Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

When was your last tan? *

MM

DD

YYYY

SELECT A SHADE PROFILE THAT BEST MATCHES YOU *

VERY FAIR | Pale or precelain skin tone, often burns, rarely tans.

FAIR | Light skin tone, burns easily, tans minimally.

MEDIUM | Beige or olive skin tone, tans more easily, but can burn.

DEEP | Brown skin tone, tans easily, rarely burns.

VERY DEEP | Dark brown or ebony skin tone, rarely burns, tans deeply.

Please mark each policy as you read them. *

By selecting the check boxes you confirm receipt of these guidelines.

Avoid overexposure to natural sunlight as it may cause skin and eye damage.

Inform us if you’re taking medication that may increase sun sensitivity. | If unsure, consult a medical professional.

For optimal results, use an indoor tanning lotion designed for UV tanning. |

You must be 18 or older to use UV tanning devices. By signing, you confirm you meet the legal age requirement.

If under 18, parental or guardian consent is required.

If you are pregnant or suspect you may be, tanning is not recommended.

Electronic Signature Acknowledgement *

I will provide my typed name as my electronic signature for this form.

I agree to abide by all rules + regulations outlined in this form.

Today's Date *

MM

DD

YYYY