Pinellas/Pasco County School Age Programs 20/21 Vacation Week Request Form
Please submit the week(s) you would like to request as your "vacation weeks". Payments will be removed for vacation requests that fall within the guidelines listed in the Vacation Policy below. You may access your online account at any time to review your child's enrollment weeks. Should you need to make any changes to your request after submission, please email
Vacation Policy reminder:
*Vacation weeks may be used for any week during the school year, including holiday weeks, but are not in addition to holiday weeks.
*The maximum amount of vacation weeks any child receives in a school year is four(4).
*Vacation weeks must be requested and approved at least 2 weeks prior to use.
*Vacation weeks must be used during school year. They do not accumulate or roll over.
*One week of vacation may not be broken up and used over multiple calendar weeks. (A week is defined as Monday-Friday in a calendar week.)
*All participants in ALL PLANS (School Age Plan, 3-day and AM/PM plans where applicable) must complete the Vacation Request Form.
*Vacation weeks do not apply to ELC participants. Please contact 727-467-9622 for more information.
PLEASE ENTER ONE CHILD PER REQUEST.
If you are requesting weeks for more than one child, please complete this request form separately for EACH CHILD.
CHILD'S First Name
CHILD'S Last Name
CHILD'S Birth Date
Please select your program site
Brooker Creek Elementary
Curlew Creek Elementary
Cypress Woods Elementary
Forest Lakes Elementary
Highland Lakes Elementary
Lake St. George Elementary
Leila Davis Elementary
Orange Grove Elementary
Safety Harbor Elementary
Sunset Hills Elementary
Tarpon Springs Elementary
Tarpon Springs Fundamental
Tarpon Springs Middle
Youth Activity Center (YAC) at J.P. Gills YMCA
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