Child Care Withdrawal Form
Please complete to fully withdrawal your child from YMCA childcare. Withdrawal requests require a two weeks notice to ensure no additional billing or drafting occurs.
Child First Name *
Child Last Name *
Parent First Name *
Parent Last Name
Street Address *
City, State Zip *
Phone Number *
Email Address *
School/Summer Camp Location *
Reason for Withdrawal + DETAILS with dates ( A $10 Administrative Fee will be invoiced for each Summer Camp week canceled.) *
Last Date of Attendance *
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DD
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I understand that withdrawal from our program requires a one week notice to ensure no additional billing or drafting occurs. *
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