Amber's Home Daycare Contract

This arrangement is betweenAmber Kesler (Provider)

1904 Karen Ct. #5
Champaign, IL 61822

Phone Number- 217-778-1250

E-mail- amberslittlemonkeys@yahoo.com

and The Family

Mother's Name- _____________________________________________
Phone Number- _____________________________________________
E-mail Address-______________________________________________
Father's Name-_______________________________________________
Phone Number- ______________________________________________
E-mail Address-______________________________________________
Child(ren)'s names
and Birthdays

-__________________________________________
-__________________________________________
-__________________________________________

Care Schedule
The child(ren) will be dropped off and picked up according to the following schedule:
Monday
Tuesday
Wednesday Thursday
Friday
Saturday
____ am
____ am
____am
____am
____am
____am/pm
____pm
____pm
____pm
____pm
____pm
____pm
Fee Structure
The Family agrees to pay $___________ per week/day for care of the child(ren) listed above. This
is a guaranteed rate and includes full pay for holidays, with no credit for absent days. Payment is due on
Monday morning for the coming week. (See Policies)
A holding fee of $___________ is due at time of signing, for spots being kept for more than 1
month. (See Policies)
Contract Changes and Renewal
Two weeks notice will be given by the Provider prior to any changes in this contract. This
agreement will be reviewed at the beginning of every CONTRACT year. Keep this copy of the contract for
your records.
Agreement
I have received and read a copy of the CONTRACT and POLICIES. By signing this agreement, I
agree to comply with all the terms of the CONTRACT and the POLICIES.
Signature of Parent/Guardian-________________________________________ Date-_____________
Signature of Parent/Guardian-________________________________________ Date-_____________
Signature of Provider- ______________________________________________ Date-_____________