you both get credit! We also enter everyone who sends or tags us in a picture of their tan into a drawing each month for a free tan!

List your Facebook and Instagram handles here if you would like to connect! (Optional)
First Client Signature*
Second Client Name

First Name*

Last Name*
Second Client Date of Birth*
Second Client Information
Have you ever had a spray tan?*
No
Yes
Spray Booth
Self Tanner
Are you tanning for a special occasion? If yes, please list below.*
No
Yes
Have you ever had any adverse reaction to any type of sunless tanning products? If yes, please describe below.*
No
Yes
What's Your Skin Type? *
Normal
Combination
Oily
Dry
Very Dry
What is your natural skin tone?*
Type 1 (always burns, never tans)
Type 2 (usually burns, tans with difficulty)
Type 3 (sometimes mild burn, gradually tans)
Type 4 (rarely burns, tans with ease)
Type 5 (very rarely burns, tans very easily)
Type 6 (never burns, tans very easily)
What color would you like to achieve today?*
Light
Medium
Dark
Very dark
Not sure
Do you have any skin concerns? *
Skin Sensitivity
Breaks out easily
Eczema/Psoriasis
Vitiligo
None
Other

If yes, please list
Have you had a sunburn in the last 6 weeks?*
Yes
No
Do you have tan lines that need to be blended? If Yes, Please explain below.*
No
Yes
We ask that you look over the prep instructions prior to your appointment, even if you have had a spray tans with other artists. All instructions are not the same, ours caters to our tanning solution. You will be sent prep instructions, but can also find the information on our website and social media.*
Ok, got it. I want the best tan possible!
How did you hear about us?*

We have an amazing referral program! If someone referred you, be sure to list their name below so you both get credit! We also enter everyone who sends or tags us in a picture of their tan into a drawing each month for a free tan!

List your Facebook and Instagram handles here if you would like to connect! (Optional)
Third Client Name

First Name*

Last Name*
Third Client Date of Birth*
Third Client Information
Have you ever had a spray tan?*
No
Yes
Spray Booth
Self Tanner
Are you tanning for a special occasion? If yes, please list below.*
No
Yes
Have you ever had any adverse reaction to any type of sunless tanning products? If yes, please describe below.*
No
Yes
What's Your Skin Type? *
Normal
Combination
Oily
Dry
Very Dry
What is your natural skin tone?*
Type 1 (always burns, never tans)
Type 2 (usually burns, tans with difficulty)
Type 3 (sometimes mild burn, gradually tans)
Type 4 (rarely burns, tans with ease)
Type 5 (very rarely burns, tans very easily)
Type 6 (never burns, tans very easily)
What color would you like to achieve today?*
Light
Medium
Dark
Very dark
Not sure
Do you have any skin concerns? *
Skin Sensitivity
Breaks out easily
Eczema/Psoriasis
Vitiligo
None
Other

If yes, please list
Have you had a sunburn in the last 6 weeks?*
Yes
No
Do you have tan lines that need to be blended? If Yes, Please explain below.*
No
Yes
We ask that you look over the prep instructions prior to your appointment, even if you have had a spray tans with other artists. All instructions are not the same, ours caters to our tanning solution. You will be sent prep instructions, but can also find the information on our website and social media.*
Ok, got it. I want the best tan possible!
How did you hear about us?*

We have an amazing referral program! If someone referred you, be sure to list their name below so you both get credit! We also enter everyone who sends or tags us in a picture of their tan into a drawing each month for a free tan!

List your Facebook and Instagram handles here if you would like to connect! (Optional)
Fourth Client Name

First Name*

Last Name*
Fourth Client Date of Birth*
Fourth Client Information
Have you ever had a spray tan?*
No
Yes
Spray Booth
Self Tanner
Are you tanning for a special occasion? If yes, please list below.*
No
Yes
Have you ever had any adverse reaction to any type of sunless tanning products? If yes, please describe below.*
No
Yes
What's Your Skin Type? *
Normal
Combination
Oily
Dry
Very Dry
What is your natural skin tone?*
Type 1 (always burns, never tans)
Type 2 (usually burns, tans with difficulty)
Type 3 (sometimes mild burn, gradually tans)
Type 4 (rarely burns, tans with ease)
Type 5 (very rarely burns, tans very easily)
Type 6 (never burns, tans very easily)
What color would you like to achieve today?*
Light
Medium
Dark
Very dark
Not sure
Do you have any skin concerns? *
Skin Sensitivity
Breaks out easily
Eczema/Psoriasis
Vitiligo
None
Other

