Guardian Approval Acceptance Form

• Our non-profit is required to collect this form confirming the hairpiece has been received.
• The recipient guardian will complete guardian approval and acceptance form upon receipt of the hairpiece.
• The stylist will complete the stylist approval and acceptance form at the cut-in/styling appointment.
• If the family does not return to the salon, or child has worn the hairpiece, then this form is due immediately.

This process is not complete without submission of the Guardian form.

Guardian Approval Acceptance Form.

Name of Recipient Child:(Required)

First Last

This is to confirm that on this date(Required)

that (Name of Guardian)(Required)

First Last

Guardian Signature:(Required)

has taken delivery of hairpiece. I have inspected the unit and acknowledge that it is in good condition. I understand that once the hairpiece has been styled, it cannot be returned.

Enter Today's Date(Required)

Guardian Signature:(Required)

Parent/Guardian Acceptance
I fully understand that this hairpiece, like growth hair, is subject to damage by any chemical processing. Therefore, I understand that this business, its distributors, and stylist assume no responsibility, or liability for processing which include cuts, permanents, and coloring. In view of the above, I accept full responsibility for any processing that may result in damage to the hairpiece.

Enter Today's Date(Required)

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About Wigs For Kids

Wigs For Kids is a nonprofit organization that helps children experiencing hair loss stemming from chemotherapy, radiation therapy, alopecia, trichotillomania, burns, and other medical causes. Stylists and regular people just like you work together to give recipients the self-esteem and self-image they deserve.

24231 Center Ridge Road Westlake, OH 44145

Guardian Approval Acceptance Form.

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