Hi,

SERVICE AGREEMENT, RELEASE, WAIVER AND ASSUMPTION OF RISK

In consideration of the Services of Zoom Tan, Inc., its agents, owners, officers, affiliates, volunteers, participants, employees, and all other persons or entities acting in any capacity on their behalf (herein after collectively referred to as "ZT"), I hereby agree to, release, indemnify and discharge ZT, on behalf of myself, my spouse, my children, my parent, my heirs, assigns, personal representatives and estate as follows:

    UV TANNING - DANGER - ULTRAVIOLET RADIATION

  • I will follow operator, tanning unit, eyewear and safety instructions. Avoid too frequent or lengthy exposure. I acknowledged that repeated exposure can cause premature aging of the skin or skin cancer. I acknowledge that, as with natural sunlight, exposure to a sunlamp may cause eye and skin injury, sunburn and allergic reactions, and I expressly release ZT from any liability from any injury I may sustain from the same.
  • I agree to wear FDA compliant protective eyewear every time I UV tan. FAILURE TO USE PROTECTIVE EYEWEAR MAY RESULT IN SEVERE BURNS OR LONG-TERM INJURY TO THE EYES.
  • I acknowledge that abnormal or increased skin sensitivity or burning may be caused by certain foods, medications (including, but not limited to tranquilizers, diuretics, antibiotics, high blood pressure medication, birth control pills, and skin creams), cosmetics or toiletries. ZT has advised me to consult a physician or pharmacist before using a sunlamp, particularly if I am using prescription or non-prescription medications, have a history of skin problems, or believe I am especially sensitive to sunlight. ZT has advised me that pregnant women and women on birth control pills who use a tanning device may develop discolored skin.
  • I acknowledge that the use of UV tanning exposes to me higher temperatures which, if I am dehydrated or suffer from other medical conditions may result in lightheadedness or fainting. I acknowledge that ZT has advised me to consult a physician before using ZT's services.
  • Ultraviolet radiation from sunlamps enhances the effects of the sun. I acknowledged that ZT has advised that I not sunbathe before or after exposure to ultraviolet radiation.
  • I acknowledge that if I do not tan in the sun I will not tan by using this device.
  • I expressly consent that I would like to receive advertising text messages from ZT at the cell phone number that I have provided or any cell phone number I may provide in the future. I understand message and data rates may apply. I understand that to stop receiving texts I only have to reply to any text with the word "stop". I intend for the foregoing consent to constitute my express written consent to receive such communications as that term is defined under applicable state or federal law. Consent is not required to purchase goods, products or services from ZT.
  • ZT'S SPRAY TANNING SERVICES:

  • I hereby authorize ZT and its trained, authorized representatives to perform spray tanning procedures for my benefit.
  • I understand that spray tanning will not prevent the skin from burning in the natural sun or in a tanning bed. Burning can only be prevented by taking proper precautions when tanning with UV light exposure.
  • If I have ever had adverse effects utilizing self-tanning products or moisturizers in the past, I will likely experience similar effects with spray tanning. ZT is not responsible for any adverse reactions and no refunds will be issued.
  • I acknowledge that while all the active ingredients in ZT's spray tanning solutions are FDA approved for use as a self-tanning skin agent, I acknowledge the FDA has not specifically approved the ingredients for use in a spray-on mist application.
  • I acknowledge that ZT recommends using protective eyewear and nose filters when using ZT's spray tanning services.
  • I acknowledge that Zoom Tan recommends holding my breath as the spray nozzles pass by my face to avoid inhaling any spray. ZT recommends not putting any lotions or creams on the bottom of my feet when using ZT services.
  • I acknowledge the use of DHA in the spray tanning solution may permanently stain garments and other items. I further accept that after re-dressing, the initial bronzers may transfer to my clothing if I pursue strenuous physical activity causing perspiration.
  • I realize that if I have any history of asthma or a respiratory condition, such condition could be aggravated by the use of spray tanning. I acknowledge that Zoom Tan has suggested I consult a physician before using Zoom Tan spray tanning services.
  • I understand and will comply with all instructions for proper use of the spray tanning unit. I am using these services at my own risk. I hereby relieve ZT and hold ZT harmless from any liability involved with the use of its tanning services. I expressly acknowledge that ZT is not liable for any injury to person or property.
  • I expressly consent that I would like to receive advertising text messages from ZT at the cell phone number that I have provided or any cell phone number I may provide in the future. I understand message and data rates may apply. I understand that to stop receiving texts I only have to reply to any text with the word "stop". I intend for the foregoing consent to constitute my express written consent to receive such communications as that term is defined under applicable state or federal law. Consent is not required to purchase goods, products or services from ZT.
  • ADDITIONAL TERMS AND CONDITIONS OF USE; DISCLAIMERS, WAIVERS

