Today's Date:__________________
Effective Date:_________________
Child's Name___________________
Birth Date:_____________________
Home Address:_________________
Home Phone:__________________
Sponsors Name:________________
Duty Phone:___________________
Commander/First Sergeant:______________________________________
Parent/Guardians Name:________________________________________
Employer:_______________________Work Phone:___________________
Person(s) designated to pick up child(ren) other than parents:
Name:__________________________Duty Phone:____________________
Name:__________________________Duty Phone:____________________
* child(ren) will not be released to anyone other than
parent/guardian(s) or those listed above without written
Authorization from parent/guardian.
Person(s) must show picture identification prior to release of
child(ren)
Emergency contact
Each child being cared for in Busy Bees Family Childcare home must have an emergency contact other than parent. Only one (1) is required but I prefer to have two (2).
Name:__________________________Phone:_____________________
Address:________________________Work #:______________________
Name:__________________________Phone:_______________________
Address:________________________Work #:_______________________
** Provider will contact the individual(s) above to ensure that they
are aware that you have listed them as your emergency contact.
Please inform the individual(s) that they will be
contacted in the event that a emergency arises such as an illness and I am not
able to contact you the parent/guardian and that they will be expected to pick
the child (ren) up in a timely manner.
Fees & charges
Registration Fee
This will be a $100.00 non-refundable fee payable prior to the first week of care. This fee will be used to hold your slot if you are not starting right away and to purchase equipment and supplies for your child. This is a non-refundable fee that is not credited to any weeks of care.
Signature_______________________________ Date________________
Childcare rates in this home are based on a yearly rate.
Full-time
Infants through 2 1/2 $92.00/week per slot
2 1/2 through kindergarten
$69.00/week per slot
Before/after School care
$37.00/week per slot
Shift Work $92.00/week per slot
Parent
understands that they pay the rate every week of the year. To include all vacation time.
____________ yes/no
**The provider will determine Payments. Provider reserves the right to increase rates with a written
Two (2) week notice.
Parents must
also understand that I have training’s every month and I will
Attend
these. 1. 2nd Wednesday on every month I must leave here by
1700.
2. 2nd Tuesday of the month of Jan,
Mar, May, July, Sept, and Nov I will need to leave here by 1650 at the
latest. Parents whose work schedule
requires their children be here after this time will need to make alternate
arraignments on these nights. I know
this might seem like an inconvenience to you, but this is how I better myself and
learn new ways to teach your children.
I also must have 24hrs of training to renew my license each year. So if I do not make it to these training’s,
there is a really good chance that I will not get my licensed renewed. _________ yes/no
Late fees
There will be
a fee of $5.00 per 15 minutes increments for a maximum rate of $20.00 for the
first hour and $10.00 every hour thereafter, including any portion of an
hour. All late fees must be paid upon
pick-up of child(ren). No exceptions
made.
_________ yes/no
All Childcare
fees are due Friday morning two (2) weeks in advance. Child(ren) will not be allowed in care if payment is not made and
a late fee
of $10.00 per day will be enforced. Provider also has the right to terminate
without notice in the event of non-payment. And all fees paid up to this time
will not be refunded.
________ yes/no
Returned check fees
There will be a $35.00 fee assessed for any returned check. In addition, the parent will pay for all expenses to the providers account resulting from the returned check.
Holding slot(s)
This Child care home will not hold any slot unless there is a signed contract and that all forms required are filled out and returned to this facility. And all fees are paid up (to include registration fees)
Full-time Care
Full-time care
is for children requiring care for at least 15 HOURS and not to exceed 45 HOURS
a week. Your child does not have to
attend full-time but the rate is always the same regardless if your child attends
one (1) or five (5) days of the week.
_________ yes/no
If you choose to contract for certain days of the week, your rate will be for those particular days only. If you would like to attend on a day that you have not contracted for than you will be charged a daily rate for that day.
