Signatures:
The signatures below indicate agreement with this contract and with the
written policies of the provider (contained in a separate document). The
provider may change policies as needed with advance written notice.
__________________________
___________________________
Parent’s name
Parent’s signature/date
__________________________
____________________________
Parent’s name
Parent’s signature/date
__________________________
____________________________
Provider’s name
Provider’s signature/date
If the parent or legal guardian is under the age of 18, a co-signer must sign
this agreement and act as guarantor to the contract and agree to be bound
by all financial terms.