If yes, please list
Have you had a sunburn in the last 6 weeks?*
Yes
No
Do you have tan lines that need to be blended? If Yes, Please explain below.*
No
Yes
We ask that you look over the prep instructions prior to your appointment, even if you have had a spray tans with other artists. All instructions are not the same, ours caters to our tanning solution. You will be sent prep instructions, but can also find the information on our website and social media.*
Ok, got it. I want the best tan possible!
How did you hear about us?*

We have an amazing referral program! If someone referred you, be sure to list their name below so you both get credit! We also enter everyone who sends or tags us in a picture of their tan into a drawing each month for a free tan!

List your Facebook and Instagram handles here if you would like to connect! (Optional)
Fifth Client Name

First Name*

Last Name*
Fifth Client Date of Birth*
Fifth Client Information
Have you ever had a spray tan?*
No
Yes
Spray Booth
Self Tanner
Are you tanning for a special occasion? If yes, please list below.*
No
Yes
Have you ever had any adverse reaction to any type of sunless tanning products? If yes, please describe below.*
No
Yes
What's Your Skin Type? *
Normal
Combination
Oily
Dry
Very Dry
What is your natural skin tone?*
Type 1 (always burns, never tans)
Type 2 (usually burns, tans with difficulty)
Type 3 (sometimes mild burn, gradually tans)
Type 4 (rarely burns, tans with ease)
Type 5 (very rarely burns, tans very easily)
Type 6 (never burns, tans very easily)
What color would you like to achieve today?*
Light
Medium
Dark
Very dark
Not sure
Do you have any skin concerns? *
Skin Sensitivity
Breaks out easily
Eczema/Psoriasis
Vitiligo
None
Other

If yes, please list
Have you had a sunburn in the last 6 weeks?*
Yes
No
Do you have tan lines that need to be blended? If Yes, Please explain below.*
No
Yes
We ask that you look over the prep instructions prior to your appointment, even if you have had a spray tans with other artists. All instructions are not the same, ours caters to our tanning solution. You will be sent prep instructions, but can also find the information on our website and social media.*
Ok, got it. I want the best tan possible!
How did you hear about us?*

We have an amazing referral program! If someone referred you, be sure to list their name below so you both get credit! We also enter everyone who sends or tags us in a picture of their tan into a drawing each month for a free tan!

List your Facebook and Instagram handles here if you would like to connect! (Optional)
Sixth Client Name

First Name*

Last Name*
Sixth Client Date of Birth*
Sixth Client Information
Have you ever had a spray tan?*
No
Yes
Spray Booth
Self Tanner
Are you tanning for a special occasion? If yes, please list below.*
No
Yes
Have you ever had any adverse reaction to any type of sunless tanning products? If yes, please describe below.*
No
Yes
What's Your Skin Type? *
Normal
Combination
Oily
Dry
Very Dry
What is your natural skin tone?*
Type 1 (always burns, never tans)
Type 2 (usually burns, tans with difficulty)
Type 3 (sometimes mild burn, gradually tans)
Type 4 (rarely burns, tans with ease)
Type 5 (very rarely burns, tans very easily)
Type 6 (never burns, tans very easily)
What color would you like to achieve today?*
Light
Medium
Dark
Very dark
Not sure
Do you have any skin concerns? *
Skin Sensitivity
Breaks out easily
Eczema/Psoriasis
Vitiligo
None
Other

If yes, please list
Have you had a sunburn in the last 6 weeks?*
Yes
No
Do you have tan lines that need to be blended? If Yes, Please explain below.*
No
Yes
We ask that you look over the prep instructions prior to your appointment, even if you have had a spray tans with other artists. All instructions are not the same, ours caters to our tanning solution. You will be sent prep instructions, but can also find the information on our website and social media.*
Ok, got it. I want the best tan possible!
How did you hear about us?*

We have an amazing referral program! If someone referred you, be sure to list their name below so you both get credit! We also enter everyone who sends or tags us in a picture of their tan into a drawing each month for a free tan!