Child care
will not be provided for your child when you or your spouse is
off work and
payment will still be expected. The
care provided here at Busy bee is quality and not quantity, You are paying for
a slot and not for the time your child spends in my care.
________ yes/no
Late fees will be collected on the day that late care was provided. Beyond such time will be considered and subject to late payment fee. No further care will be provided until late fees are paid. No refunds will be given for days missed due to non-payment of late fees.
Arrival/Pick up Procedures
Busy Bees
hours are 0700-1650 Monday through Friday
No care will be provided before or after these times or weekends unless pre-arranged and approved by the provider.
Sponsors Work Schedule __________________
Spouses Work ________________________ Phone ________________
Spouses Work Schedule ______________________________________
If you expect
to arrive later than the schedule drop off time please call me so that I can
plan according. The same is required
for late pick up.
It is
important to understand that late arrival does not justify late departure.
If you are
late picking up your child(ren) and do
not contact the provider late fees will go into effect.
_______ yes/no
Notification
of provider’s intent to take vacation will be given in a two- (2) week
notice. The provider is in no way
obligated to find back up care for you, and is in no way responsible for the
back up provider’s actions. You will be
responsible for paying your back up provider.
Each child is authorized to take as much vacation they want, due to the
fact that you are paying on a yearly basis and that you will be paying me
regardless if your child is here or not, that include when I am on vacation for
two weeks. If I choose to take more
than 2 weeks I will not charge you for the extra time. I do not require that you give me notice,
but common courtesy would be for you to give me a (2) week notice prior to taking a vacation, so that I can plan my
schedule with the children. Parents
have read the above statement and that they agree to it.
_________________________________ Date_______________________
Busy Bees Child care will be closed on all Federal Holidays and Down days to include Christmas eve, Christmas, and the day after Christmas (if Christmas falls on a Thursday of that year), Thanksgiving and the day after Thanksgiving, and New Years Eve and New Years Day. Payment will still be expected for these days. Care will only be provided on these days because of special circumstances, there will be a surcharge of $20.00 extra per child in the event your child(ren) need to attend.
Trial Period/Termination of Care
Each child is
accepted in the Busy Bees Family Child care on a condition of a Two (2) week
trial period to adjust and become familiar with the program. At any time during the two (2) week trial
period, if the provider or parent feels that this is not a suitable arrangement
for the child, the contract can be terminated by either party without penalty,
notice, or specific reason, and no fee paid up to this time will be refunded.
After the two
(2) week trial period Busy Bees Family Child care home requires that you give a
two (2) week written notice before terminating care or you will be charged Two
(2) weeks of full-time care. If the
provider gives the parent notice and the parent decides to leave prior to that
notice you will still be bound by this contract and be required to give two(2)
weeks notice.
____________________________ Date ___________
Provider
reserves the right to immediately terminate this contract without notice or
penalty, upon default (failure to abide by providers policies and this
contract) by the parent(s) or failure to make payments when due. In addition, the provider may terminate in
the case of a debilitating condition brought on suddenly, such as one due to an
accident, to provider or an immediate family member.
Health Policy
Busy Bees
Family Childcare home will not administer any medicines without a doctors
prescription and an AF Form 1055 (medication Permission Form) filled out by the
parent. Children requiring prescription
medication for a contagious illness must stay home until the child has been on
the medication for a period of 24 hours.
Some illnesses require the child to stay out of care longer.
__________________ Date ________
Parent(s) will
be notified immediately if their child(ren) is to become ill while attending
this program. Parent(s) will also be
required to pick their child(ren) up in a timely manner. If parent(s) are not able to be contacted
then their emergency contact will be notified and they will be required to pick
up the child(ren). If reasonable
efforts are not made to pick up a sick child, then this contract is subject to
immediate termination. Provider must
institute this policy for the health and safety of all concerned. If the child's illness becomes severe
enough, or after three hours, the child may be sent to a hospital, and parent
will be required to pay all resulting emergency costs to the related agencies
and possible substitute providers costs.
