Y-Care Change/Cancellation Parent Name* First Last Email* Child Name* First Last Which type of care would you like to change?* Before School Only After School Only Before and After School Y-Care Location (School)* How would you like to change your child's care?* Add Days Subtract Days Cancel a Week of Care Weeks to Add Days To*Week 12: Oct 16-20Week 13: Oct 23-27Week 14: Oct 30 - Nov 3Week 15: Nov 6-10Week 16: Nov 13-17Week 17: Nov 20-21Week 18: Nov 27 - Dec 1Week 19: Dec 4-8Week 20: Dec 11-15Week 21: Dec 18-20Week 22: Jan 3-5Week 23: Jan 8-12Week 24: Jan 16-19Week 25: Jan 22-26Week 26: Jan 29 - Feb 2Week 27: Feb 5-9Week 28: Feb 12-16Week 29: Feb 20-23Week 30: Feb 26 - Mar 1Week 31: Mar 4-8Week 32: Mar 11-15Week 33: Mar 18-22Week 35: Apr 1-4Week 36: Apr 8-11Week 37: Apr 15-19Week 38: Apr 22-25Week 39: Apr 29 - May 3Week 40: May 6-9Week 41: May 13-17Week 42: May 20-22Hold the CTRL key to select multiple weeks.Which days do you need for Week 12: Oct 16-20* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 13: Oct 23-27* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 14: Oct 30 - Nov 3* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 15: Nov 6-10* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 16: Nov 13-17* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 17: Nov 20-21* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 18: Nov 27 - Dec 1* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 19: Dec 4-8* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 20: Dec 11-15* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 21: Dec 18-20* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 22: Jan 3-5* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 23: Jan 8-12* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 24: Jan 16-19* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 25: Jan 22-26* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 26: Jan 29 - Feb 2* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 27: Feb 5-9* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 28: Feb 12-16* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 29: Feb 20-23* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 30: Feb 26 - Mar 1* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 31: Mar 4-8* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 32: Mar 11-15* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 33: Mar 18-22* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 35: Apr 1-4* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 36: Apr 8-11* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 37: Apr 15-19* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 38: Apr 22-25* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 39: Apr 29 - May 3* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 40: May 6-9* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 41: May 13-17* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 42: May 20-22* Monday Tuesday Wednesday Thursday Friday Weeks to Remove Days From*Week 12: Oct 16-20Week 13: Oct 23-27Week 14: Oct 30 - Nov 3Week 15: Nov 6-10Week 16: Nov 13-17Week 17: Nov 20-21Week 18: Nov 27 - Dec 1Week 19: Dec 4-8Week 20: Dec 11-15Week 21: Dec 18-20Week 22: Jan 3-5Week 23: Jan 8-12Week 24: Jan 16-19Week 25: Jan 22-26Week 26: Jan 29 - Feb 2Week 27: Feb 5-9Week 28: Feb 12-16Week 29: Feb 20-23Week 30: Feb 26 - Mar 1Week 31: Mar 4-8Week 32: Mar 11-15Week 33: Mar 18-22Week 35: Apr 1-4Week 36: Apr 8-11Week 37: Apr 15-19Week 38: Apr 22-25Week 39: Apr 29 - May 3Week 40: May 6-9Week 41: May 13-17Week 42: May 20-22Hold the CTRL key to select multiple weeks.Which days do you need for Week 12: Oct 16-20* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 13: Oct 23-27* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 14: Oct 30 - Nov 3* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 15: Nov 6-10* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 16: Nov 13-17* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 17: Nov 20-21* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 18: Nov 27 - Dec 1* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 19: Dec 4-8* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 20: Dec 11-15* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 21: Dec 18-20* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 22: Jan 3-5* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 23: Jan 8-12* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 24: Jan 16-19* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 25: Jan 22-26* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 26: Jan 29 - Feb 2* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 27: Feb 5-9* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 28: Feb 12-16* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 29: Feb 20-23* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 30: Feb 26 - Mar 1* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 31: Mar 4-8* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 32: Mar 11-15* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 33: Mar 18-22* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 35: Apr 1-4* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 36: Apr 8-11* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 37: Apr 15-19* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 38: Apr 22-25* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 39: Apr 29 - May 3* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 40: May 6-9* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 41: May 13-17* Monday Tuesday Wednesday Thursday Friday Which days do you need for Week 42: May 20-22* Monday Tuesday Wednesday Thursday Friday Week Dates to Cancel*Week 12: Oct 16-20Week 13: Oct 23-27Week 14: Oct 30 - Nov 3Week 15: Nov 6-10Week 16: Nov 13-17Week 17: Nov 20-21Week 18: Nov 27 - Dec 1Week 19: Dec 4-8Week 20: Dec 11-15Week 21: Dec 18-20Week 22: Jan 3-5Week 23: Jan 8-12Week 24: Jan 15-19Week 25: Jan 22-26Week 26: Jan 29 - Feb 2Week 27: Feb 5-9Week 28: Feb 12-16Week 29: Feb 20-23Week 30: Feb 26 - Mar 1Week 31: Mar 4-8Week 32: Mar 11-15Week 33: Mar 18-22Week 35: Apr 1-4Week 36: Apr 8-11Week 37: Apr 15-19Week 38: Apr 22-25Week 39: Apr 29 - May 3Week 40: May 6-9Week 41: May 13-17Week 42: May 20-22Hold the CTRL key to select multiple weeks.Reason for Changes or Additional Information* Cancellations and adjustments must be submitted 14 days in advance in order for a credit (or refund if there are no future enrollments) to be given. If an adjustment is not requested by the 14-day deadline, the account will be charged for the original enrolled dates, and no adjustments will be made. Accounts will not be adjusted and credits/refunds will not be given for non-attendance, including illness.By submitting this electronic notice, I acknowledge that I have read and agree to the above change/cancellation policy.* Yes