  • I recognize and acknowledge that there are certain risks of injury in the use of ZT's services, and I voluntarily agree to assume the full risk of any and all injuries, damages or loss, regardless of severity, that I may sustain as a result of the use of ZT's services. As a material inducement for ZT to permit me to use its facilities and equipment, I hereby waive and hold ZT harmless for any and all claims and damages (including legal fees) present or future, foreseen or unforeseen, anticipated or unanticipated (collectively "Claims"), I may have (or accrue to me) against ZT, including its shareholders, directors, agents, employees, affiliated companies and partnerships (collectively the "ZT Parties") and generally release the ZT Parties from any and all Claims, including but not limited to those involving: (i) the use of any UV or NON-UV (spray) equipment, (ii) any loss or theft or personal property, and (iii) accidental injuries, such as "slip and fall" injuries within ZT's facilities.
  • I have read this form carefully and am aware that in using ZT's facilities and services, I am expressly assuming the risk and legal liability and waiving and generally releasing all claims for injuries, damages or loss which I may sustain as a result of participating in any and all activities connected with and associated with any ZT provided services, including but in no way limited to UV and Spray tanning.
  • This facility carries liability insurance for injuries caused by tanning devices and, by Florida law, this facility will only allow one tan every 24 hours.
  • I expressly consent that I would like to receive advertising text messages from ZT at the cell phone number that I have provided or any cell phone number I may provide in the future. I understand message and data rates may apply. I understand that to stop receiving texts I only have to reply to any text with the word "stop". I intend for the foregoing consent to constitute my express written consent to receive such communications as that term is defined under applicable state or federal law. Consent is not required to purchase goods, products or services from ZT.
  • If any provision above is null, void or unenforceable under applicable law, it shall be deemed omitted and shall not apply, but the other provisions shall remain in effect.
  • I acknowledge that ZT utilizes audio and video surveillance of open, common areas of the facility's interior for protection of clients, employee and ZT and provide express consent to the use of the same. I agree that ZT is not responsible/liable for for the unlawful actions of clients or the general public that violate the privacy of our clients, employees or the general public.
  • NEW YORK TANNING FACILITY STATEMENT OF ACKNOWLEDGMENT FORM

  • I acknowledge that if I am visiting a ZT salon in the state of New York that I have read and understand the New York State Department of Health Tanning Hazards Information Sheet, provided in the link below, prior to using any ultraviolet radiation device.
    New York State Department of Health Tanning Hazards Information Sheet

New York State Department of Health regulations require that tanning facility operators provide you with the following information so that you can make an informed judgement about indoor tanning and the use of tanning facilities.

What is "tanning"?

Tanning is the body's response when your skin is exposed to ultraviolet (UV) radiation. The skin becomes damaged and produces extra pigment to protect itself against the UV radiation. This pigment makes the skin look darker.

What is UV radiation?

UV radiation is a form of energy from natural sunlight or from a tanning device such as a sunlamp, tanning booth or tanning bed that is not visible to the human eye. It is classified as carcinogenic to humans and can cause cancer.

What are the health risks associated with tanning?

Health risks associated with tanning:

  • Skin cancer
  • Burns and injury to the skin and eyes
  • Premature aging of the skin
  • Allergic reactions
  • Worsen existing medical conditions
  • Immune suppression

Factors that put you at increased risk for developing skin cancer:

  • Lighter natural skin
  • Family or personal history of skin cancer
  • History of sunburn early in life
  • Skin that burns, freckles, reddens easily, or is painful in the sun
  • Blue or green eyes and blond or red hair
  • Certain types and/or a large number of moles
Are indoor tanning devices safer than tanning in natural sunlight?

No. The UV radiation produced by indoor tanning devices can cause the same damage to the skin as natural sunlight. Exposure to UV radiation, whether from an indoor tanning device or from natural sunlight, increases health risks for everyone.

Avoid indoor tanning if:
  • You burn easily and don't usually tan in natural sunlight.
  • You get frequent cold sores. UV radiation can lead to common light-sensitive ailments.
  • You have medical conditions like lupus and vitiligo. UV radiation can worsen symptoms.
  • You are immune suppressed. UV radiation can be more hazardous.
  • You eat certain foods or use certain cosmetics or medications that can make your skin burn more easily. This reaction is called "photosensitivity." Ask the tanning facility operator or employee for a list of these items.
For persons who choose to expose themselves to UV radiation from indoor tanning devices:
  • Always wear FDA certified protective eyewear. If you don't have your own FDA certified protective eyewear, request it from the tanning facility operator or employee.
  • Learn your skin type and understand the exposure limits recommended by the manufacturer of the tanning device.
  • Seek medical attention for severe burns, allergic reactions and unusual skin lesions or sores.
  • Report any injuries or adverse reactions promptly to the tanning facility operator or employee.
Tanning access by minors

Effective August 15, 2012, New York State Public Health Law prohibits persons under seventeen (17) years of age from using UV radiation devices. It requires that persons seventeen (17) years of age have a parent or legal guardian sign a consent form before using UV radiation devices. Persons eighteen (18) years of age or older must provide a driver's license or other photo identification, issued by a government entity or educational institution, before using UV radiation devices.




I HAVE READ AND UNDERSTAND THIS DOCUMENT AND CONSENT AND AGREE TO ITS TERMS AND CONDITIONS. I FURTHER ACKNOWLEDGE THAT I AM OF LEGAL AGE AND I HEREBY CONSENT, BY PROVIDING ZT'S EMPLOYEE MY CONFIRMATION CODE, TO THE USE OF AN ELECTRONIC SIGNATURE TO RECORD MY AGREEMENT WITH THE TERMS OF THIS SERVICE AGREEMENT, RELEASE, WAIVER AND ASSUMPTION OF RISK.