Summer Vacation Request Form
To receive a refund, this form must be received 5 business days BEFORE the requested date.

For Example: If you are looking to request a Friday as a vacation day, the form must be turned in by the previous Friday!
5 business days = Friday you submitted + Monday + Tuesday + Wednesday + Thursday.

Email address *
Child's Name: *
For multiple children: Please indicate each child's first and last name separated by a comma
Your answer
Child's ACES Site: *
Your answer
Requested Vacation Dates
SUMMER: Consistent Care = 5 vacation days, Pick Your Days = none, not eligible during the summer session
1st Vacation Date Requested: *
MM
/
DD
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YYYY
2nd Vacation Date Requested:
MM
/
DD
/
YYYY
3rd Vacation Date Requested:
MM
/
DD
/
YYYY
4th Vacation Date Requested:
MM
/
DD
/
YYYY
5th Vacation Date Requested:
MM
/
DD
/
YYYY
Additional Comments:
Your answer
I would like to receive my refund in the following way: *
Please note - we cannot issue a refund for care dates that have not yet been paid.
Parent/Guardian Signature *
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
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