DROP-IN DAYCARE-CHILD CARE CONTRACT
 

Childcare services will be provided for:

Child’s Name:                                                                                     Age:                                        

Child’s Name:                                                                                     Age:                                        

Child’s Name:                                                                                     Age:                                        

Drop-ins are considered to be an odd day where care is needed.  Drop-in is not more than 20 hours per week with a minimum of two hours.  The rate for a drop-in child is $____per hour.  A 24-hour notice is required for Drop-in care.

It is the parent’s responsibility to provide such things as diapers/pull-ups, change or clothes, powders/ointments, medication, etc.

Payment is due at the time your child is dropped off.  A fee of $____will be charged on all returned checks.  Childcare services will be immediately halted until payment in full of fees and bank charges have been made, in cash.  In addition, from that point forward cash will be required on all future drop-in appointments.

Our childcare facility is closed on New Year’s Eve, New Year’s Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, Christmas Eve, Christmas Day, and the day after Christmas.

I/We have read, and do understand and agree to abide by the terms and conditions stated above.  I also understand that these terms and conditions may change as needed, and that I will be notified of such changes in advance.

Emergency Medical Form

 This authorizes ( name:                                                     ), Home Daycare Provider, to secure EMERGENCY medical care for my child: _________________________________

When I/We cannot be immediately reached at the time of the emergency. I/We will be responsible for the emergency medical charges upon receipt of the statement.

     ____________________________________is the preferred doctor/hospital/clinic. __________________________________________________________________________________

Parent/Guardian’s Signature:                                                                         Date:__________________
Phone Number:_____________________________________________________________________
Parent Address_____________________________________________________________________

_____________________________________________________________________________________

Childcare Provider’s Signature:                                                                      Date_____________________

NOTES: