30–DAY VACATION NOTICE

The Children’s Center at CALTECH

286 S. Chester Ave., Pasadena CA 91106

Please complete this form if you are planning to take your child on a vacation from the Children’s Center at CALTECH.

Child:__________________________ Classroom:_______________________

Parent(s) name(s):_________________________________________________

Phone number:_______________________

Vacation starts:_______________ My will return to the Center: ______________

PARENT SIGNATURE_________________________TODAY’S DATE;_____________