List your Facebook and Instagram handles here if you would like to connect! (Optional)
Seventh Client Name

First Name*

Last Name*
Seventh Client Date of Birth*
Seventh Client Information
Have you ever had a spray tan?*
No
Yes
Spray Booth
Self Tanner
Are you tanning for a special occasion? If yes, please list below.*
No
Yes
Have you ever had any adverse reaction to any type of sunless tanning products? If yes, please describe below.*
No
Yes
What's Your Skin Type? *
Normal
Combination
Oily
Dry
Very Dry
What is your natural skin tone?*
Type 1 (always burns, never tans)
Type 2 (usually burns, tans with difficulty)
Type 3 (sometimes mild burn, gradually tans)
Type 4 (rarely burns, tans with ease)
Type 5 (very rarely burns, tans very easily)
Type 6 (never burns, tans very easily)
What color would you like to achieve today?*
Light
Medium
Dark
Very dark
Not sure
Do you have any skin concerns? *
Skin Sensitivity
Breaks out easily
Eczema/Psoriasis
Vitiligo
None
Other

If yes, please list
Have you had a sunburn in the last 6 weeks?*
Yes
No
Do you have tan lines that need to be blended? If Yes, Please explain below.*
No
Yes
We ask that you look over the prep instructions prior to your appointment, even if you have had a spray tans with other artists. All instructions are not the same, ours caters to our tanning solution. You will be sent prep instructions, but can also find the information on our website and social media.*
Ok, got it. I want the best tan possible!
How did you hear about us?*

We have an amazing referral program! If someone referred you, be sure to list their name below so you both get credit! We also enter everyone who sends or tags us in a picture of their tan into a drawing each month for a free tan!

List your Facebook and Instagram handles here if you would like to connect! (Optional)
Eighth Client Name

First Name*

Last Name*
Eighth Client Date of Birth*
Eighth Client Information
Have you ever had a spray tan?*
No
Yes
Spray Booth
Self Tanner
Are you tanning for a special occasion? If yes, please list below.*
No
Yes
Have you ever had any adverse reaction to any type of sunless tanning products? If yes, please describe below.*
No
Yes
What's Your Skin Type? *
Normal
Combination
Oily
Dry
Very Dry
What is your natural skin tone?*
Type 1 (always burns, never tans)
Type 2 (usually burns, tans with difficulty)
Type 3 (sometimes mild burn, gradually tans)
Type 4 (rarely burns, tans with ease)
Type 5 (very rarely burns, tans very easily)
Type 6 (never burns, tans very easily)
What color would you like to achieve today?*
Light
Medium
Dark
Very dark
Not sure
Do you have any skin concerns? *
Skin Sensitivity
Breaks out easily
Eczema/Psoriasis
Vitiligo
None
Other

If yes, please list
Have you had a sunburn in the last 6 weeks?*
Yes
No
Do you have tan lines that need to be blended? If Yes, Please explain below.*
No
Yes
We ask that you look over the prep instructions prior to your appointment, even if you have had a spray tans with other artists. All instructions are not the same, ours caters to our tanning solution. You will be sent prep instructions, but can also find the information on our website and social media.*
Ok, got it. I want the best tan possible!
How did you hear about us?*

We have an amazing referral program! If someone referred you, be sure to list their name below so you both get credit! We also enter everyone who sends or tags us in a picture of their tan into a drawing each month for a free tan!

List your Facebook and Instagram handles here if you would like to connect! (Optional)
Ninth Client Name

First Name*

Last Name*
Ninth Client Date of Birth*
Ninth Client Information
Have you ever had a spray tan?*
No
Yes
Spray Booth
Self Tanner
Are you tanning for a special occasion? If yes, please list below.*
No
Yes
Have you ever had any adverse reaction to any type of sunless tanning products? If yes, please describe below.*
No
Yes
What's Your Skin Type? *
Normal
Combination
Oily
Dry
Very Dry
What is your natural skin tone?*
Type 1 (always burns, never tans)
Type 2 (usually burns, tans with difficulty)
Type 3 (sometimes mild burn, gradually tans)
Type 4 (rarely burns, tans with ease)
Type 5 (very rarely burns, tans very easily)
Type 6 (never burns, tans very easily)
What color would you like to achieve today?*
Light
Medium
Dark
Very dark
Not sure
Do you have any skin concerns? *
Skin Sensitivity
Breaks out easily
Eczema/Psoriasis
Vitiligo
None
Other

