Before allowing an initial exposure at a tanning facility of a person under eighteen (18) years of age, the owner or operator shall witness the person's parent or legal guardian signing and dating a warning statement as follows:

"WARNING STATEMENT

This statement must be read and signed by a parent or legal guardian of any person under eighteen (18) years of age before allowing the initial exposure at this tanning facility.

DANGER -- ULTRAVIOLET RADIATION WARNING

Follow instructions.

Avoid overexposure. As with natural sunlight, overexposure can cause eye and skin injury and allergic reactions. Repeated exposure may cause premature aging of the skin and skin cancer.

Wear protective eyewear. FAILURE TO USE PROTECTIVE EYEWEAR MAY RESULT IN SEVERE BURNS OR LONG-TERM INJURY TO THE EYES.

Medications or cosmetics may increase your sensitivity to the ultraviolet radiation. Consult a physician before using sunlamp or tanning equipment if you are using medications or have a history of skin problems or believe yourself to be especially sensitive to sunlight.

I have read the above warning and understand what it means before undertaking any tanning equipment exposure.

Signature of Operator of Tanning Facility or Equipment

Signature of parent or legal guardian

Print name of minor and parent or legal guardian

Date

OR

The consumer is illiterate or visually impaired, or both, and I have read the warning statement aloud and in full to the consumer in the presence of the below signed witness.

Signature of Operator of Tanning Facility or Equipment

Witness

Date"