Child Care Schedule, Payment & Fee Agreement at a glance
What it is: The Child Care Schedule, Payment & Fee Agreement is for a Parent or Guardian who agrees to pay a Provider for child care as scheduled.
Who signs: The Parent's Signature and the Provider's Signature, each with a Date, are on the Agreement.
A filled-in Child Care Schedule, Payment & Fee Agreement example: a family sets a weekly rate
How to fill out Child Care Schedule, Payment & Fee Agreement, box by box
Parent or Guardian, Provider and payment
After I, write the names of the Parent or Guardian; after "as scheduled below to", write the Provider's name.
Write what the Parent or Guardian agrees to pay, what it is per, and what it is due on.
Additional overtime charge
In the event the child or children are cared for at times additional to those scheduled, the Parent or Guardian agrees to pay an additional overtime charge per hour of $, due on the date you enter.
Additional fees agreed upon
Under Additional fees agreed upon, enter Registration $ per, Activity/Material $ per and Deposit $ for.
Costs of regular child care
The Parent or Guardian will be expected to pay the costs of regular child care whether the child or children are in care or not, to hold the slot(s) in the Provider's business: write Yes/No and initial.
This will include the Parent or Guardian's and the Provider's vacation times: write Yes/No and initial.
This will include the child's or family sick time: write Yes/No, and if yes initial.
Notice of changes and vacation time
The Provider agrees to give notice before any change is made to charges or fees, and will provide a new Agreement in the event of a change; enter the notice.
The Provider agrees to give notice for personal/vacation time; enter the notice.
Child Care Schedule
Under Child Care Schedule, enter the Name and Days & hours of Child #1 and, if any, of Child #2 and Child #3.
Parent and Provider signatures
Parent's Name and Signature and Date go on the Parent's lines; Provider's Name and Signature and Date go on the Provider's lines.
Sources
[1] Child Care Schedule, Payment & Fee Agreement (Child Care Resource Network, a Program of The Job Council, Word/LW/4-06; the served file; no issuer file found) (the Official source link on this page).
