Haircuts with Baldy the Barber
Please fill and submit the form to sign up for an appointment!
Student Information
Student Name
*
First Name
Last Name
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mode of Student Transportation:
*
Bus Rider
Car Rider
Walker
Parent/Guardian's Information
Parent/Guardian's Name - Primary
*
First Name
Last Name
Parent Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian's Name - Secondary
First Name
Last Name
Parent Email
example@example.com
Parent Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
In case of emergency, who will be notified? Please answer the fields below:
Emergency Contact Person
*
First Name
Last Name
Emergency Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Haircut Appointment Openings
Choose a time for your haircut:
*
Parent Name
*
Parent/Guardian Signature
*
Date Signed
*
/
Month
/
Day
Year
Date
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