Haircut Permission Form
Please complete this form to authorize a haircut for a minor. All information will remain confidential.
Child's Full Name
*
First Name
Last Name
Child's Date of Birth
*
-
Month
-
Day
Year
Date
Parent or Guardian's Full Name
*
First Name
Last Name
Relationship to Child
*
Please Select
Mother
Father
Legal Guardian
Other
Parent or Guardian's Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent or Guardian's Email Address
example@example.com
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Does the child have any allergies or sensitivities we should be aware of?
Requested Haircut Style or Instructions
*
Preferred Stylist (if any)
Requested Date for Haircut
*
-
Month
-
Day
Year
Date
Parent or Guardian's Signature
*
Submit Permission
Submit Permission
Should be Empty: