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PLANET BEACH SERVICE & UV RELEASE INFORMATION

Informed Consent: UV Indoor Tanning Precautions & Release

1. Failure to use eye protection may result in permanent damage to the eyes. Federal/Provincial indoor tanning regulations require the use of approved eyewear.

2. Overexposure to ultraviolet light causes burns.

3. UV Tanning sessions are restricted to once every 24 hour period.

4. Repeated exposure may result in premature aging of the skin, cancer and other conditions.

5. Abnormal skin sensitivity or burns may be caused by reactions of ultraviolet light to certain: a. foods b. cosmetics c. medications, including but not limited to tranquilizers, diuretics, antibiotics, high blood pressure medicines, or birth control.

6. Any person taking a prescription or over the counter medication should consult a physician before tanning.

7. Pregnant women should consult a physician before using a tanning device.

8. A person with skin that burns easily and never tans should avoid indoor tanning.

9. A person with a family or past medical history of skin cancer should avoid indoor tanning.

10. UV Services are restricted to individuals 18+ years of age. 

11. “Contraindication: This product must not be used if skin lesions, or open wounds are present.”

12. “Warning: This product should not be used on individuals who have had skin cancer or have a family history of skin cancer.”

13. “Warning: Persons repeatedly exposed to UV radiation should be regularly evaluated for skin cancer.”

By my signature affixed below, I affirm that I have carefully read, understood and acknowledged the statements listed herein relating to indoor tanning. I have been given adequate instructions for the proper use of indoor tanning and I 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 facility.

I Agree

Informed Consent: DHA Sunless Application

DHA is listed in the Food, Drug and Cosmetic Act (FD&C Act) as a color additive for use in imparting color to the human body. However, its use in cosmetics - including sunless "tanning" application - is restricted to external application. 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).   In addition, no color additive may be used in cosmetics intended for use in the area of the eye unless the color additive is permitted specifically for such use (21 CFR 70.5a). The CFR defines "area of the eye" as follows:

"The area enclosed within the circumference of the supra-orbital ridge, including the eyebrow, the skin below the eyebrow, the eyelids and the eyelashes, and conjunctival sac of the eye, the eyeball, and the soft areolar tissue that lies within the perimeter of the infra-orbital ridge." (21 CFR 70.3s) Because the FDA has not specifically tested or reviewed DHA exposure for other than external use, it recommends that users take measures to protect exposure to eyes, lips, mucous membranes, and prevent inhalation. In accordance with these guidelines, we recommend the following:

  • Like most cosmetics, avoid exposure to the eyes, as well as the immediate area surrounding the eyes.
  •  Avoid exposure to the lips and other parts of the body covered by mucous membrane; this can be accomplished by using a barrier product such as a lip balm.
  • Follow the manufacturer's breathing instructions to avoid inhaling or ingesting the sunless product. Nose plugs are also recommended.

By my signature affixed below, I affirm that I have carefully read, understood and acknowledged the statements listed above relating to DHA “sunless” application: I state that I am not aware of any medical condition or other reason that would prohibit me from sunless application. 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 facility. 

I Agree

Informed Consent: Automated Spa Service 

Red Light Therapy: (Lumiere/pbRenew/Red Fusion/Beauty Angel/Rejuvenate/Red Light Therapy): follow manufacturer guidelines and notifications which are available in each location to review. It is recommended that red light sessions be limited to one session per 24 hours. 

1. pbRenew© Facial Line: as with all topically applied skin care products, use caution when applying products in the eye area. If contact with the eyes occurs, flush with cool water.

2. Not intended for children, pregnant women or individuals with light sensitive conditions: The safety of this technology for use by clients with light-sensitive conditions has not been confirmed. An alternative treatment is recommended for these clients.

3. Eyewear during red light facial or body session: The frequency of light wave emitted by the red light device is within the visible light spectrum and poses no threat of retinal burn or any other eye injury; however due to the brightness and the red light possibly causing sensitivity, it is always recommended that approved eyewear is worn during each session. Some clients with extreme sensitivity to bright light and choose not to use eyewear may experience slight discomfort including a temporary mild headache. Clients that wear contact lenses should be aware that heat and ventilation wind may dry out lenses and it is recommended to remove them prior to session.

4. Conditions requiring physician’s authorization: clients with any of the following conditions are required by Planet Beach to provide documented medical approval prior to your first heat therapy session: Heart/respiratory problems, high blood pressure, kidney disorders, nervous conditions (i.e. epilepsy) open lesions, skin pustules or cysts or shellfish allergies. 

5. Photosensitivity: certain medications and substances can cause an adverse reaction in the skin when exposed to light. May be caused by

6. certain perfumes or plants such as St John's Wort in contact with the skin; metabolic disorders such as Porphyria and other light induced rashes (not recommended for clients with this condition); autoimmune disease, such as Lupus Erythematosus; and albinism. A list of these substances is posted in this facility for your review.  

I Agree

Heat & Infrared Therapy (Including Hydration Station/Infrared Sauna/ Red Fusion): Always follow manufacturers warnings and directions for use, which can be provided, by the spa staff upon request. It is recommended Heat Therapy sessions be limited to one session per 24-hour period.   

1. Water intake: clients are advised to drink 16oz of water both immediately before and after each heat therapy session to prevent dehydration and enhance skin results.

2. Not intended for children, pregnant or nursing women or individuals with heat sensitive conditions: the safety of this technology for use by children, pregnant women and clients with heat sensitive conditions has not been confirmed. An alternative treatment is recommended.