If yes, please list
Have you had a sunburn in the last 6 weeks?*
Yes
No
Do you have tan lines that need to be blended? If Yes, Please explain below.*
No
Yes
We ask that you look over the prep instructions prior to your appointment, even if you have had a spray tans with other artists. All instructions are not the same, ours caters to our tanning solution. You will be sent prep instructions, but can also find the information on our website and social media.*
Ok, got it. I want the best tan possible!
How did you hear about us?*

We have an amazing referral program! If someone referred you, be sure to list their name below so you both get credit! We also enter everyone who sends or tags us in a picture of their tan into a drawing each month for a free tan!

List your Facebook and Instagram handles here if you would like to connect! (Optional)
Tenth Client Name

First Name*

Last Name*
Tenth Client Date of Birth*
Tenth Client Information
Have you ever had a spray tan?*
No
Yes
Spray Booth
Self Tanner
Are you tanning for a special occasion? If yes, please list below.*
No
Yes
Have you ever had any adverse reaction to any type of sunless tanning products? If yes, please describe below.*
No
Yes
What's Your Skin Type? *
Normal
Combination
Oily
Dry
Very Dry
What is your natural skin tone?*
Type 1 (always burns, never tans)
Type 2 (usually burns, tans with difficulty)
Type 3 (sometimes mild burn, gradually tans)
Type 4 (rarely burns, tans with ease)
Type 5 (very rarely burns, tans very easily)
Type 6 (never burns, tans very easily)
What color would you like to achieve today?*
Light
Medium
Dark
Very dark
Not sure
Do you have any skin concerns? *
Skin Sensitivity
Breaks out easily
Eczema/Psoriasis
Vitiligo
None
Other

If yes, please list
Have you had a sunburn in the last 6 weeks?*
Yes
No
Do you have tan lines that need to be blended? If Yes, Please explain below.*
No
Yes
We ask that you look over the prep instructions prior to your appointment, even if you have had a spray tans with other artists. All instructions are not the same, ours caters to our tanning solution. You will be sent prep instructions, but can also find the information on our website and social media.*
Ok, got it. I want the best tan possible!
How did you hear about us?*

We have an amazing referral program! If someone referred you, be sure to list their name below so you both get credit! We also enter everyone who sends or tags us in a picture of their tan into a drawing each month for a free tan!

List your Facebook and Instagram handles here if you would like to connect! (Optional)
Client Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
If client is under the age of 18, parent/guardian signature required for services
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
Have you ever had a spray tan?*
No
Yes
Spray Booth
Self Tanner
Are you tanning for a special occasion? If yes, please list below.*
No
Yes
Have you ever had any adverse reaction to any type of sunless tanning products? If yes, please describe below.*
No
Yes
What's Your Skin Type? *
Normal
Combination
Oily
Dry
Very Dry
What is your natural skin tone?*
Type 1 (always burns, never tans)
Type 2 (usually burns, tans with difficulty)
Type 3 (sometimes mild burn, gradually tans)
Type 4 (rarely burns, tans with ease)
Type 5 (very rarely burns, tans very easily)
Type 6 (never burns, tans very easily)
What color would you like to achieve today?*
Light
Medium
Dark
Very dark
Not sure
Do you have any skin concerns? *
Skin Sensitivity
Breaks out easily
Eczema/Psoriasis
Vitiligo
None
Other

If yes, please list
Have you had a sunburn in the last 6 weeks?*
Yes
No
Do you have tan lines that need to be blended? If Yes, Please explain below.*
No
Yes
We ask that you look over the prep instructions prior to your appointment, even if you have had a spray tans with other artists. All instructions are not the same, ours caters to our tanning solution. You will be sent prep instructions, but can also find the information on our website and social media.*
Ok, got it. I want the best tan possible!
How did you hear about us?*

We have an amazing referral program! If someone referred you, be sure to list their name below so you both get credit! We also enter everyone who sends or tags us in a picture of their tan into a drawing each month for a free tan!

List your Facebook and Instagram handles here if you would like to connect! (Optional)
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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