PARENT WITHDRAWAL (EXIT) FORM

I understand that I must give my two-weeks allowing my child/children to attend day care for the weeks or pay my two-weeks tuition if the need for emergency withdrawal arises.

Please accept this as my TWO-WEEK’S NOTICE for the withdrawal of my child/children as required by my Parent & Provider Contract Agreement.

Moving Rates are too high Child aging out Challenging behavior Policy Issues Change in childcare needs Other (please specify)

Would you refer to my program?
Yes No

Submit