Clubhouse Change Form

Clubhouse Change Form

Please complete one form per child. All changes must be submitted using this form, prior to the upcoming month’s cut off date. For each change a fee of $15 will be charged to your account
Clubhouse Location*
Parent/Guardian Name*

First NameLast Name
Child's Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
Change to*
Time - Before School

LGUSD 7:00AM
Days per Week - Before school

MondayTuesdayWednesdayThursdayFriday
Time - After School -

5:00PMExtended 5:00PM-6:00PM
Time - After School-NOTUSED

5:00PMExtended 5:00PM-6:00PM
Days Per Week - After School

MondayTuesdayWednesdayThursdayFriday
Kinder Care & Extended Care

Until 3:00PMUntil 5:00PMExtended Care 5:00PM-6:00PM
Time - Kinder Care

Until 3:00PMUntil 5:00PM
Days Per Week - Kinder Care

MondayTuesdayWednesdayThursdayFriday
Reason for cancellation

Please note the cutoff date per month in order for tuition changes to be processed and take effect on the 1st of the new billing month.