Drop-In Contract

DROP-IN CONTRACT

Childcare services will be provided for:

Child’s Name: DOB:

Care will be provided by Christine Child, of The Child’s Place Family Daycare, a home-based daycare fully licensed through Fairfax County in Virginia.

Drop-ins are considered to be an odd day when care is needed. Drop-in is not more than 20 hours per week with a minimum of two hours per occurrence. The rate for drop-in care is $10.00 per hour or fraction thereof per child. The adult to child ratio in Provider’s home is regulated by Fairfax County, and as such, drop-in care may not always be available. Reservations for drop-in care will be accepted on a first requested, first served basis. Cancellation of a drop-in reservation with less than 24 hours notice will result in the Parent being invoiced $20 per child per occurrence.

It is the Parent’s responsibility to provide diapers/pull-ups, wipes, powders/ointments, a portable changing pad, baby formula or expressed breast milk, bottles, jars of baby food, and a change of clothes. Provider will supply snacks and meals to toddlers and older children in care during meal periods.

Payment is due at the time your child is dropped off. A fee of $25 will be charged for all returned checks. Childcare services will be immediately halted until payment in full of fees and bank charges have been made, in cash.

Transportation to and from Provider’s home will be provided by Parent. Parent will escort Child to and from Provider’s home and will leave Child only with Provider.

Provider will release Child only to Parent or to the following adult ______, as designated by Parent. Provider may request a valid form of identification from the adult prior to releasing the Child.

Prior to the initial drop-in occurrence, 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.

Prior to the initial drop-in occurrence, 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.

Prior to the initial drop-in occurrence, 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.

Our childcare facility is closed on all Federal holidays. For a complete list of holidays, please see Provider’s List of Holidays.

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.

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Provider’s Signature Date

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Mother’s Signature Date

______

Home Address Phone No.

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E-mail Alt. Phone No.

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Father’s Signature Date

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Home Address Phone No.

______

E-mail Alt. Phone No.

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