Bellevue Rec 2024 Week 4 Care Program Request

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This form is for parents that are paying for the BEFORE CARE and AFTER CARE program ONLY! You will be required to specify your weekly needs in this form. There is a different form for each week. All requests must be made at least two weeks prior to the first day of camp so staff can be scheduled appropriately. However, we recommend that requests are made ASAP!!! Please notify the camp director of any changes via email. THIS FORM DOES NOT SIGN YOUR CHILD UP FOR SUMMER CAMP!

Parent/Guardian Name

Contact Number

Child or family name *

Please list the times your child will need to be in the care program on Monday. *

Please list the times your child will need to be in the care program on Tuesday. *

Please list the times your child will need to be in the care program on Wednesday. *

Please list the times your child will need to be in the care program on Thursday. *

Please list the times your child will need to be in the care program on Friday. *

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