All health regulations will be complied within this childcare home.
Ill children
expose other children, as well as the provider, to the spread of the illness
and require additional care and attention that the provider is unable to
give. Moreover, sick children want care
from their parent in the comfort of their own home. If other children become ill due to exposure to your sick child,
either because he/she was returned to Childcare before recovery or because
he/she was not picked up promptly upon notice of being ill, other families will
be unnecessarily inconvenienced. If the provider or
her family becomes ill due to exposure to a sick child, all of the children may
need to have alternate care. This is
disruptive to all. Cooperation is
extremely important on this issue.
Obviously, it will not be possible to avoid the spread of all infectious
illnesses. However, minimizing exposure
and providing good hygienic procedures in the childcare home are helpful means
to limit and control the problem.
Accordingly, for the benefit for all involved, the following illness
policy will be strictly enforced.
In general
Children who have exhibited any symptoms of infectious illness in a 24 hour
period are likely to be contagious and should remain at home.
Examples of
associated symptoms include, but are not limited to: fever of 100.6 or higher when
measured orally (rectal for infants), nausea or vomiting, diarrhea, sore
throat, loss of voice, hacking or continuous coughing, runny nose (other than
clear) draining eyes or ears, rash or lice.
Children must
have a signed statement determined by their Family Practice Provider stating
that they may attend care and as long as the child(ren) do not need special medical
treatment.
Children with
a fever 100.6 or higher must stay out of the family childcare home until they
are fever free for 24 hours.
Provider is
not allowed to administer medication for the first twenty-four hours of the prescription
medication for the childcare child, because of Air Force regulations and the
possibility of an allergic reaction.
Children with
a mild cold can attend care. However,
when the cold reaches the point that the child(ren) will not play, cries, whines,
wants to be held constantly, has a continuous cough, or the nose secretions are not
clear, then the parent will be required to pick the child up and keep him/her
at home.
If your
child(ren) is found by a physician to have pinkeye or conjunctivitis they will
not be allowed into the child care home until all medication has been taking,
and a doctors statement that allows the child(ren) to return to care.
The provider
reserves the right to determine whether a child should go home or remain in
childcare when illness is a consideration.
Extra close supervision and more stringent cleaning precautions are
taken whenever a child has become ill so as to limit the number of sick
children.
If the
provider or the provider’s child(ren) become ill, the provider will notify you
as soon as possible. The provider in
these circumstances will try to arrange back up care, but is in no way
obligated to find care. It is strongly
recommended that you have a trusted neighbor, friend or relative as a back up
or an emergency back up provider prior to such a situation. Any fees incurred for backup care will be
applied as a credit to your next childcare payment.
_______________________ Date ______________
Meals will be
served at the following times:
Breakfast: 0730
AM Snack: 0900
Lunch: 1130/1145
PM Snack: 1445
Children not
present at these times will not be served. Please make every effort to feed your child(ren) prior to care if
they will not be present at these times.
No food will
be brought into the childcare home from outside. If the child has a food allergy, medical documentation must be
provided prior to the childcare provider supplementing the child's diet.
Busy Bees Child care home will serve well-balanced meals approved by the USDA Food program. A variety of fruits and vegetables will be served at each meal, to include milk. No foods will be forced on a child but will be asked and expected to at least try everything. No food will be used as punishment or rewards.
Supplies to be provided by the parent
The following is a list of items needed for your child to use while in this child care home:
Diapers (1large bag ) provider will let
you know when it is time for more.
Extra change of clothing (2 if your child(ren)
are not potty trained).
Special blanket or teddy bear for nap
time.
Toothbrush
Slippers for inside wear, rubber sole
preferred.
Several bibs (this will be used for
mealtimes if your child uses one)
Bottles and Nipples (one for every meal
your child will be eating here)
Each child will be provided his/her own
cubical for storing his/her belongings, so there will not be a need to have to
bring a diaper bag each day.
