Change Week Form

1. Parent information
Parents info*

First Name Last Name
Cell Phone*

Area Code Phone Number
E-mail*
2. Child's Information
Child 1*

First Name Middle Name Last Name
Currently enrolled *

Full Summer ( June 25 - August 8)Week 1 (June 25 - June 28)Week 2 (July 1 - July 5)Week 3 (July 8 - July 12)Week 4 (July 15 - July 19)Week 5 (July 22 - July 26)Week 6 (July 29 - August 2)Week 7 (August 5 - August 8)
Change Requested*

Full Summer ( June 25 - August 8)Week 1 (June 25 - June 28)Week 2 (July 1 - July 5)Week 3 (July 8 - July 12)Week 4 (July 15 - July 19)Week 5 (July 22 - July 26)Week 6 (July 29 - August 2)Week 7 (August 5 - August 8)
Child 2

First Name Middle Name Last Name
Currently enrolled

Full Summer ( June 25 - August 8)Week 1 (June 25 - June 28)Week 2 (July 1 - July 5)Week 3 (July 8 - July 12)Week 4 (July 15 - July 19)Week 5 (July 22 - July 26)Week 6 (July 29 - August 2)Week 7 (August 5 - August 8)
Change Requested

Full Summer ( June 25 - August 8)Week 1 (June 25 - June 28)Week 2 (July 1 - July 5)Week 3 (July 8 - July 12)Week 4 (July 15 - July 19)Week 5 (July 22 - July 26)Week 6 (July 29 - August 2)Week 7 (August 5 - August 8)
Child 3

First Name Middle Name Last Name
Currently enrolled

Full Summer ( June 25 - August 8)Week 1 (June 25 - June 28)Week 2 (July 1 - July 5)Week 3 (July 8 - July 12)Week 4 (July 15 - July 19)Week 5 (July 22 - July 26)Week 6 (July 29 - August 2)Week 7 (August 5 - August 8)
Change Requested

Full Summer ( June 25 - August 8)Week 1 (June 25 - June 28)Week 2 (July 1 - July 5)Week 3 (July 8 - July 12)Week 4 (July 15 - July 19)Week 5 (July 22 - July 26)Week 6 (July 29 - August 2)Week 7 (August 5 - August 8)
Child 4

First Name Middle Name Last Name
Currently enrolled

Full Summer ( June 25 - August 8)Week 1 (June 25 - June 28)Week 2 (July 1 - July 5)Week 3 (July 8 - July 12)Week 4 (July 15 - July 19)Week 5 (July 22 - July 26)Week 6 (July 29 - August 2)Week 7 (August 5 - August 8)
Change Requested

Full Summer ( June 25 - August 8)Week 1 (June 25 - June 28)Week 2 (July 1 - July 5)Week 3 (July 8 - July 12)Week 4 (July 15 - July 19)Week 5 (July 22 - July 26)Week 6 (July 29 - August 2)Week 7 (August 5 - August 8)
If you have additional children please add in the comments below
4. Payment Information
A $75 per child change week fee when you submit this form. This fee is non refundable.
Number of Children Making Changes*
Total

$0.00

Payment

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

General comments
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1. Parent information

2. Child's Information

4. Payment Information