3. It is not recommended to use Infrared Services if you have any of the following conditions: Active cancer, epilepsy, broken bones, slipped disc, infectious skin conditions, low blood pressure, open skin abrasions, pregnant or breastfeeding, inflamed areas, varicose veins. You should consult your physician if you have a pacemaker or are taking certain medications including: diuretics, barbiturates, beta blockers, anticholinergic and some over the counter drugs such as antihistamines.

Conditions requiring physician’s authorization: Clients with any of the following conditions are required by Planet Beach to provide documented medical approval prior to your first heat therapy session: Heart/Respiratory problems, high blood pressure, kidney disorders, nervous conditions (i.e. epilepsy) open lesions, have a history of dizziness, fainting spells, narcolepsy, and skin pustules or cysts.

I Agree

Massage Therapy (Including Hydro Massage/Sit Down Massage): Follow manufacture warnings and instructions provided by staff, upon request. It is recommended that these sessions be limited to one session per 24 hour period.

1. Not intended for children, or pregnant women: the safety of this technology for use by children or pregnant women has not been confirmed and an alternative treatment is recommended.

2. Conditions requiring physicians authorization: clients with any of the following conditions are required by Planet Beach® to provide documented medical approval prior to using this service: cardiac disease, swelling or inflammation, phlebitis, thrombosis, broken bones or fractures, varicose veins, hematoma, HIV, cancer, severe/acute back pain or fever.

3. Anyone suffering from one or more of the following conditions upon which heat or massage have an adverse effect should receive physician approval prior to use.

Teeth Whitening: Follow manufacturer warnings and instructions provided by staff, upon request.   It is recommended 3 sessions be performed within a 24 hour period, and ideally consecutively, to achieve the best results. I understand that results will vary and that my teeth will never be whiter than what my genes naturally allow. The results of this treatment are not intended to be permanent, and repeat touch up treatments may be necessary to maintain the color desired. This treatment will only allow white enamel, not fillings or crowns. This treatment cannot be used if you are pregnant, have gum disease, open cavities or an allergy to peroxide or aloe vera.

1. If the gel comes in contact with the gum tissue or lips, it may cause inflammation or whitening of these areas which usually will reverse within 30 minutes. It may also cause a tingling sensation.

2. Some people can experience tooth sensitivity during the first 24 hours after treatment.

3. Some individuals may develop white spots due to calcium deposits that occur in the teeth naturally. These are not caused by the gel. The product will make this more visible, but the appearance is temporary and should diminish over time.

4. After the treatment, it is natural for the color to regress over time. This is usually gradual but can be accelerated by exposing teeth to various staining agents, such as coffee, tea, tobacco, red wine, dark sodas, etc. It is recommended that you should not eat or drink anything other than water for 60 minutes after the treatment, as teeth are particularly vulnerable to staining during this timespan. When using a touch up pen, it is also recommended to refrain from staining agents until usage is stopped. For both treatments, it is recommended to stay away from staining agents for 24 hours for maximum results.

5. Individuals who are pregnant or lactating, individuals that have had braces removed within the last 6 months, individuals under the age of 14, and individuals with silver fillings in or near the front upper or lower 8 teeth should not use this service. Piercings or other metal objects within the oral cavity should be removed before treatment or they may be damaged or turn black. If a sharp pain in a particular tooth during treatment is experienced, the treatment should be stopped as this could be a sign of an open cavity, and a dentist should be consulted.

I Agree

I understand and agree that the administration of the above services is not an exact science. I hereby certify that said processes have been explained to me and that I have all the information that I desire with regard to said processes, the possible adverse skin reactions and side effects and/ or other possible complications. I consent to and authorize the administration of said processes by Planet Beach and I understand and agree that it will use its best judgment in administering said processes. I have read and agreed to the instructions for proper use of the damage or harm that I might incur due to my use of the facilities. I further understand that Planet Beach services should not be construed as a substitute for medical examination, diagnosis or treatment and that I should see a physician, chiropractor or other qualified medical specialist for any mental or physical ailment of which I am aware. I affirm that I have stated all my known medical conditions, and answered all questions in this document honestly and to the best of my knowledge. By my signature affixed below, I affirm that I have read, understood and acknowledged the statements listed herein and verbally expressed to me relating to the Mystic Tan, Lumiere or pbRenew, Heat Therapy Services, Red Light Therapy Services, Massage Therapy Services, Infrared Therapy Services, Teeth Whitening and all associated sessions and treatments provided within Planet Beach. 

All clients must be 18 years or older to utilize UV Services.

Informed Consent: Minors in the Spa  

Minimum age to use spa and sunless service is 16 years old. Clients under the age of 18 are not permitted to use UV services, even with parental consent. Government issued photo identification may be required at any time to show proof of age for all clients. For clients under age 18, a parent/legal guardian is required prior to using this facility and its services. As parent/legal guardian of the above assigned minor, I hereby grant permission for said minor to use services at this facility. I attest that I am the parent/legal guardian of said minor and attest to the age of the minor. I have carefully read, understood, and ensured all questions in this form have been answered to the best of my ability and I acknowledged and agreed to the above listed statements and hereby agree that said minor and I will abide by all warnings and instructions.


First Client Name

First Name*

Last Name*

Phone*
First Client Date of Birth*
First Client Information

Please answer the following:

1. Have you taken any prescribed or over the counter medication(s) recently ? (If yes, please consult list of photosensitizing medication(s))*
No
Yes
2. Have you ever developed an allergic reaction or sun poisoning from tanning? (If yes, please consult physician before UV tanning) *
No
Yes
3. Are you currently pregnant? If yes, consult your physician for services. No heat therapy services should be used. (Also applies for use in all weight management and massage services) *
No
Yes
4. Have you ever been diagnosed with skin Cancer? If yes, do not tan. *
No
Yes

Equipment Weight Capacity

For safety reasons, please be aware that our equipment has the following maximum weight limits as per the manufacturer's guidelines. Exceeding the weight limits could result in bodily injury or damage to equipment. I understand that if I exceed the limit and damage the equipment I will be responsible for repair costs. 

