Vacation Request Form
Names of Children
*
Childcare Location
*
Choose a Location
County YMCA
Downtown YMCA
Eastside YMCA
Glenwood Park YMCA
Camp Sherwin
The Y at Early Learning Center
The Y at Early Learning University
The Y @ Elk Valley Elementary School
The Y at Fairview Elementary
The Y @ First Presbyterian Church- Waterford
The Y @ McKean Elementary School
The Y @ Northwestern Elementary School
The Y @ Summit United Methodist Church
The Y @ Wattsburg Elementary Center
PKC
Dates Requested:
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Parent Info:
Parent Email
*
Parent/Guardian Signature
Date
MM slash DD slash YYYY