2022 Summer Vacation Request Form
Children who are enrolled for the entire nine week summer program are allotted one week of vacation time based on their scheduled days (i.e. enrolled three days per week receive three days of vacation credit, children enrolled five days per week receive five days of vacation credit). Please complete this form two weeks prior to your requested vacation dates for the credit to appear on your next invoice.
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Child First Name *
Child Last Name *
Summer Program: *
Teacher *
We will use our first day of vacation on:  
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DD
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YYYY
We will use our second day of vacation on:  
MM
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DD
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YYYY
We will use our third day of vacation on:  
MM
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DD
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YYYY
We will use our fourth day of vacation on:  
MM
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DD
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YYYY
We will use our fifth day of vacation on:  
MM
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DD
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YYYY
I understand by turning in this form with a two-week notice I will be credited for the day(s) listed above (one week of vacation time allowed based on child's schedule), if my child is enrolled for the entire summer program. *
Required
Parent Signature *
Parent Email *
Date *
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DD
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YYYY
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