Hair We Go x Shizzy Cutz Youth Fall Program Registration

Hair We Go x Shizzy Cutz Youth Fall Program Registration 🌟✂️

Register your child(ren) for the fall program and review transportation, pickup authorization, and permissions.
Parent / Guardian Information
Parent / Guardian Full Name

First NameMiddle NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Child Information
Enrollment Type
Child Full Name

First NameMiddle NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Age
School Name
Grade
Additional Child Details
Additional Child
Multiple Children Instruction
Child Name
Child Age
Transportation Details
Is transportation needed?
Pickup address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Drop-off address, if different

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Authorized Pickup and Emergency Contact
Authorized Pickup Person 1 Name

First NameMiddle NameLast Name
Authorized Pickup Person 1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Name

First NameMiddle NameLast Name
Health, Support Needs, and Parent Notes
Allergies, medical conditions, medications, dietary restrictions, accessibility needs, or other support information
Does your child have a support plan?
Parent goals, concerns, or anything staff should know about your child
Permissions and Acknowledgments
Photo permission
Program activity permissions

Other
Parent/Guardian Full Name for Acknowledgment

First NameLast Name
Date signed

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
To confirm your child's first-week spot, send $50 per child via Cash App to $thevillageceo.
Has payment been sent?
Should be Empty:

Hair We Go x Shizzy Cutz Youth Fall Program Registration 🌟✂️

Parent / Guardian Information

Child Information

Additional Child Details

Transportation Details

Authorized Pickup and Emergency Contact

Health, Support Needs, and Parent Notes

Permissions and Acknowledgments