  • Sundome Stand Up - None
  • Affinity 500 Laydown - 300 lbs
  • Hydration Station - 265 lbs
  • Beauty Angel - 300 lbs
  • Infrared Sauna - 300 lbs
  • Massage Chair -250 lbs
  • Mystic Tan - 250 lbs
I acknowledge the equipment manufacturer's weight capacity and will use services for which I am within the safety limit. *

Skin Type Analysis – To determine UV exposure schedule

Please read each of the following questions and place the corresponding number of your answer in the box to the right. Your total score will determine your skin type so posted exposure time guides can be adhered to. 

Determination based on your hereditary disposition:

What is your natural eye color? *
What is your natural hair color? *
What is the color of your un-radiated skin? *

Determination based on your own experience with sunbathing (to unexposed skin):

What happens when you sunbathe more than two hours in the sun without sunscreen?*
To what degree are you able to turn brown? *
Do you turn brown directly after sunbathing? *
How does your face react to the sun? *

Your tanning habits:

When sunbathing indoors, do you tan in the nude?*
When did you last sunbathe indoors or outdoors?*

Please add up the scores for the above questions to determine your total score. Total Score will be a number between 0-36 that corresponds to the skin type chart below and assists with determining your exposure time. 


TOTAL SCORE: *

Skin Type - Sun burning & Tanning History

1 - Always burns easily; never tans - Total Score: 0-7
2 - Always burns easily; tans minimally - Total Score: 8 – 13
3 - Burns moderately; tans gradually - Total Score: 14 – 19
4 - Burns minimally; always tans well - Total Score: 20 – 25
5 - Rarely burns; tans profusely - Total Score: 26 – 31
6 - Never burns; deeply pigmented - Total Score: > 31


Initial Exposure Time Recommendation

Skin Type 1| UV tanning not recommended.

Skin Type 2| 5-6 mins

Skin Type 3| 6-7 mins

Skin Type 4| 8-9 mins

Skin Type 5| 9-10 mins

Gradually increase your exposure time by 1 minute per session. For skin types 2&3 stay at 8-10 mins for a few sessions before increasing again. To build your tan quickly, tan 2 days consecutively and take the 3rd off until desired color is reached and always use and indoor tanning lotion and protective goggles. 

First Client Signature*
Second Client Name

First Name*

Last Name*
Second Client Date of Birth*
Second Client Information

Please answer the following:

1. Have you taken any prescribed or over the counter medication(s) recently ? (If yes, please consult list of photosensitizing medication(s))*
No
Yes
2. Have you ever developed an allergic reaction or sun poisoning from tanning? (If yes, please consult physician before UV tanning) *
No
Yes
3. Are you currently pregnant? If yes, consult your physician for services. No heat therapy services should be used. (Also applies for use in all weight management and massage services) *
No
Yes
4. Have you ever been diagnosed with skin Cancer? If yes, do not tan. *
No
Yes

Equipment Weight Capacity

For safety reasons, please be aware that our equipment has the following maximum weight limits as per the manufacturer's guidelines. Exceeding the weight limits could result in bodily injury or damage to equipment. I understand that if I exceed the limit and damage the equipment I will be responsible for repair costs. 

  • Sundome Stand Up - None
  • Affinity 500 Laydown - 300 lbs
  • Hydration Station - 265 lbs
  • Beauty Angel - 300 lbs
  • Infrared Sauna - 300 lbs
  • Massage Chair -250 lbs
  • Mystic Tan - 250 lbs
I acknowledge the equipment manufacturer's weight capacity and will use services for which I am within the safety limit. *

Skin Type Analysis – To determine UV exposure schedule

Please read each of the following questions and place the corresponding number of your answer in the box to the right. Your total score will determine your skin type so posted exposure time guides can be adhered to. 

Determination based on your hereditary disposition:

What is your natural eye color? *
What is your natural hair color? *
What is the color of your un-radiated skin? *

Determination based on your own experience with sunbathing (to unexposed skin):

What happens when you sunbathe more than two hours in the sun without sunscreen?*
To what degree are you able to turn brown? *
Do you turn brown directly after sunbathing? *
How does your face react to the sun? *

Your tanning habits:

When sunbathing indoors, do you tan in the nude?*
When did you last sunbathe indoors or outdoors?*

Please add up the scores for the above questions to determine your total score. Total Score will be a number between 0-36 that corresponds to the skin type chart below and assists with determining your exposure time. 


TOTAL SCORE: *

Skin Type - Sun burning & Tanning History

1 - Always burns easily; never tans - Total Score: 0-7
2 - Always burns easily; tans minimally - Total Score: 8 – 13
3 - Burns moderately; tans gradually - Total Score: 14 – 19
4 - Burns minimally; always tans well - Total Score: 20 – 25
5 - Rarely burns; tans profusely - Total Score: 26 – 31
6 - Never burns; deeply pigmented - Total Score: > 31


Initial Exposure Time Recommendation

Skin Type 1| UV tanning not recommended.

Skin Type 2| 5-6 mins

Skin Type 3| 6-7 mins

Skin Type 4| 8-9 mins

Skin Type 5| 9-10 mins

Gradually increase your exposure time by 1 minute per session. For skin types 2&3 stay at 8-10 mins for a few sessions before increasing again. To build your tan quickly, tan 2 days consecutively and take the 3rd off until desired color is reached and always use and indoor tanning lotion and protective goggles. 

