1)_____________________________________________________________________________________________________________________
Mother / Legal Guardian
Home Phone Work Phone Ext.
Home Phone Work Phone Ext.______________________________________________________________________________________________________________________________
Home Address
______________________________________________________________________________________________________________________________
Employer's Name
______________________________________________________________________________________________________________________________
Employer's Address
And
2)_____________________________________________________________________________________________________________________
Father's / Legal Guardian Home phone Work Phone Ext.
Home phone Work Phone Ext.______________________________________________________________________________________________________________________________
Home Address
______________________________________________________________________________________________________________________________
Employer's Name
_____________________________________________________________________________________________________________________________
Employer's Address
And
3)_____________________________________________________________________________________________________________________ Day Care Director's NameBusiness Phone
Business Phone_____________________________________________________________________________________________________________________________
Day Care Address
For the care of the following child(ren):
______________________________________ _______/______/______ ___________________________________
Child's Name Date of Birth Nickname
Date of Birth Nickname_____________________________________ _______/______/______ ___________________________________
Child's Name Date of Birth Nickname
Date of Birth Nickname_____________________________________ _______/______/______ ___________________________________
Child's Name Date of Birth Nickname
Date of Birth NicknameRates:
The fee will be $_________.00 per month $_________.00 bi-weekly $__________.00 per week
If fee is due on a holiday on which we will be closed than it must be paid the day before of our closing.
Hours of Care:
____________ a.m. / p.m. to ____________ a.m. / p.m.
Days of Care:
____Monday ____Tuesday ____Wednesday ____Thursdaay ____Friday
Payment Method:
Once you have picked a payment method it cannot be changed.
____Monthly ____Bi-Weekly ____Weekly
Overtime rate:
For the purpose of this contract, overtime will be considered as drop-off before _________a.m. / p.m. and pick-up after __________a.m. / p.m.
If the parent / legal guardian makes prior arrangements with the provider, the child (ren) may stay overtime at the following rate: 0-23 months $______.__per hour 24months and up $_______.___per hour.
If the parent / legal guardian has not informed the provider that she / he will be arrving later than the agreed upon times, the following rate will be charged: $_____.__per 10 minutes. Overtime fee is due immediately upon late arrival. Child will not be readmitted until overtime fee has been paid.
Repeated late pick-ups unless they have been pre-approved may result in termination of contract.
Late Fees:
There is a fee of $_____.___ each day that payment has not been recieved. This policy is strictly enforced to all of our day care clients. Day care services will be suspended until all fees have been collected.
Vacations, Holidays and other absences:
Because our operating costs do not change there will not be a deduction made in day care rates or tuition fees due to holidays, vacations, or any other absence for any reason.
Termination Procedure:
Either parent / legal guardian or provider may terminate this contract by giving two weeks written notice in advance of child's enrollment ending date. Payment by parent / legal guardian is due for the notice period, whether or not the child is brought to the facility / provider for care. Failure by the provider to enforce one or more terms of this contract does not waive the right of the provider to enforce any other terms of the contract.
The provider reserves the right to decide who may or may not come into my facility / home at any time. I also reserve the right to give notice of termination, without a two week notice period.
Examples of Reasons:
1) Children who are considered an endangerment to themselves or other children.
2) When parents have not fulfilled payment requirements. All payments must be upto date.
3) Parents that are constantly late and do not take the time call and inform me, or any other breach of this contract.
4) Children that we feel are showing signs of not having adapted to our program e.g.excessive crying at drop-off time.
Court Fees:
Should it become necessary to go to court over non-payment of fees owed, court & attorney fees will be added to your bill. It will be your responsibility to pay me your entire bill.
Signatures:
By signing this contract, parent(s) / legal guardians accept to abide by the written policies of the provider / director. They acknowledge they have recieved a copy of the parent handbook/ policies. Provider / Director may amend the policies by giving the parent(s) / guardian(s) a copy of the new or changed policies at least 1 week before they go into affect.
Director's / Provider's Signature:____________________________________________ Date:_______________________
Mother's / Legal Guardian's Signature:______________________________________Date:________________________
Father's / Legal Guardian's Signature:_______________________________________Date:_______________________
Co-signer's Signature:_____________________________________________________Date:________________________
If the parent or legal guardian is under age 18, a co-signer must sign this contract and act as a guarantor to the contract and agree to be bound by all of the financial terms.
