Opulence Spray Tan New Client Consent Form

All new clients must fill this form out, read and sign prior to getting a Spray Tan

Name: _________________________________________________________________

E-mail: _________________________________________________________________

Phone:__________________ ______________________________________________

Street Address_____________________________________________________ ___

City, State, Zip Code_____________________________________________________

Birth Date:_____________ ____________________________________ (MM/DD/YY)

Custom Spray Tanning uses a Spray Tanning machine to apply a cosmetictanning solution that contains dihydroxyacetone (DHA). DHA is a non-toxicsugar, derived of sugar beet and/or sugarcane . Each individual is unique, therefore clients who have sensitive skin may experience a minor rash.

Hormonal changes such as the menstrual cycle and menopause can also effect the results of the spray tan . Opulence Spray Tan cannot guarantee the results of a spray tan, as every individual is different.

The solution can rub off on clothing, however the use of a mild detergent will take out any color that has transferred to sheets and clothing.

If you have a skin disease(s) and are using medications, please check withyour physician before receiving a spray tan. Please notify your TanningConsultant if you've had any intense treatment such as a chemical peel orhave been using strong chemical compounds on your skin.

Keep in mind if you have recently had a peel or are currently using Retin-A or a Retinol you can peel in surrounding areas around the area that you had a peel or applied Retin-A. Oftentimes the Rentin-A /Retinol moves to other areas around the area that you put the product on and it will cause peeling in that area as well. Therefore it is advised to not spray tan the area in which you've had a recent peel or applied Retin-A/Retinol.

Our Formula does NOT have any UV protection. Use SPF sun protection

Although there have been no reports of side effects , we advise pregnant women to consult with their DR prior to getting a Spray Tan.

Acknowledgement

I

_______________________________________

(print

name)

have

read

and

agree

to

hold

Opulence

Spray

Tan

harmless

if

any

of

the

above

(but

not

limited

to )

occurs .

I

understand

that

my

results

are

notguaranteed.

I

am

using

this

service

at

my

own

discretion

and

understand

that

there

are

no

refunds

for

any

tanning

service

purchases

(packages

included)

for

any

reason.

Please

remember

to

follow

the

pre-tan

preparation

and

after-tan

maintenance

guidelines

to

achieve

ideal

results ,

which

can

be

found

at

www.opulencespraytan.com

under

the

spray

tan

tips

section

1.

The

Spray

Tanning

process

has

been

explained

to

me

and I

hereby

agree

to

allow

Opulence

Spray

Tan

to

apply

spray

tan

solution

to

my

skin.

2. To my Knowledge , I have no medical condition or allergy which would preclude me from having this procedure done.

3. I agree to hold harmless Opulence Spray Tan LLC and the spray tan technician of any medical complications that may arise and i have been advised to discontinue use if any reaction occurs.

4. I understand that the results of spray tanning may vary and that no guarantees of specific results are offered or implied.

5. I hereby release Opulence Spray Tan LLC as well as the spray tan technician, and hold them harmless from any liability involved in the use of or arising during the tanning process.

6.

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Mobile

Cancellation

Policy

-

We

have

set

this

time

aside

especially

for

you.

Failure

to

contact

us

24

hours

prior

to

your

scheduled

time

to

cancel/reschedule

will

result

in

a

75 %

charge

of

your

full

service

Same

day

cancellation

(within

24

hours)

on

a

holiday

or

a

holiday

weekend

will

result

in

a

100%

charge

of

your

service

In

Studio

Cancellation

Policy

-

You

May

cancel

your

appointment

anytime up to 4 hours before your scheduled

service

with

no

penalty.

CANCELLING/

RESCHEDULING your appointment

within

the

4

HOURS

before

your scheduled appointment will result

in

a

charge

of

$25 .

NO

SHOW

appointments will be charged for one

full

tan

($59).

I agree to notify Opulence Spray Tan if I am pregnant or may be pregnant at the time of a scheduled appointment.

7. I have read and completely understand the conditions of this form. _____ _________(Initial)

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Opulence Spray Tan accepts cash and credit cards as forms of payment

for products and services . I understand that I may be required to

sign

a

sales

receipt to approve and accept products and services provided

By entering your credit card information you are agreeing to be charged deemed necessary by the business to reconcile any unpaid services or associated fees. ______________(Initial)

Credit Card Information

__________________________________________________________________

_______________________________________________________________________________

Signature:_______________

Date:____________

How

did

you

hear

about

Opulence

Spray

Tan

?________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________