Third Client Name

First Name*

Last Name*
Third Client Date of Birth*
Third Client Information

Please answer the following:

1. Have you taken any prescribed or over the counter medication(s) recently ? (If yes, please consult list of photosensitizing medication(s))*
No
Yes
2. Have you ever developed an allergic reaction or sun poisoning from tanning? (If yes, please consult physician before UV tanning) *
No
Yes
3. Are you currently pregnant? If yes, consult your physician for services. No heat therapy services should be used. (Also applies for use in all weight management and massage services) *
No
Yes
4. Have you ever been diagnosed with skin Cancer? If yes, do not tan. *
No
Yes

Equipment Weight Capacity

For safety reasons, please be aware that our equipment has the following maximum weight limits as per the manufacturer's guidelines. Exceeding the weight limits could result in bodily injury or damage to equipment. I understand that if I exceed the limit and damage the equipment I will be responsible for repair costs. 

  • Sundome Stand Up - None
  • Affinity 500 Laydown - 300 lbs
  • Hydration Station - 265 lbs
  • Beauty Angel - 300 lbs
  • Infrared Sauna - 300 lbs
  • Massage Chair -250 lbs
  • Mystic Tan - 250 lbs
I acknowledge the equipment manufacturer's weight capacity and will use services for which I am within the safety limit. *

Skin Type Analysis – To determine UV exposure schedule

Please read each of the following questions and place the corresponding number of your answer in the box to the right. Your total score will determine your skin type so posted exposure time guides can be adhered to. 

Determination based on your hereditary disposition:

What is your natural eye color? *
What is your natural hair color? *
What is the color of your un-radiated skin? *

Determination based on your own experience with sunbathing (to unexposed skin):

What happens when you sunbathe more than two hours in the sun without sunscreen?*
To what degree are you able to turn brown? *
Do you turn brown directly after sunbathing? *
How does your face react to the sun? *

Your tanning habits:

When sunbathing indoors, do you tan in the nude?*
When did you last sunbathe indoors or outdoors?*

Please add up the scores for the above questions to determine your total score. Total Score will be a number between 0-36 that corresponds to the skin type chart below and assists with determining your exposure time. 


TOTAL SCORE: *

Skin Type - Sun burning & Tanning History

1 - Always burns easily; never tans - Total Score: 0-7
2 - Always burns easily; tans minimally - Total Score: 8 – 13
3 - Burns moderately; tans gradually - Total Score: 14 – 19
4 - Burns minimally; always tans well - Total Score: 20 – 25
5 - Rarely burns; tans profusely - Total Score: 26 – 31
6 - Never burns; deeply pigmented - Total Score: > 31


Initial Exposure Time Recommendation

Skin Type 1| UV tanning not recommended.

Skin Type 2| 5-6 mins

Skin Type 3| 6-7 mins

Skin Type 4| 8-9 mins

Skin Type 5| 9-10 mins

Gradually increase your exposure time by 1 minute per session. For skin types 2&3 stay at 8-10 mins for a few sessions before increasing again. To build your tan quickly, tan 2 days consecutively and take the 3rd off until desired color is reached and always use and indoor tanning lotion and protective goggles. 

Fourth Client Name

First Name*

Last Name*
Fourth Client Date of Birth*
Fourth Client Information

Please answer the following:

1. Have you taken any prescribed or over the counter medication(s) recently ? (If yes, please consult list of photosensitizing medication(s))*
No
Yes
2. Have you ever developed an allergic reaction or sun poisoning from tanning? (If yes, please consult physician before UV tanning) *
No
Yes
3. Are you currently pregnant? If yes, consult your physician for services. No heat therapy services should be used. (Also applies for use in all weight management and massage services) *
No
Yes
4. Have you ever been diagnosed with skin Cancer? If yes, do not tan. *
No
Yes

Equipment Weight Capacity

For safety reasons, please be aware that our equipment has the following maximum weight limits as per the manufacturer's guidelines. Exceeding the weight limits could result in bodily injury or damage to equipment. I understand that if I exceed the limit and damage the equipment I will be responsible for repair costs. 

  • Sundome Stand Up - None
  • Affinity 500 Laydown - 300 lbs
  • Hydration Station - 265 lbs
  • Beauty Angel - 300 lbs
  • Infrared Sauna - 300 lbs
  • Massage Chair -250 lbs
  • Mystic Tan - 250 lbs
I acknowledge the equipment manufacturer's weight capacity and will use services for which I am within the safety limit. *

Skin Type Analysis – To determine UV exposure schedule

Please read each of the following questions and place the corresponding number of your answer in the box to the right. Your total score will determine your skin type so posted exposure time guides can be adhered to. 

Determination based on your hereditary disposition:

What is your natural eye color? *
What is your natural hair color? *
What is the color of your un-radiated skin? *

Determination based on your own experience with sunbathing (to unexposed skin):

What happens when you sunbathe more than two hours in the sun without sunscreen?*
To what degree are you able to turn brown? *
Do you turn brown directly after sunbathing? *
How does your face react to the sun? *

Your tanning habits:

When sunbathing indoors, do you tan in the nude?*
When did you last sunbathe indoors or outdoors?*

Please add up the scores for the above questions to determine your total score. Total Score will be a number between 0-36 that corresponds to the skin type chart below and assists with determining your exposure time. 


TOTAL SCORE: *

Skin Type - Sun burning & Tanning History

1 - Always burns easily; never tans - Total Score: 0-7
2 - Always burns easily; tans minimally - Total Score: 8 – 13
3 - Burns moderately; tans gradually - Total Score: 14 – 19
4 - Burns minimally; always tans well - Total Score: 20 – 25
5 - Rarely burns; tans profusely - Total Score: 26 – 31
6 - Never burns; deeply pigmented - Total Score: > 31


Initial Exposure Time Recommendation

Skin Type 1| UV tanning not recommended.

