Child Care Financial Agreement

This child care financial Agreement is made this ______day of ______, 2011,

by and among ______, residing at ______

ParentsParents’ Address

______and ______, residing at ______

ProviderProvider’s Address

______. This agreement is for the care of ______,

Child’s Name

______, residing at ______,

Date of BirthChild’s Address

______.

Phone Number

WHEREAS, Provider is a duly licensed Family Day Care Provider under the Code of Virginia;

WHEREAS, Provider is a self-employed individual and desires to provide family day care services for Child in her own home in a safe and nurturing environment;

WHEREAS, the Parties desire to set forth their respective rights and obligation to each other;

THEREFORE, the Parties agree as follows:

  1. VIRGINIA FAMILY DAY CARE SYSTEM REGULATIONS

Provider agrees to comply with the DAY CARE STANDARDS.

  1. PROVIDER’S RIGHTS AND RESPONSIBILITIES
  2. Provider will provide child care services in her own home for Child in accordance with the DAY CARE STANDARDS and

with this Agreement.

  1. Provider will provide child care services for Child beginning on ______according to the following

schedule:

Arrival Time Departure Time

Monday______

Tuesday______

Wednesday______

Thursday______

Friday______

Provider and Parent may agree to modify this schedule by mutual agreement.

  1. Provider is responsible for planning Child’s daily activities. Provider will follow Parent’s wishes, as expressed in the Authorization Agreement form, concerning Child’s participation in field trips and water activities.
  1. If Provider is ill or otherwise unable to provide child care services for Child on a particular day, Provider will make every attempt to arrange for replacement services to be performed by a substitute, who will comply with the DAY CARE STANDARDS and the other Provider performance requirements in this Agreement.
  1. Provider will be available for parent conferences to discuss Child’s

progress, Parent’s child care needs and any other issues of concern to

Parent.

  1. Provider will release Child only to Parent or to

______, as designated by

Designated Adult

Parent.

  1. PARENTS’ RIGHTS AND RESPONSIBILITIES
  1. Transportation to and from Family Day Care Home will be provided by Parent. Parent will escort Child to and from Provider’s home and will leave Child only with Provider or, if applicable, with the Provider’s substitute designated pursuant to Section 2(d).
  1. Prior to the Commencement Date, Parent will complete and provide Provider with a Parent/Guardian Authorization Agreement form, granting or denying permission for Child to participate in field trips and water activities.
  1. Prior to the Commencement Date, Parent will complete and provide Provider with an Emergency and Medical Authorization Form, which shall contain the name, address, and telephone number of Child’s physician and instructions for emergency medical treatment.
  2. Prior to the Commencement Date, Parent will provide Provider with a written statement explaining any of their child’s special requirements, child care needs or any other referral information as contained on the Developmental History form.
  1. Prior to the first day in care, Parent will provide Provider with an immunization record and physical exam signed by a physician. Provider will notify Parent when these records need to be updated.
  1. Prior to the first day of care, Parent will provide Provider with the Child’s proof of identity as required by Virginia state law.

4.FINANCIAL AGREEMENT

  1. Parent will directly compensate Provider for provider services hereunder by paying the sum of: ______dollars ($______) upon the execution of this agreement and $______monthly thereafter. Monthly payment will be due on the ______day of each month.
  2. Parent agrees to pay a late fee of $5.00 per 15 minute interval if arriving before scheduled arrival time or after scheduled departure time. (i.e.: $5.00 for 1 – 15 minutes late; $10 for 16 – 30 minutes late, etc.) Late fees will be billed by invoice on the first day of the week following the late arrival(s) or departure(s).
  3. Parent agrees to pay a late fee of $25.00 if monthly payment is made more than three (3) business days after the due date stipulated in Section 4(a.) Additionally, Parent agrees to pay a $25.00 returned check fee for all payments returned for insufficient funds or any other reason. Late and returned check fees will be billed by invoice on the first day of the week following the occurrence.
  4. Parent will be financially responsible for all time Provider is scheduled to provide child care services to Child and Parent understands that there will be no reimbursements if Child is unable to come to Provider’s home due to Child’s illness, vacation, or any other cause. If Child is scheduled to attend on a part-time basis, neither holidays nor any other days are transferable to a day when Child does not regularly attend.
  5. All holidays, as listed in the Annual List of Holidays provided to Parents, shall be payable, with the exception of holidays which fall on days when the Child is not regularly scheduled to attend.
  6. Provider will advise Parents in advance (not less than 2 months) of three (3) weeks per year during which the business will be closed. The first two (2) of these weeks shall be payable to the Provider. The remaining week will not be payable to the Provider.
  7. It is anticipated and agreed to by the Parties that the amount to be paid by the Parent may be adjusted on an annual basis with such adjustment becoming effective in the month of commencement of services each year.

5.TERM OF AGREEMENT

The term of contract is for one (1) year, and may be renewed for an additional period of one (1) year by mutual agreement of the Parties.

6.TERMINATION

Each of the Parties may terminate this Agreement upon two (2) weeks written notice to the other Party or upon mutual agreement of Parent and Provider.

7.SEVERABILITY

Any clause of this Agreement which does not comply with the DAY CARE STANDARDS, or is found otherwise unenforceable, shall be severed. The Parties agree to comply with the remaining provisions of the Agreement.

8.DEFINITIONS

As used in this Agreement:

  1. Feminine pronouns or other terms shall include both the feminine and the masculine;
  2. Singular terms shall include both the singular and the plural. Plural terms shall include both the plural and the singular;
  3. “Parent” shall refer to the parent or guardian;
  4. “And” means “and/or;”
  5. “Or” means “and/or;”
  6. “Each” means “any and all.”

______

Provider’s SignatureDate

______

Mother’s SignatureDate

______

Home AddressPhone Number

______

E-mailAlt. Phone Number

______

Father’s SignatureDate

______

Home AddressPhone Number

______

E-mailAlt. Phone Number

1