Self-Care Program Sign-Up Form Program Description: Our Self-Care Program provides 4 youth per week (under age 18) with either: A free boys haircut A free girls Spa Day (nails and feet) This program is designed for children and families who may be struggling or in need of support. Services are free, first-come-first-serve, and based on weekly submissions.

List the best days/ times your child is available

Program Agreement Confirmation of Free Service: This program is completely free for youth and families. Appointment Notification: Outsiders Youth Association will notify me when it is my child's turn. Appointments are filled first-come-first-serve based on submission order. No-Show Policy: If my child cannot attend, I will notify Outsiders at least 24 hours in advance. Repeated no-shows may delay participation. Photo / Appreciation Sharing Requirement: Parents will take the picture and share it by posting to the Outsiders Youth page or tagging Outsiders Youth Association. This helps reach more children and families.

Optional Program Photo Release: I give permission for Outsiders Youth Association to share photos of my child. I do NOT give permission.

Signatures Parent/Guardian Signature