Skin Type 2| 5-6 mins

Skin Type 3| 6-7 mins

Skin Type 4| 8-9 mins

Skin Type 5| 9-10 mins

Gradually increase your exposure time by 1 minute per session. For skin types 2&3 stay at 8-10 mins for a few sessions before increasing again. To build your tan quickly, tan 2 days consecutively and take the 3rd off until desired color is reached and always use and indoor tanning lotion and protective goggles. 

Fifth Client Name

First Name*

Last Name*
Fifth Client Date of Birth*
Fifth Client Information

Please answer the following:

1. Have you taken any prescribed or over the counter medication(s) recently ? (If yes, please consult list of photosensitizing medication(s))*
No
Yes
2. Have you ever developed an allergic reaction or sun poisoning from tanning? (If yes, please consult physician before UV tanning) *
No
Yes
3. Are you currently pregnant? If yes, consult your physician for services. No heat therapy services should be used. (Also applies for use in all weight management and massage services) *
No
Yes
4. Have you ever been diagnosed with skin Cancer? If yes, do not tan. *
No
Yes

Equipment Weight Capacity

For safety reasons, please be aware that our equipment has the following maximum weight limits as per the manufacturer's guidelines. Exceeding the weight limits could result in bodily injury or damage to equipment. I understand that if I exceed the limit and damage the equipment I will be responsible for repair costs. 

  • Sundome Stand Up - None
  • Affinity 500 Laydown - 300 lbs
  • Hydration Station - 265 lbs
  • Beauty Angel - 300 lbs
  • Infrared Sauna - 300 lbs
  • Massage Chair -250 lbs
  • Mystic Tan - 250 lbs
I acknowledge the equipment manufacturer's weight capacity and will use services for which I am within the safety limit. *

Skin Type Analysis – To determine UV exposure schedule

Please read each of the following questions and place the corresponding number of your answer in the box to the right. Your total score will determine your skin type so posted exposure time guides can be adhered to. 

Determination based on your hereditary disposition:

What is your natural eye color? *
What is your natural hair color? *
What is the color of your un-radiated skin? *

Determination based on your own experience with sunbathing (to unexposed skin):

What happens when you sunbathe more than two hours in the sun without sunscreen?*
To what degree are you able to turn brown? *
Do you turn brown directly after sunbathing? *
How does your face react to the sun? *

Your tanning habits:

When sunbathing indoors, do you tan in the nude?*
When did you last sunbathe indoors or outdoors?*

Please add up the scores for the above questions to determine your total score. Total Score will be a number between 0-36 that corresponds to the skin type chart below and assists with determining your exposure time. 


TOTAL SCORE: *

Skin Type - Sun burning & Tanning History

1 - Always burns easily; never tans - Total Score: 0-7
2 - Always burns easily; tans minimally - Total Score: 8 – 13
3 - Burns moderately; tans gradually - Total Score: 14 – 19
4 - Burns minimally; always tans well - Total Score: 20 – 25
5 - Rarely burns; tans profusely - Total Score: 26 – 31
6 - Never burns; deeply pigmented - Total Score: > 31


Initial Exposure Time Recommendation

Skin Type 1| UV tanning not recommended.

Skin Type 2| 5-6 mins

Skin Type 3| 6-7 mins

Skin Type 4| 8-9 mins

Skin Type 5| 9-10 mins

Gradually increase your exposure time by 1 minute per session. For skin types 2&3 stay at 8-10 mins for a few sessions before increasing again. To build your tan quickly, tan 2 days consecutively and take the 3rd off until desired color is reached and always use and indoor tanning lotion and protective goggles. 

Sixth Client Name

First Name*

Last Name*
Sixth Client Date of Birth*
Sixth Client Information

Please answer the following:

1. Have you taken any prescribed or over the counter medication(s) recently ? (If yes, please consult list of photosensitizing medication(s))*
No
Yes
2. Have you ever developed an allergic reaction or sun poisoning from tanning? (If yes, please consult physician before UV tanning) *
No
Yes
3. Are you currently pregnant? If yes, consult your physician for services. No heat therapy services should be used. (Also applies for use in all weight management and massage services) *
No
Yes
4. Have you ever been diagnosed with skin Cancer? If yes, do not tan. *
No
Yes

Equipment Weight Capacity

For safety reasons, please be aware that our equipment has the following maximum weight limits as per the manufacturer's guidelines. Exceeding the weight limits could result in bodily injury or damage to equipment. I understand that if I exceed the limit and damage the equipment I will be responsible for repair costs. 

  • Sundome Stand Up - None
  • Affinity 500 Laydown - 300 lbs
  • Hydration Station - 265 lbs
  • Beauty Angel - 300 lbs
  • Infrared Sauna - 300 lbs
  • Massage Chair -250 lbs
  • Mystic Tan - 250 lbs
I acknowledge the equipment manufacturer's weight capacity and will use services for which I am within the safety limit. *

Skin Type Analysis – To determine UV exposure schedule

Please read each of the following questions and place the corresponding number of your answer in the box to the right. Your total score will determine your skin type so posted exposure time guides can be adhered to. 

Determination based on your hereditary disposition:

What is your natural eye color? *
What is your natural hair color? *
What is the color of your un-radiated skin? *

Determination based on your own experience with sunbathing (to unexposed skin):

What happens when you sunbathe more than two hours in the sun without sunscreen?*
To what degree are you able to turn brown? *
Do you turn brown directly after sunbathing? *
How does your face react to the sun? *

Your tanning habits:

When sunbathing indoors, do you tan in the nude?*
When did you last sunbathe indoors or outdoors?*

Please add up the scores for the above questions to determine your total score. Total Score will be a number between 0-36 that corresponds to the skin type chart below and assists with determining your exposure time. 


