Summer Fun Schedule Change Form

Child's Name

Child's Home School

Parent's Name

Parent Email Address

Please check the dates you would like to schedule care below. If you need all of the days in any week, you can select the checkbox in blue next to "Full Week" and it will fill the whole week in for you.

This submission will replace your original schedule, so please be sure to mark all dates that you need care with a checkmark.

All dates that you do not need care should be unchecked.

	Full Week 6/16-20
June 16	June 16
June 17	June 17
June 18	June 18
June 19	June 19
June 20	June 20

	Full Week 6/23-27
June 23	June 23
June 24	June 24
June 25	June 25
June 26	June 26
June 27	June 27

	Full Week 6/30 - 7/4 (MLEDP Closed July 3 & 4)
June 30	June 30
July 1	July 1
July 2	July 2

	Full Week 7/7-11
July 7	July 7
July 8	July 8
July 9	July 9
July 10	July 10
July 11	July 11

	Full Week 7/14-18
July 14	July 14
July 15	July 15
July 16	July 16
July 17	July 17
July 18	July 18

	Full Week 7/21-25
July 21	July 21
July 22	July 22
July 23	July 23
July 24	July 24
July 25	July 25

	Full Week 7/28 - 8/1
July 28	July 28
July 29	July 29
July 30	July 30
July 31	July 31
August 1	August 1

Parent/Guardian Signature

Sign above by holding down the left button of your mouse of by using your finger in the gray area.

Date Submitted

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Center Profile Pages

This submission will replace your original schedule, so please be sure to mark all dates that you need care with a checkmark.