Parent-Provider Child Care Contract Form
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1
2PARENT-PROVIDER CHILD CARE CONTRACT
I.
The following contract is between _____________________________________________________________________
(Parents of child(ren) in care)
_______________________________________ located at ____________________________________________ for the
and
(Child Care Provider)
(Address of child care facility)
children listed below:
Child's Name_________________________
Date of Birth ____________________
Child's Name_________________________
Date of Birth ____________________
Child's Name_________________________
Date of Birth ____________________
Child's Name_________________________
Date of Birth ____________________
II.
Standard Rates and Payment Policies:
1.
A deposit of $_____________ is required. The deposit will be applied to the last week’s payment or to the termination
notice period if proper notice is not given (see V. Termination procedure).
2.
The fee will be $__________
per hour
per day
per week (circle one)
Days and hours of care provided will be: ____________________________________________________________
3.
Payment is to be given:
weekly
bi-weekly
other ________________ on _________________________
(Day of week/month)
4.
The child care provider will provide (check all that apply):
Breakfast
Morning Snack
Lunch
Afternoon Snack
Dinner
5.
The parent(s)/guardian(s) will provide the following (check all that apply):
Change of Clothes
Formula/Breast Milk
Diapers & Wipes
Infant Food
Provider will supply ______________________________________________ for an additional fee of $____________.
Other special arrangements include _________________________________________________________________
_____________________________________________________________________________________________
III.
Rates for holidays, absences, vacations, overtime:
1.
Care will not be provided, but payment is due, on the following holidays when they occur on a day the child(ren) is/are
regularly scheduled for care:
________________________
_________________________
________________________
_________________________
________________________
_________________________
________________________
_________________________
________________________
_________________________
2.
The provider will be notified by ___________ if the child(ren) will be absent for the day.
(time)
3.
Policy for payment of absences is: __________________________________________________________________
4.
Fees and policies for provider’s vacation: ___________________________________________________________
5.
Fees and policies for parent/guardian’s vacation: ______________________________________________________
6.
If the provider is unable to provide care because of illness or emergency, the policy is:__________________________
_____________________________________________________________________________________________
7.
If
the parent/guardian drops off the child earlier or picks up later than the times specified above, the following overtime
rate will be charged: $____________ per ____________ or portion thereof.
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