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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.
Generic or Chemical Name
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,
and tetracycline derivatives:
chlortetracycline, demeclocycline, doxycycline, methacycline, minocycline, oxytetracycline
mestranol and norethynodrel, diethylstilbestrol
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.
NO MEDICATION ABBREVIATIONS UNAPPROVED ABBREVIATIONS U, IU, QD, or qd, QOD or qod, qn, ug, BT, > or <, Allergies: MEDICATION, DIET, TREATMENT, LAB ORDERS 1. Sign consent for: Left Right with Possible PCI 2. Old charts to accompany patient to cath lab 3. If patient had previous coronary bypass surgery, please obtain previous bypass surgery report. 4. Clip both groin areas. 5.
Cone Crazy Written by Sue Pezzolla, Master Gardener Coordinator, Cornell Cooperative Extension of Albany County Photographs by Chuck Schmitt, Senior Resource Educator, Cornell Cooperative Extension of Albany County 'Firebird' is just one example of one of the new coneflowers. The humble purple coneflower has undergone a botanical makeover that will knock your socks off. Sh