Child Care Financial Agreement - DOC by 3TU0Q1Sj

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									                            Child Care Financial Agreement


This child care financial Agreement is made this ______ day of ______________, 2011,
by and among _____________________________, residing at ____________________
                         Parents                                        Parents’ Address
_____________________ and ______________________, residing at ______________
                                        Provider                                  Provider’s Address
____________________. This agreement is for the care of ______________________,
                                                                        Child’s Name
_______________________, residing at _____________________________________,
       Date of Birth                                  Child’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.

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

                  b. 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.

     c. 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.

     d. 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.

     e. 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.

     f.   Provider will release Child only to Parent or to
          _______________________________________, as designated by
                    Designated Adult
          Parent.


3.   PARENTS’ RIGHTS AND RESPONSIBILITIES

     a. 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).

     b. 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.

     c. 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.



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          d. 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.

          e. 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.

          f. 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

          a. 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.
          b. 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).
          c. 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.
          d. 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.
          e. 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.
          f. 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.
          g. 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



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                 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:
            a. Feminine pronouns or other terms shall include both the feminine and
                 the masculine;
            b. Singular terms shall include both the singular and the plural. Plural
                 terms shall include both the plural and the singular;
            c. “Parent” shall refer to the parent or guardian;
            d. “And” means “and/or;”
            e. “Or” means “and/or;”
            f. “Each” means “any and all.”

______________________________________                          __________________
            Provider’s Signature                                       Date


______________________________________                          __________________
            Mother’s Signature                                         Date


______________________________________                          __________________
            Home Address                                               Phone Number


______________________________________                          __________________
            E-mail                                                     Alt. Phone Number


______________________________________                          __________________
            Father’s Signature                                         Date


______________________________________                          __________________
            Home Address                                               Phone Number


______________________________________                          __________________
            E-mail                                                     Alt. Phone Number




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