C.A.R.E. Schedule Change / Withdrawal Form

Important Notes About Schedules Change Requests:

Requests to add before- or after-school CARE to your child’s schedule will be approved based on availability.
If you withdraw from an after-school option, re-enrollment is not guaranteed.
Schedule changes received by the 25th of the month will take effect with the following month’s billing.
All approved schedule changes will be charged a $10 fee
All approved refunds will be applied as a household credit unless otherwise requested. If another form of refund is requested, an additional $5 processing fee will be applied.

"*" indicates required fields

Child's Name*

First Last

Parent's Name*

First Last

C.A.R.E. Site*

Primary Phone*

Email Address*

Request Type*

Withdrawal Date

I would like to ADD

Before-School

After-School

AM Kindergarten Add-On (Extended-Day)

Requested Start Date

I would like to REMOVE

Before-School

After-School

AM Kindergarten Add-On (Extended Day)

Last day my child will use the option above

Signature