Tanning Salon Release Form
Tanning Salon Release Form
Please complete the form with accurate and up-to-date details.
Client Information
Name
Are you 18 or older?
Date of Birth
Address
Phone number
Parent/Guardian Information (for Clients Under 18)
Name
Phone number
Evaluation
Skin Color
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Fair
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Medium
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Olive
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Brown
-
Black
-
Skin Type
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Sensitive
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Dry
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Oily
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Combination
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Normal
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Are you sensitive to heat or light?
Have you ever experienced an allergic reaction to tanning products?
Have you had any tanning within 6 months?
Do you have any skin conditions (e.g., eczema, psoriasis)?
Are you currently taking medications that may cause sensitivity to UV rays?
Do you have any scars or recent surgeries?
Have you been diagnosed with any cardiovascular diseases?
Do you have any respiratory ailment?
Do you have hypertension/high blood pressure?
Are you pregnant?
Are you breastfeeding?
Have you used any exfoliants or skin products in the past 24 hours?
Consent
By signing below, I acknowledge that I have provided accurate information and have been informed of the risks associated with tanning, including but not limited to, skin damage, premature aging, and an increased risk of skin cancer. I understand that tanning is a voluntary service, and I am responsible for any resulting effects on my skin and health.
I understand that [Your Company Name] has provided safety instructions and guidelines for the use of tanning equipment, and I agree to follow all instructions to ensure my safety during my tanning sessions.
I hereby release [Your Company Name], its employees, and affiliates from any liability, including injury or adverse reactions, arising from my use of tanning services. This release is binding for the duration of my use of [Your Company Name] services.
Name:
Date:
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