Tanning Consent Form


Name: _______________________________________________________

Address: _____________________________________________________

Email: __________________________________ Phone Number:___________________

Please read, understand and sign the following:

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 ONLY if you follow guidelines to protect mucous membranes. When receiving sunless tans containing DHA it may be difficult to avoid exposure to sensitive areas including the eyes, lips, mucous membranes or internally.  We offer nose plugs and lip balm. 

You should wear a dark swimsuit or underwear.  Spa undergarments may be available upon request.  The solution will wash out of most clothing.  It is always best to wear dark loose fitting cotton clothing.  It is advised to wash the undergarment or clothing worn as soon as possible after your session.

Everyone is different, all ingredients used in this procedure are intended for cosmetic use and generally regarded as safe.  There are however, occasions where individuals may be allergic to one or more ingredients in the spray tan solution. 

Be advised there is a small percentage of people whose skin may not react favorable to spray tanning.  That is why we do NOT advise being sprayed for the first time when you have special occasion.

Caution – Pregnant or nursing women should consult their physician before using.

Warning – This product does not contain sunscreen and does not protect against sunburn.  Repeated exposure of unprotected skin to UV light may increase the risk of skin again, skin cancer and other harmful effect to the skin even if you do not burn.

I have been provided with spray tan care instructions, which I have read and understand completely.  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.  Use of our facilities is at your own risk, and we shall not be liable for any injury or damages resulting from your use of our services or facilities.  If you are aware of any health problems, we urge you to see your doctor before using our services.  I am aware that any services or products purchased at Lesley’s Beauty Bar are nonrefundable.  I have read and completely understand this consent form.

Client Signature: _________________________________________________________

Client Name Printed: _______________________________________ Date: _____________

If client is under the age of 18, parent/guardian signature required for services

Parent/Guardian Signature: ________________________________ Date: _______________