TOTAL SCORE: *

Skin Type - Sun burning & Tanning History

1 - Always burns easily; never tans - Total Score: 0-7
2 - Always burns easily; tans minimally - Total Score: 8 – 13
3 - Burns moderately; tans gradually - Total Score: 14 – 19
4 - Burns minimally; always tans well - Total Score: 20 – 25
5 - Rarely burns; tans profusely - Total Score: 26 – 31
6 - Never burns; deeply pigmented - Total Score: > 31


Initial Exposure Time Recommendation

Skin Type 1| UV tanning not recommended.

Skin Type 2| 5-6 mins

Skin Type 3| 6-7 mins

Skin Type 4| 8-9 mins

Skin Type 5| 9-10 mins

Gradually increase your exposure time by 1 minute per session. For skin types 2&3 stay at 8-10 mins for a few sessions before increasing again. To build your tan quickly, tan 2 days consecutively and take the 3rd off until desired color is reached and always use and indoor tanning lotion and protective goggles. 

Seventh Client Name

First Name*

Last Name*
Seventh Client Date of Birth*
Seventh Client Information

Please answer the following:

1. Have you taken any prescribed or over the counter medication(s) recently ? (If yes, please consult list of photosensitizing medication(s))*
No
Yes
2. Have you ever developed an allergic reaction or sun poisoning from tanning? (If yes, please consult physician before UV tanning) *
No
Yes
3. Are you currently pregnant? If yes, consult your physician for services. No heat therapy services should be used. (Also applies for use in all weight management and massage services) *
No
Yes
4. Have you ever been diagnosed with skin Cancer? If yes, do not tan. *
No
Yes

Equipment Weight Capacity

For safety reasons, please be aware that our equipment has the following maximum weight limits as per the manufacturer's guidelines. Exceeding the weight limits could result in bodily injury or damage to equipment. I understand that if I exceed the limit and damage the equipment I will be responsible for repair costs. 

  • Sundome Stand Up - None
  • Affinity 500 Laydown - 300 lbs
  • Hydration Station - 265 lbs
  • Beauty Angel - 300 lbs
  • Infrared Sauna - 300 lbs
  • Massage Chair -250 lbs
  • Mystic Tan - 250 lbs
I acknowledge the equipment manufacturer's weight capacity and will use services for which I am within the safety limit. *

Skin Type Analysis – To determine UV exposure schedule

Please read each of the following questions and place the corresponding number of your answer in the box to the right. Your total score will determine your skin type so posted exposure time guides can be adhered to. 

Determination based on your hereditary disposition:

What is your natural eye color? *
What is your natural hair color? *
What is the color of your un-radiated skin? *

Determination based on your own experience with sunbathing (to unexposed skin):

What happens when you sunbathe more than two hours in the sun without sunscreen?*
To what degree are you able to turn brown? *
Do you turn brown directly after sunbathing? *
How does your face react to the sun? *

Your tanning habits:

When sunbathing indoors, do you tan in the nude?*
When did you last sunbathe indoors or outdoors?*

Please add up the scores for the above questions to determine your total score. Total Score will be a number between 0-36 that corresponds to the skin type chart below and assists with determining your exposure time. 


TOTAL SCORE: *

Skin Type - Sun burning & Tanning History

1 - Always burns easily; never tans - Total Score: 0-7
2 - Always burns easily; tans minimally - Total Score: 8 – 13
3 - Burns moderately; tans gradually - Total Score: 14 – 19
4 - Burns minimally; always tans well - Total Score: 20 – 25
5 - Rarely burns; tans profusely - Total Score: 26 – 31
6 - Never burns; deeply pigmented - Total Score: > 31


Initial Exposure Time Recommendation

Skin Type 1| UV tanning not recommended.

Skin Type 2| 5-6 mins

Skin Type 3| 6-7 mins

Skin Type 4| 8-9 mins

Skin Type 5| 9-10 mins

Gradually increase your exposure time by 1 minute per session. For skin types 2&3 stay at 8-10 mins for a few sessions before increasing again. To build your tan quickly, tan 2 days consecutively and take the 3rd off until desired color is reached and always use and indoor tanning lotion and protective goggles. 

Eighth Client Name

First Name*

Last Name*
Eighth Client Date of Birth*
Eighth Client Information

Please answer the following:

1. Have you taken any prescribed or over the counter medication(s) recently ? (If yes, please consult list of photosensitizing medication(s))*
No
Yes
2. Have you ever developed an allergic reaction or sun poisoning from tanning? (If yes, please consult physician before UV tanning) *
No
Yes
3. Are you currently pregnant? If yes, consult your physician for services. No heat therapy services should be used. (Also applies for use in all weight management and massage services) *
No
Yes
4. Have you ever been diagnosed with skin Cancer? If yes, do not tan. *
No
Yes

Equipment Weight Capacity

For safety reasons, please be aware that our equipment has the following maximum weight limits as per the manufacturer's guidelines. Exceeding the weight limits could result in bodily injury or damage to equipment. I understand that if I exceed the limit and damage the equipment I will be responsible for repair costs. 

  • Sundome Stand Up - None
  • Affinity 500 Laydown - 300 lbs
  • Hydration Station - 265 lbs
  • Beauty Angel - 300 lbs
  • Infrared Sauna - 300 lbs
  • Massage Chair -250 lbs
  • Mystic Tan - 250 lbs
I acknowledge the equipment manufacturer's weight capacity and will use services for which I am within the safety limit. *

Skin Type Analysis – To determine UV exposure schedule

Please read each of the following questions and place the corresponding number of your answer in the box to the right. Your total score will determine your skin type so posted exposure time guides can be adhered to. 

