School Age Child Care Change Form

Parent/Guardian's Name: *

First

Last

Child's Name: *

First

Last

Please submit a separate form for each child.

Phone *

Email *

Before/After Care Site

1. Add to Schedule

Changes to your child's schedule must be made by the 20th of the month prior.

Effective Date Begin:

Effective Date End:

Add AM or PM

AM
PM

If adding PM, please choose number of days per week

Two (2)
Three (3)
Five (5)

Please note: If a spot is not currently available in our after care program, you will be placed on a wait list and notified when a spot becomes available.

If you selected the two (2) or three (3) day option above, please indicate which days you would like to enroll

Please note: We will do our best to accommodate those who choose our 2 or 3 day care option. Changes are not active until you receive a confirmation email from the program director. If a spot is not currently available in our after care program, you will be placed on a wait list and notified when a spot becomes available.

2. Change Days

Changes to your child's schedule must be made by the 20th of the month prior. Please note: we suggest families choose permanent days for the entire school year, and will do our best to accommodate day changes for those who choose our 2 or 3 day care option. Changes are not active until you receive a confirmation email from the program director.

I would like to change my days to (check all that apply):

3. Cancel Enrollment

Deposits are non-refundable. If 30 days' written notice is provided, the deposit will be applied to the child's last month of enrollment. If 30 days' notice is not provided, a credit will be applied to your account that can be used for other programming.

Check all that apply:

Cancel AM
Cancel PM
Cancel Vacation Days

Please note that cancelling enrollment in SACC does not cancel your membership. If you wish to change your membership, please contact membership@fspymca.org.

Please provide dates for vacation days:

Reason for cancellation:

Effective Begin Date:

Effective End Date:

Today's Date: *

Canceling your School Age Child Care registration does not cancel or suspend your membership. Please allow 5-7 days for processing deposit requests. If you are adding to your schedule or changing your schedule, you will receive a confirmation email. Please sign by entering your name below: *

1. Add to Schedule

2. Change Days

3. Cancel Enrollment

Contact Us

Main Facility Hours

1. Add to Schedule

2. Change Days

3. Cancel Enrollment

SHARE THIS

Contact Us

Main Facility Hours