It is expected that your child is respectful of provider’s personal property and furnishings. A certain amount of "wear and tear" is normal, but if your child is malicious upon breaking or damaging any item, provider will expect reimbursement in full for the replacement cost of a like or identical item within one month.
Field Trip/Transportation
Part of Busy
Bees child care program activities include going on walks, going to the park
(maybe off base), play group, or to the library, post office, fire station,
bowling alley. A note may be left on
the door letting parents know where we have gone. Occasionally daily errands and transporting to and from school
are considered normal childcare activities.
Parents must
understand that if they choose not to have their child transported in a
vehicle, than they will be required to find back up care and pay both the
provider and the back up.
_______________ yes/no
You will be
asked to fill out a Field Trip Permission Slip for any outing in addition to
those listed above. By signing this
contract, you are giving me permission to transport your child(ren) in my
vehicle while he/she is in my care.
Preschool Curriculum
Here at Busy Bees child care home each child ages two to five years are
included in a preschool curriculum that is provided to him/or her by the
provider. The curriculum used is either Kapers for Kids or Star-Bright learning program or I will use my own curriculum that I have
collected from many different training’s over the last seven years. The curriculum will promote growth in all of
the skill areas with a wide variety of activities in music, science, creative
art, language, movement and more. The
program includes learning experiences in social skills; cognitive powers; large
muscle and fine motor development; coordination and sequencing; and recognition
of colors, shapes, numbers and letters.
The program is new and different each year, to keep your child
interested and enthusiastic. Many of
the activities include take home materials designed to include you in your child's
day-to day experiences. When I use the
Kapers or Star Brite program (which I have to pay for each month) your child
will bring home a "Parent Letter" explaining the creative teaching
themes and special days for the month.
There will be some weeks that your child brings home papers every day,
But there will also be weeks that your child does not bring home any papers, it
will all depend on the activities that we are doing. Just because you are not seeing any thing in the way of papers
does not mean that we have not been busy all day. Alot of our learning is done hands on with things like magnets,
puzzles, books, etc…
a) That the
parent is the biological or legally adoptive parent, legal guardian, or
custodian of the child(ren) whose care is the subject of this contract, or is
otherwise authorized to enter into this contract for the care of the child(ren)
named herein.
b) That the
provider may, at anytime, transport the child(ren) in the providers vehicle, strollers,
wagons, or on walks, and to lend provider with an approved car seat for such
purposes, if requested.
c) That the
provider shall not be liable for any damages arising from personal injuries
sustained while participating in child care activities in or about the
providers premises and, intending to be legally bound, parent waives, releases,
and forever discharges provider from any claims against provider, personal
representatives, heirs, and assigns, for damages or injuries sustained by the
child(ren) while participating in, or attending any child care activities of
providers or while being transported by the provider.
d) That in the
event of a default or breech of this contract by the parent(s), to pay
provider, in addition to all sums determined to be due all cost of enforcement,
or collection, including but not limited to reasonable attorneys fees, court
cost, and other expenses of litigation.
e) That the
terms and conditions of the contract shall be binding upon the parent(s),
his/her personal representatives, heirs and assigns.
f) That the
parent(s) understand and agrees to allow their child(ren) 18 months or older to
be placed on a mat for nap or overnight sleep.
g) That the
parent(s) give permission for the provider to photograph child(ren) and also
show and/or give the photographs to other parents, for public display, or other
promotional purpose.
h) That the
childcare position will be considered open and available until the following
criteria have been met: A signed contract by both parents and indicating a
starting date, and payment to include registration and first two weeks
payment. Positions will not be held for
more than two weeks beyond the signed contract date. No money will be refunded in case of default by parent(s)
I) That
parent(s) will give Busy bees Child care home a two week written notice before
removing their child(ren) from care. If
a two-week notice is not given the parent(s) will pay the provider two weeks at
full time care.
j) And if the
provider gives the parent(s) notice and the parent(s) choose to leave care
prior to the notice, they will still be bound by the contracts two week written
notice policy.
