TANNING EQUIPMENT USE AGREEMENT
This Agreement is an Integral Part of your Rental Agreement dated
Before using any sun tanning equipment, you should consider the answer to each of the fol owing questions in order to determine the effects that this equipment wil have on you.
Are you frequently exposed to the sun?Have you ever experienced a major sunburn?Do you tan easily?Do you have a tendency to burn?Do you have al ergies to sunlight?Are you taking any medication that would cause sensitivity to sunlight?Have you ever been advised by a physician to stay out of the sun?
We advise you to consult with a physician before using tanning equipment if the answer to any of the above questions is yes. In addition, the fol owing precautions are necessary when using tanning equipment. These include but are not limited to:
1. Use protective eyewear at al times. 2. Limit your use to NO more than 20 minutes per visit.
3. Do not wear any jewelry in the tanning bed. 4. Be sure the timer is set correctly before you start.
It is understood that al tanning equipment is made available at no extra cost to the resident and that its use is strictly voluntary. Because there is no conclusive long-term evidence that can guarantee the safety of tanning equipment, I understand that its use is entirely at my own risk, I agree NOT to hold the owners, management, or their agents of this community liable for any visual impairment or skin disorders directly or indirectly resulting from the use of the health club's tanning equipment. I also agree to fol ow al instructions listed above and posted in the tanning spa room. I have read the additional warnings and cautions from the Food and Drug Administration reprinted on the back of this form. I have been provided with protective eyewear.
have read and understand the above release of liability statements
Some Potential Photosensitizing Agents The following table lists agents that may increase sensitivity to ultraviolet light resulting in a phototoxic or photoallergic response. Reprinted from the Food and drug Administration, 1980. Product Class Generic or Chemical Name Product Class Generic or Chemical Name
coal tars and coal-tar derivatives, wood tars,
sulfonamides (sulfamethoxazole, sulfisoxazole, trisulfapryimidines), nalidxic acid, trimethoprim
Chlorthalidone, furosemide, thiazides and
silicylanilides, halogenated carbanilides, halogenated phenols (antibacterials in
acridine, antharacene, eosin (lipstick),
*deodarant bar soaps, antiseptics, cosmetics)
erythosin, fluorescin, methyl violet, methylene blue, orange, red, rose bengal,
tetracycline and tetracycline derivatives:
chlortetracycline, demeclocycline, doxycycline, methacycline, minocycline, oxytetracycline
mestranol and norethynodrel, diethylstilbestrol
8-methoxypsoralen, 4.5.8-trimethylypsoralen)
sulfonylureas (acetohexamide, chlorpropamide,
Containing ethereal oils, *oil of bergamot,
oil of cedar, citron, lavendar, lemon, lime,
diphenhydramine, promethazine, triptolidine, chlorpheniramine
chlorprothixene, doxepin, haloperidol, loxapine, thiothixene
phenothiazines: acetophenazine, chlorpromazine, fluphenazine, perphenazine, prochlorperazine,
* We advise caution when using Irish Spring and other deodorant soaps.
thioridazine, trifluoperazine, triflupromazine
* We recommend that pregnant women NOT use the tanning bed. * Shalimar perfume contains oil of bergamot which can cause pigmentation spots. * Not wearing protective eyewear may cause damage to the eyes. * Repeated exposure may cause skin cancer or premature aging of the skin. * Abnormal skin sensitivity or burning may result from the tanning process if the customer is also consuming or using certain foods, cosmetics, medications
such as tranquil izers, antibiotics, diuretics, high blood pressure medication, antincopastics, or birth control pil s.
* Any person taking prescription or over-the-counter drugs should consult a physician before using a tanning device.
Copyright 2012, Marathon Management, Inc.
No portion of this document may be reproduced without the written approval of Marathon Management, Inc.
TANNING EQUIPMENT USE AGREEMENT This Agreement is an Integral Part of your Rental Agreement datedBefore using any sun tanning equipment, you should consider the answer to each of the fol owing questions in order to determine the effects that this equipment wil have on you. Are you frequently exposed to the sun?Have you ever experienced a major sunburn?Do you tan easily?Do you have a tendency
2013 Preventive Drug List For High-Deductible Health Plans Only effective 1/1/13 If your High-Deductible Health Plan includes the Preventive Drug List option, you just pay a copay for preventive care medications instead of having to meet your plan’s deductible for certain prescription drugs. Prescription drugs on the Preventive Drug List will be covered as if you already met your dedu