21tanning

Do you have the english version of the list of medications or can anyone tell me what they are?????? Please & Thank you!!:)(:

Neon Beach

21tanning

does anyone know where to buy tanning supplies in bulk for cheap or hit me up with a site?!

MissPrissRA

Name____________________________________ ________Date of Birth:_______________________

Address:________________________________________ ____________________________________

City:_______________________________State:__________________Zip:______________________

Home Phone: ___________________________________Cell Phone:___________________________

Email:________________________________________ ______Referred by:_____________________


1. Have you taken any prescribed or over-the-counter medications recently? YES NO
If yes, consult a physician before using a tanning device.

2. List medications. ________________________________________ _____

3. Do you freckle or peel when tanning? YES NO

4. Have you ever developed a rash, a blister, or an allergic reaction from tanning? YES NO
If yes, begin tanning as a type II to minimize any skin reactions.

5. Are you pregnant presently? YES NO
If yes, do you have a doctors permission to tan? YES NO

6. Are you under a doctor’s care presently? YES NO
If yes, please list medical conditions. _______________________________

7. Have you ever been diagnosed with a skin cancer? YES NO

8. Do you presently have or have you ever had cataracts? YES NO

9. Do you wear contact lenses? YES NO
If yes, moisturize before and after tanning to prevent dryness.

10. Do you know how to wear eye protection? YES NO

11. Have you routinely tanned in the last 30 days? YES NO
If yes, how many days/weeks of: ____Outdoor, ____Indoor, ____Both

12. Do you burn each time you go into the sun? YES NO

13. Do you tan easily? YES NO





page 2


Prior to my initial exposure, I __________________________ (customer) was given the opportunity to read the warning above. It was provided to me by __________________________ (tech) at TROPIC TAN. I fully understand, fully accept, and fully assume all risks associated with tanning. By my signature affixed below, I acknowledge that I have read and understand the warning statements listed heroen relating to tanning, and that after signing this document, I have received a copy of same.

______________________________________ ______________________________________
Signature of Customer Date Signature of Witness Date

For anyone under the age of 18, a parent / legal guardian must also consent to your use of tanning equipment.
As Parent/Guardian or Tutor of the signed minor, I hereby grant permission for said minor to utilize the tanning device(s) at this establishment. I have read and understand the preceding warning statements and do herby agree that the signed minor will use protective eyewear while tanning.

________________________________________ __ ________________________________________ _
Signature of Minor Date Signed Approval of Parent / Guardian Date



I, _________________________(customer) have chosen to use the tanning equipment being offered by TROPIC TAN and I do fully and unconditionally agree to the following: 1)I am fully aware of, I freely accept and fully assume all the risks of injury, illness, and aggravation of medical conditions that are inherent in the use of the tanning equipment. I represent to TROPIC TAN that I have consulted with my family physician or other health authority regarding my intent to use tanning equipment, and that I am physically capable of using such equipment, 2) I hereby discharge, relinquish, waive, and release TROPIC TAN and/or its officers, directors, agents, servants, volunteers, employees, leaders, other tanning participants, parent company, subsidiaries and affiliates (all of whom are hereinafter collectively referred to as Releasees) from any and all loss, damage, expense, injury, accident, delay, and/or liability of any kind or nature whatsoever in connection with my use of the tanning equipment, 3) I further indemnify, save, defend, and hold harmless TROPIC TAN and/ or its Releasees from all claims, actions and/or expenses which might arise from any use of the tanning equipment, 4) I hereby sign and deliver the Release and Indemnification to TROPIC TAN to induce TROPIC TAN to permit my use of the tanning equipment., and I hereby acknowledge that such use is at my own risk and without any representation of any kind or nature having been made by Tropic Tan and/or it Releasees, 5)I do not suffer from any of the following: albinism, actinic prurigo, dermatomositis, exzema, polymorphous light eruption, high blood pressure, lichen ruber planus, lung tuberculosis, lupus erythematosus, melasma, photo allergic eczema, porphyria, acne rosacea, solar urinary, varix, xeroderma pigmentosum, and/or any other condition which can be aggravated by ultraviolet light exposure, 6)I am not taking any medication that could make my skin extra sensitive to ultraviolet light. I do fully and unconditionally agree to: Always wear eye protection meeting FDA standards while tanning; Use moisturizer in each eye prior to and immediately following use of tanning equipment if I wear contacts; Never tan indoors and/or outdoors twice in a 24 hour period; report all skin changes to my family physician or other health authority fro evaluation; Notify TROPIC TAN when I change my medications; Tan my nude body parts only 1/3 of the recommended exposure time during initial tanning visits; Read and abide by all signs posted in the tanning room All information on both sides of this form is correct. I HAVE READ, FULLY UNDERSTAND, AND FULLY AGREE TO COMPLY WITH ALL OF THE ABOVE!

Date__________________________ Signature_______________________________ ______________ Witness_________________________________ _______

__________________

MissPrissRA

so it looks a little distorted on here but that basically it....

__________________

sonyafly

Does anyone have a mobile sunless tanning waiver? Something I can send into my liability insurance company? Thanks!

Tan&Trim

Skin Type:__________
(1) A person who uses a tanning device in this tanning facility must use protective eyewear.
(2) If the provided eye protection is not worn, use of a tanning device in this tanning facility may cause damage to the eyes.
(3) Overexposure to the ultraviolet radiation produced by a tanning device in this tanning facility may cause burns.
(4) Exposure to the ultraviolet radiation produced by the tanning devices in this tanning facility may cause premature aging of the skin and skin cancer.
(5) Abnormal skin sensitivity to ultraviolet radiation or burning may be caused by certain foods, cosmetics, or medication, including the following:
(A) Tranquilizers.
(B) Diuretics.
(C) Antibiotics.
(D) High blood pressure medication.
(E) Birth control medication.
(F) Other photosensitizing agents as determined under rules adopted by the board.
(6) A person who is taking a prescription drug or an over-the-counter drug should consult a physician or pharmacist before using a tanning device. Check the posted list of drugs and products known to increase the photosensitivity of the skin.

I have read the contents of this consent form carefully and state that I am not aware of any medical condition or other reason that would prohibit me from tanning. I understand that I will not be allowed to exceed the maximum allowable time posted on the tanning device. I have been given adequate instructions for the proper use of the tanning equipment, 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.

Signature: ________________________________________ ____ Date: ________-________-20_______

Print Name: _______________________________________ Birthdate: ________-_______-19_______

Address: ________________________________________ _________________ Apt #_______________

City: ________________________________________ ___ State: ___________ Zip: ________________

Phone: _____________________________ E-mail: ________________________________________ ___

How did you hear about us or from whom specifically?
**************************************** **************************************** *****
PARENTAL SIGNATURE REQUIRED IF UNDER AGE 18:

I hereby give my permission as: ________parent _______legal guardian of______________________________________ _________________,

who is ___________ years of age, to tan at this tanning facility. I have read and fully understand this
Client Release and Informed Consent Form and hereby agree to accept all of the provisions.

Signature: ________________________________________ ____ Date: _________-_______-20_______

Print Name of Parent/Legal Guardian: ________________________________________ _____________