Hair We Go x Shizzy Cutz After-School Camp Registration 2026-2027

Hair We Go x Shizzy Cutz After School Program Registration 2026-2027

Complete this registration to enroll your child in the Hair We Go x Shizzy Cutz After School Program.
Official After School Program Registration. Please complete this form while the VAV parent portal is being updated. Your submission goes directly to Village Against Violence staff and will be added to the after school registration system. You do not need to register again on the website.
Child Information
Child's Full Name

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Age
Grade
School
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Intended Start Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Additional Child Information
Parent or guardian information, emergency contacts, and authorized pickup adults entered later in the form will apply to both children unless you explain otherwise.
Would you like to register an additional child?
Additional child's full name

First NameLast Name
Student Type
Care Option
Date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Age
Grade
School
Home address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Intended start date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Expected days of attendance
Transportation needed
Allergies
Medical conditions we should know about
Current medications and instructions
Dietary restrictions

Other
Accessibility or accommodation needs

Other
IEP or 504 information staff should know
Behavioral or emotional support information
Photo permission
Video permission
Activities permission
Permission to seek emergency medical care if a parent or guardian cannot be reached
Different emergency contact, pickup, or support information for the additional child
Parent or Guardian Information
Parent/Guardian Full Name

First NameMiddle NameLast Name
Relationship to Child
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Home Address (if different from the child's)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Preferred Contact Method
Emergency Contacts and Pickup
Emergency contacts
Emergency contact 1 name

First NameMiddle NameLast Name
Emergency contact 1 relationship
Emergency contact 1 phone number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency contact 2 name

First NameMiddle NameLast Name
Emergency contact 2 relationship
Emergency contact 2 phone number
Please enter a valid phone number.Format: (000) 000-0000.
Authorized pickup adults
Adults authorized to pick up the child
Is anyone prohibited from picking up the child?
If yes, explain
Photo identification may be required at pickup.
Health and Support Information
Allergies

Other
Please describe any food allergies and reactions
Medical conditions we should know about
Current medications and instructions
Dietary restrictions

Other
Accessibility or accommodation needs

Other
IEP or 504 information staff should know
Behavioral or emotional support information
Child's physician name

First NameMiddle NameLast Name
Physician phone number
Please enter a valid phone number.Format: (000) 000-0000.
Health insurance provider
Permission to seek emergency medical care if a parent or guardian cannot be reached
Program and Attendance
Expected days of attendance
Transportation needed
Who normally picks up the child?

First NameLast Name
Attendance and transportation notice
Tuition
Payer name

First NameLast Name
Permissions and Agreements
Photo Permission
Video Permission
Activities Permission
Acknowledgment of Program Expectations
Parent Certification
Parent/Guardian Printed Name

First NameMiddle NameLast Name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Hair We Go x Shizzy Cutz After School Program Registration 2026-2027

Child Information

Additional Child Information

Parent or Guardian Information

Emergency Contacts and Pickup

Health and Support Information

Program and Attendance

Tuition

Permissions and Agreements