Child care agreement
Program
Child’s name
Child’s date of birth
Parent or guardian
Start date
Days of care:MondayTuesdayWednesdayThursdayFriday
Drop-off time
Pickup time
Room or program
Tuition and payment
Tuition amount
Payment due date
Late payment fee
Tuition is charged:WeeklyEvery two weeksMonthly
Registration or other fees
Ways to pay
Late pickup
Closing time
Late pickup fee, and how it is counted
Illness
When a child must stay home
How soon a sick child must be picked up
When a child may come back
Absences, closures and leaving
Tuition for sick days, vacation and holidays
Days the program is closed
Notice the family gives to leave
Notice the program gives to end care
We have read this agreement and the program’s written policies. We agree to follow them.
Parent or guardian signature
Date
Director or owner signature
Date
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