Summer Camp Change Form

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Notice of Fee Change, Temporary Absence or Withdrawal

If for any reason you decide to change or drop your child's enrollment from the Peoria Summer Camp Program, notification must be submitted by Thursday for the following week. You may use this form for notification. Please complete the form fields and submit the form when done.
Please correct the field(s) marked in red below:

PARENT/CHILD INFORMATION
Required Information

 *
PARENT/CHILD INFORMATION Required Information

Please check one of the four options below (changing-absent-inactive-withdrawing):

1. CHANGING FEE CONTRACTS

1. CHANGING FEE CONTRACTS
If changing fee contracts, select all days ATTENDING    -    $25 per day or $105 per week
If changing fee contracts, select all days ATTENDING - $25 per day or $105 per week
If changing fee contracts, select all days for LUNCH    -    $2.75 per day
If changing fee contracts, select all days for LUNCH - $2.75 per day

2. ABSENCE

2. ABSENCE

3. INACTIVE

3. INACTIVE

4. WITHDRAWING

4. WITHDRAWING

ADDITIONAL INFORMATION/COMMENTS


Check the box below if you are currently on Quick Pay/EFT:

By submitting this form, I understand that I am amending my existing Fee Attendance Contract and I agree to continue to abide by the policies and guidelines as originally signed.

 

In order to receive a receipt of this submitted form, you MUST fill in your email below.

  1. To receive a copy of your submission, please fill out your email address below and submit.