Determination based on your hereditary disposition:

What is your natural eye color? *
What is your natural hair color? *
What is the color of your un-radiated skin? *

Determination based on your own experience with sunbathing (to unexposed skin):

What happens when you sunbathe more than two hours in the sun without sunscreen?*
To what degree are you able to turn brown? *
Do you turn brown directly after sunbathing? *
How does your face react to the sun? *

Your tanning habits:

When sunbathing indoors, do you tan in the nude?*
When did you last sunbathe indoors or outdoors?*

Please add up the scores for the above questions to determine your total score. Total Score will be a number between 0-36 that corresponds to the skin type chart below and assists with determining your exposure time. 


TOTAL SCORE: *

Skin Type - Sun burning & Tanning History

1 - Always burns easily; never tans - Total Score: 0-7
2 - Always burns easily; tans minimally - Total Score: 8 – 13
3 - Burns moderately; tans gradually - Total Score: 14 – 19
4 - Burns minimally; always tans well - Total Score: 20 – 25
5 - Rarely burns; tans profusely - Total Score: 26 – 31
6 - Never burns; deeply pigmented - Total Score: > 31


Initial Exposure Time Recommendation

Skin Type 1| UV tanning not recommended.

Skin Type 2| 5-6 mins

Skin Type 3| 6-7 mins

Skin Type 4| 8-9 mins

Skin Type 5| 9-10 mins

Gradually increase your exposure time by 1 minute per session. For skin types 2&3 stay at 8-10 mins for a few sessions before increasing again. To build your tan quickly, tan 2 days consecutively and take the 3rd off until desired color is reached and always use and indoor tanning lotion and protective goggles. 

Ninth Client Name

First Name*

Last Name*
Ninth Client Date of Birth*
Ninth Client Information

Please answer the following:

1. Have you taken any prescribed or over the counter medication(s) recently ? (If yes, please consult list of photosensitizing medication(s))*
No
Yes
2. Have you ever developed an allergic reaction or sun poisoning from tanning? (If yes, please consult physician before UV tanning) *
No
Yes
3. Are you currently pregnant? If yes, consult your physician for services. No heat therapy services should be used. (Also applies for use in all weight management and massage services) *
No
Yes
4. Have you ever been diagnosed with skin Cancer? If yes, do not tan. *
No
Yes

Equipment Weight Capacity

For safety reasons, please be aware that our equipment has the following maximum weight limits as per the manufacturer's guidelines. Exceeding the weight limits could result in bodily injury or damage to equipment. I understand that if I exceed the limit and damage the equipment I will be responsible for repair costs. 

  • Sundome Stand Up - None
  • Affinity 500 Laydown - 300 lbs
  • Hydration Station - 265 lbs
  • Beauty Angel - 300 lbs
  • Infrared Sauna - 300 lbs
  • Massage Chair -250 lbs
  • Mystic Tan - 250 lbs
I acknowledge the equipment manufacturer's weight capacity and will use services for which I am within the safety limit. *

Skin Type Analysis – To determine UV exposure schedule

Please read each of the following questions and place the corresponding number of your answer in the box to the right. Your total score will determine your skin type so posted exposure time guides can be adhered to. 

Determination based on your hereditary disposition:

What is your natural eye color? *
What is your natural hair color? *
What is the color of your un-radiated skin? *

Determination based on your own experience with sunbathing (to unexposed skin):

What happens when you sunbathe more than two hours in the sun without sunscreen?*
To what degree are you able to turn brown? *
Do you turn brown directly after sunbathing? *
How does your face react to the sun? *

Your tanning habits:

When sunbathing indoors, do you tan in the nude?*
When did you last sunbathe indoors or outdoors?*

Please add up the scores for the above questions to determine your total score. Total Score will be a number between 0-36 that corresponds to the skin type chart below and assists with determining your exposure time. 


TOTAL SCORE: *

Skin Type - Sun burning & Tanning History

1 - Always burns easily; never tans - Total Score: 0-7
2 - Always burns easily; tans minimally - Total Score: 8 – 13
3 - Burns moderately; tans gradually - Total Score: 14 – 19
4 - Burns minimally; always tans well - Total Score: 20 – 25
5 - Rarely burns; tans profusely - Total Score: 26 – 31
6 - Never burns; deeply pigmented - Total Score: > 31


Initial Exposure Time Recommendation

Skin Type 1| UV tanning not recommended.

Skin Type 2| 5-6 mins

Skin Type 3| 6-7 mins

Skin Type 4| 8-9 mins

Skin Type 5| 9-10 mins

Gradually increase your exposure time by 1 minute per session. For skin types 2&3 stay at 8-10 mins for a few sessions before increasing again. To build your tan quickly, tan 2 days consecutively and take the 3rd off until desired color is reached and always use and indoor tanning lotion and protective goggles. 

Tenth Client Name

First Name*

Last Name*
Tenth Client Date of Birth*
Tenth Client Information

Please answer the following:

1. Have you taken any prescribed or over the counter medication(s) recently ? (If yes, please consult list of photosensitizing medication(s))*
No
Yes
2. Have you ever developed an allergic reaction or sun poisoning from tanning? (If yes, please consult physician before UV tanning) *
No
Yes
3. Are you currently pregnant? If yes, consult your physician for services. No heat therapy services should be used. (Also applies for use in all weight management and massage services) *
No
Yes
4. Have you ever been diagnosed with skin Cancer? If yes, do not tan. *
No
Yes

Equipment Weight Capacity

For safety reasons, please be aware that our equipment has the following maximum weight limits as per the manufacturer's guidelines. Exceeding the weight limits could result in bodily injury or damage to equipment. I understand that if I exceed the limit and damage the equipment I will be responsible for repair costs. 