This (11-page) contract shall be construed in accordance with and otherwise governed by the laws of the State of Colorado and the United States Air Force. Should any provision of this contract be found, held, or deemed unenforceable, or void, as contrary to law or public policy, under the laws of the State of Colorado or any other state of the United States, which may be interpreting this contract, the parties intend that the remaining provisions of this contract shall continue in full force and be binding upon the parties.
Entire Contract
This contract contains the entire understanding between the parties and supersedes any prior understandings and/or written or oral contracts between them. Any and all written or oral contracts previously made by and between any of the parties are hereby merged in this writing. Any contract hereafter made shall not change, modify, terminate, or discharge this contract, in whole or part, unless such agreement is in writing and signed by both parties here. There are no representations, agreements, arrangements, or understandings, oral or written, between and among the parties relating to this contract and the subject matter hereof, which are not fully expressed herein.
Your fee is: ________________ Regular Hours
Drop off time is: ____________ and your pick up time will be:
___________
Your fee is: ________________ Shift Work
Drop off time is: ____________ and your pick up time will be:
___________
Parent agrees to call the provider in the event that there might be a
need for late pick up. _________________________________________________
Parent also understands that I might not always be able to care for
your child late due to training’s. ____________________ Date ______________
The parties below have executed this contract on_____________________
Clause
Parents
understand that if they choose to leave this child care home in the first 90
days of signing this contract, the provider will back rate the extra dollars
the parents saved by paying on a yearly basis and charge the parents the
following rate. $8.00 for under 2 ½ and
$6.00 for over 2 ½ for each week the contract was effective. The provider will also need a two-week
notice and if the parent chooses to leave without giving a two-week notice, the
provider will also charge the parent two weeks of full time care on a weekly
basis.
Parent(s) have
read the above statement and agree to the conditions.
_____________________________________ Date_________________
_____________________________________ Date_________________
BY SIGNING THIS CONTRACT YOU STATE YOUR AGREEMENT TO THE INFORMATION CONTAINED HEREIN. HAVE ACKNOWLEDGED RECEIVING A COPY OF THE 11- PAGE CONTRACT, YOU HAVE READ AND FULLY UNDERSTAND ITS PROVISIONS AND AGREE TO ABIDE BY THE CONTENTS THEREIN. ALSO, IN THE EVENT THAT I FAIL TO PAY CHILD CARE SERVICES, AND I AM TURNED OVER TO A COLLECTION AGENCY FOR NON-PAYMENT OF SUCH SERVICES, OR OTHER VIOLATIONS OF THIS CONTRACT, I UNDERSTAND THAT THE PROVIDER WILL ACCRUE, AND I AGREE TO PAY, INTEREST ON THE UNPAID BALANCE OF THIS ACCOUNT AT THE RATE OF 1.5% PER MONTH (18% ANNUAL RATE). IN THE EVENT THIS ACCOUNT BECOMES DELINQUENT, I AGREE TO PAY ANY AND ALL COSTS OF COLLECTION AS STATED IN THE PARENTS REPRESENTATIONS AND COVENANTS.
__________________________ _______________________
Shelley Emig
Signature of Sponsor
Busy Bees Family Child Care
USAFA, Colorado 80840 ______________________
Signature of parent
* Provider requires that the
Sponsor/Parent have this contract notarized by the base legal
Office prior to accepting your child(ren) to care.
State of Colorado
County of El Paso
I,_________________________________, a
Notary Public in and for the County and State
Aforesaid, do hereby certify that on
______________day of___________,19______,
Before me personally
appeared_________________________________________________
In Witness Whereof, I have hereunto set
my hand and official seal this day and year above.
My commission Expires:
______________________________________
Notary Public