2026 Summer Camp Schedule Change Form

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2026 Summer Camp Schedule Change Form

Do NOT use this form to enroll your child for the 2026 Summer Camp Program.

If for any reason you decide to change or drop your child's enrollment from the Peoria Summer Camp Program, notification must be submitted no later than 12:00PM (noon) on Wednesday PRIOR to the week of your change. You must use this form for notification. Verbal changes at the site or with customer service over the phone are NOT accepted. Please complete the form and submit when finished.

** Schedule Changes requesting additional days are NOT guaranteed. Space is limited at each location and your requested schedule may NOT be available. You will be contacted if your request can NOT be accommodated.
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Child Information* This field is required.
Parent Name (First and Last Name)
Child's FIRST Name
Child's LAST Name
Please Select
Please Select
Alta Loma
Cheyenne
Parkridge
Paseo Verde
Sundance
Sunset Heights
Zuni Hills
Summer Camp Location
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Email* This field is required.
Parent/Guardian E-mail Address
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Phone Number* This field is required.
Parent/Guardian Phone Number
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What would you like to do with your schedule?* This field is required.
Change my weekly attendance
My child will be ABSENT
WITHDRAW my child permanently from summer camp
Add/Change/Delete my child's Summer School schedule for the month of June
6
My NEW weekly attendance schedule begins on (LAST day of Camp is Friday 7/24):* This field is required.
Date
Year
Month
Day
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Please select your child's NEW WEEKLY ATTENDANCE schedule below. Unscheduled days of attendance is $50.00 p/day per child. Full Time is 4 or 5 days/wk = $185 (flat rate), Part Time is 1-3 days/wk = $115 (flat rate). NO daily rates. NO program on May 25. Camp will be held at Cheyenne and Sunset Heights ONLY on June 19 and July 3. * This field is required.LAST day of SUMMER CAMP is Friday 7/24
Monday
Tuesday
Wednesday
Thursday
Friday
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Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Row 0, Column 4
Monday
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Tuesday
Row 0, Column 1
Wednesday
Row 0, Column 2
Thursday
Row 0, Column 3
Friday
Row 0, Column 4
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First Date child will be ABSENT from the Summer Camp program (LAST day of camp is Friday 7/24)* This field is required.
First Date Child Will Be Absent
Month
Day
Year
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Date child will RETURN to the Summer Camp program (LAST day of Camp is Friday 7/24)* This field is required.
Date child will return to the program
Month
Day
Year
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What PUSD SUMMER SCHOOL site is your child attending (not summer camp location)?* This field is required.
Please Select
Please Select
Apache
Cotton Boll
Country Meadows
Ira Murphy
Lake Pleasant
Oasis
Paseo Verde
Santa Fe
Sky View
Zuni Hills
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The City of Peoria does NOT provide transportation for Summer School children. Please contact your child's school office or PUSD Transportation.* This field is required.
I acknowledge that transportation is not provided by the City of Peoria
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What childcare schedule are you requesting while your child attends Summer School? PUSD transportation is NOT available prior to Summer School starting in the mornings.* This field is required.Additional days must be available and approved. Your child MUST be attending PUSD SUMMER SCHOOL for this summer school rate to apply. Proof of summer school attendance may be requested.
Summer School care, MON-THURS ONLY: $95.00 per week, through June 25th. Must be attending summer school through PUSD. This is a weekly flat rate. Less number of days are NOT available.
Summer School care, MON-THURS PLUS All day camp on Friday is $132.00 per week through June 26th. Must be attending summer school through PUSD. This a weekly flat rate. Less number of days are NOT available.
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Effective Date of Withdrawal * This field is required.
Date
Month
Day
Year
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Reason for Withdrawal* This field is required.
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Small
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Additional information/comments
0/50
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Small
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Ok
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By submitting this form, I understand that I am amending my existing Summer Camp Attendance Contract and I agree to continue to abide by the policies and guidelines as originally signed.

Reminder: Schedule changes for additional days of attendance are NOT guaranteed. You will be contacted if your request CANNOT be accommodated.
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