• I authorize Kellys Mobile Tan to perform spray tanning procedures for my benefit. Undergoing this service may cause individual sensitivities, such as drying of the skin, rash, or aggravation to those prone to asthma or allergies even in clients with no prior history of adverse reactions. You must check with your physician if you have any major illness, respiratory, or skin disorders. We are not able to provide services if you are pregnant, have asthma, have broken skin, suspicious growths, or any communicable diseases, or are using Accutane or any related product or if we feel that the services could be potentially harmful. Use of sunless tanning can cause your blood sugar levels to rise. Please consult with a physician before using our service if you have a diabetic condition or any other concern.
  
  
  While it is our highest priority to make you feel as comfortable as possible, the process requires you to stand facing the technician with your legs apart and arms out to the side. If too much product is applied in one area, we may need to sponge the area and gently dab off the excess and reapply. Staining may occur on certain fabrics, such as nylon or leather. If you are not comfortable with this process, you should not proceed.
  
  
  The active ingredient in the spray is DHA20 (Dihidroxyacetone), which is a natural substance derived from sugar beets. DHA20 works with the amino acids in the skin, causing a chemical reaction that turns the skins upper layers to brown. Most importantly, the DHA used in spray tanning has not been approved for internal consumption and could cause damage if inhaled or absorbed in eyes, nose, lips, eyebrows, eyelash. This will most likely occur if you decide to proceed. Therefore, you are taking a risk if it is later scientifically determined to be harmful to your health. Some of the ingredients used in our solution contain a sugar base and may contain nut extract.
  
  I have had sufficient opportunity to read and understand the potential complications of a spray tan. I have reviewed all of the information on Kelly's Mobile Tan website, including this form, and all of my questions have been answered to my satisfaction and I accept the risks and sensitivities involved with this service. I understand the procedure and believe I have adequate knowledge upon which to base an informed consent. I hereby relieve Kelly Lovallo and Kellys Mobile Tan, LLC and hold them harmless from any liability involved in the use of the tanning process/products. I know that this company does not carry liability insurance for injuries caused by tanning devices.
  I have read and understand the above statements and hold Kelly Lovallo and Kelly's Mobile Tan harmless with regard to any and all claims
  

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