  • Sundome Stand Up - None
  • Affinity 500 Laydown - 300 lbs
  • Hydration Station - 265 lbs
  • Beauty Angel - 300 lbs
  • Infrared Sauna - 300 lbs
  • Massage Chair -250 lbs
  • Mystic Tan - 250 lbs
I acknowledge the equipment manufacturer's weight capacity and will use services for which I am within the safety limit. *

Skin Type Analysis – To determine UV exposure schedule

Please read each of the following questions and place the corresponding number of your answer in the box to the right. Your total score will determine your skin type so posted exposure time guides can be adhered to. 

Determination based on your hereditary disposition:

What is your natural eye color? *
What is your natural hair color? *
What is the color of your un-radiated skin? *

Determination based on your own experience with sunbathing (to unexposed skin):

What happens when you sunbathe more than two hours in the sun without sunscreen?*
To what degree are you able to turn brown? *
Do you turn brown directly after sunbathing? *
How does your face react to the sun? *

Your tanning habits:

When sunbathing indoors, do you tan in the nude?*
When did you last sunbathe indoors or outdoors?*

Please add up the scores for the above questions to determine your total score. Total Score will be a number between 0-36 that corresponds to the skin type chart below and assists with determining your exposure time. 


TOTAL SCORE: *

Skin Type - Sun burning & Tanning History

1 - Always burns easily; never tans - Total Score: 0-7
2 - Always burns easily; tans minimally - Total Score: 8 – 13
3 - Burns moderately; tans gradually - Total Score: 14 – 19
4 - Burns minimally; always tans well - Total Score: 20 – 25
5 - Rarely burns; tans profusely - Total Score: 26 – 31
6 - Never burns; deeply pigmented - Total Score: > 31


Initial Exposure Time Recommendation

Skin Type 1| UV tanning not recommended.

Skin Type 2| 5-6 mins

Skin Type 3| 6-7 mins

Skin Type 4| 8-9 mins

Skin Type 5| 9-10 mins

Gradually increase your exposure time by 1 minute per session. For skin types 2&3 stay at 8-10 mins for a few sessions before increasing again. To build your tan quickly, tan 2 days consecutively and take the 3rd off until desired color is reached and always use and indoor tanning lotion and protective goggles. 

Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
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:*
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*

Emergency Contact's Relation to Participant
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

Please answer the following:

1. Have you taken any prescribed or over the counter medication(s) recently ? (If yes, please consult list of photosensitizing medication(s))*
No
Yes
2. Have you ever developed an allergic reaction or sun poisoning from tanning? (If yes, please consult physician before UV tanning) *
No
Yes
3. Are you currently pregnant? If yes, consult your physician for services. No heat therapy services should be used. (Also applies for use in all weight management and massage services) *
No
Yes
4. Have you ever been diagnosed with skin Cancer? If yes, do not tan. *
No
Yes

Equipment Weight Capacity

For safety reasons, please be aware that our equipment has the following maximum weight limits as per the manufacturer's guidelines. Exceeding the weight limits could result in bodily injury or damage to equipment. I understand that if I exceed the limit and damage the equipment I will be responsible for repair costs. 

  • Sundome Stand Up - None
  • Affinity 500 Laydown - 300 lbs
  • Hydration Station - 265 lbs
  • Beauty Angel - 300 lbs
  • Infrared Sauna - 300 lbs
  • Massage Chair -250 lbs
  • Mystic Tan - 250 lbs
I acknowledge the equipment manufacturer's weight capacity and will use services for which I am within the safety limit. *

Skin Type Analysis – To determine UV exposure schedule

Please read each of the following questions and place the corresponding number of your answer in the box to the right. Your total score will determine your skin type so posted exposure time guides can be adhered to. 

Determination based on your hereditary disposition:

What is your natural eye color? *
What is your natural hair color? *
What is the color of your un-radiated skin? *

Determination based on your own experience with sunbathing (to unexposed skin):

What happens when you sunbathe more than two hours in the sun without sunscreen?*
To what degree are you able to turn brown? *
Do you turn brown directly after sunbathing? *
How does your face react to the sun? *

Your tanning habits:

When sunbathing indoors, do you tan in the nude?*
When did you last sunbathe indoors or outdoors?*

Please add up the scores for the above questions to determine your total score. Total Score will be a number between 0-36 that corresponds to the skin type chart below and assists with determining your exposure time. 


TOTAL SCORE: *

Skin Type - Sun burning & Tanning History

1 - Always burns easily; never tans - Total Score: 0-7
2 - Always burns easily; tans minimally - Total Score: 8 – 13
3 - Burns moderately; tans gradually - Total Score: 14 – 19
4 - Burns minimally; always tans well - Total Score: 20 – 25
5 - Rarely burns; tans profusely - Total Score: 26 – 31
6 - Never burns; deeply pigmented - Total Score: > 31


Initial Exposure Time Recommendation

Skin Type 1| UV tanning not recommended.

Skin Type 2| 5-6 mins

Skin Type 3| 6-7 mins

Skin Type 4| 8-9 mins

Skin Type 5| 9-10 mins

Gradually increase your exposure time by 1 minute per session. For skin types 2&3 stay at 8-10 mins for a few sessions before increasing again. To build your tan quickly, tan 2 days consecutively and take the 3rd off until desired color is reached and always use and indoor tanning lotion and protective goggles. 

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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