Sample Contract and Forms


These are pretty standard forms to give you an idea of what type of things you should include in a real contract. You may copy these and edit them as you like.


Sample Application

A $20.00 nonrefundable deposit per family per year is requested to hold your place. This $20.00 assures you that your place will be saved!!! Please complete all forms and return with your deposit. By returning your application and signing all the designated forms, you are hereby agreeing to all the terms stated within this booklet. I reserve the right to make changes to this contract at any time necessary.

Child’s Date of Birth ____________________________________

Child’s Name:____________________________________________

Preferred Start Date_____________________________________________

Parent/Guardian Name___________________________________________


City, State, Zip Code_____________________________________________

Home Phone_____________________________________________

Work Phone______________________________________________

Cell Phone______________________________________________

Choose One

full time________________ (minimum of 38 hours per week)

part time_______________(minimum of 25 hours per week)

Travel Authorization

I give permission for my child, _____________________________________ age_________, to leave Name of Daycare for travel in a car, or public transportation for any reason. Conditions under which children are transported are trips to parks, zoos, play centers, shopping and a variety of locations to stimulate children and let them get out of the house too. And of course, emergency situations.

I give permission for my child, _____________________________________ age_________, to walk to and/or participate in activities geared for my child but away from Name of Daycare under the supervision of Provider Name or any authorized employees of Name of Daycare.

Name of Daycare will inform me in advance of field trips beyond the immediate neighborhood. (This does not include the park which where we plan to go a great deal this summer. I will let you know those mornings that we are going to the park if possible.)

I give my permission for my school age child, ____________________________ to participate in_______________________________________away from Name of Daycare. I understand that my child WILL NOT be under supervision of Name of Daycare, or any staff member associated with Name of Daycare

______________________ _____________________________________
Date & Signature of Parent

Parental Responsibilities


1. Provide necessary information on all registration forms
2. Insure that the child’s immunizations are kept up to date, and provide the immunization information and physicians signature as required by state regulations.


1, Fees must be paid on time each Friday when you pick up your child unless prior arrangements have been made.

COMPLY WITH THE PROGRAM RULES (as specified in Parent Info Section)

1. Deliver and pick up child within times specified
2. Keep child home when displaying signs of illness
3. Arrange to get your child promptly if they become ill during daycare time
4. Notify Name of Daycare immediately if your child has a communicable disease
5. Notify Name of Daycare promptly of any changes in attendance
6. You will provide all diapers. I will provide wipes.

Tuition and Fees

Full time has a minimum of 38 hours per week. Part time has a minimum of 25 hours per week. If I take a day off in any given week, you will not be charged a minimum for the week. You will only be charged for the actual hours that you are here. However, if you also take a day off within that same week, you will be charged for 8 hours for your day if you are full time, and 5 hours if you are part time .

All of my days off, including vacations and holidays, are unpaid except for Christmas Day and Thanksgiving Day. If these two days fall on a weekday, I will be paid 8 hours of holiday pay if you are full time, and 5 hours if you are part time. I feel this is rather reasonable. I will inform you as soon as possible of days needed off, usually at least two weeks if possible, and at least one month in advance for vacations. I will also assist you in finding alternate child care. I have set up an alternate for these occasions who is also a licensed provider.

Families with more than one child enrolled will qualify for a 10% discount for the oldest child, and a 5% discount for each additional child.

I require a two week written notice in advance of your vacations. You are allowed five days of unpaid vacation per year if you are full time, and three for part time. This means that you may take five or three separate days off, or all at once, that you will not have to pay for or will not count for your weekly minimum. I prefer, however, that you take it all at once. You may also take three sick days for full time and one sick day for part time per calendar year with no notice.

After a two week trial period, I must have a two week written notice, or two weeks of your minimum weekly amount upon leaving Name of Daycare.

If you are more than 1/2 hour late to pick up your child and you have failed to inform me in the morning when you bring your child to daycare, you will be billed an extra five dollars per half hour. And please, don’t tell me you’ll be late, ask if it is ok. If you fail to pick your child up by 6:00pm and you have failed to inform me in advance, your child will be fed supper and you will be charged an additional $2.50

Parent Information
Welcome to Tiny Tot Daycare. The following will provide information on what to expect from me, what I can expect from you and your child, and how we can work together to make this a comfortable, fun, safe, learning environment for your child.

About Me
Include some information about yourself, your family your background, and your reasons for starting a home daycare.

I am a licensed provider in name of county and I will comply with all the standards put forth by the State of ______ and _____ county. I will be licensed to provide care for __children. I would like to keep a smaller group so more individual attention can be focused on each child. I am hoping to have six children including my own.

Children who are over six weeks old to one year qualify as infants. 12 months to 2 1/2 years are toddlers. 2 1/2 years to kindergarten are pre schoolers. (See tuition and fees sheet for rate information) I am allowed 3 children under 2 1/2 years, with two of those being infants, three more children under kindergarten age and the option of four more above school age. At this point, I would like to start it out small. I cannot guarantee that it will stay that way, but , I will see how it goes for now.

Health Information
Each child is required by state regulations to have on file a health statement, which includes a record of up-to-date immunizations and the signature of the child’s source of medical care. If a child’s health care summary is not complete at the time of enrollment or within thirty days after enrollment, the parents will be asked to withdraw their child from Name of Daycare until such time as the required documentation is complete. Each child who has not had a physical within the last year must have one before child care can be provided. This physical may be done by a doctor or a public health nurse. I must have on file a signed form authorizing emergency care. Emergency numbers for reaching parents or guardian and another authorized person must also be on file. No child who arrives at Name of Daycare noticeably ill, with a rash, or with a fever will be admitted for the day. Should your child become ill during the day, you will be notified immediately. I will try to keep your child separated from the other children until a parent or authorized person comes to pick them up. In the event a child contracts a communicable disease and exposes the other children, notice of such exposure will be posted, and parents will be notified when they pick up their children. The ill child will not be allowed to return to Name of Daycare until the period of contagion has passed. In case of medical emergency first aid will be administered. The parent or authorized adult will be notified as quickly as possible. If medical attention is required, I will call the local ambulance service, who will transport the child to the local hospital. Every effort will be made to contact the child’s own physician. Children with a contagious illness will not be allowed in daycare until properly medicated. This includes, but is not limited to : Strep, pink eye, ear infection, sinus infection (green nasal drainage) Child must be on an antibiotic for a minimum of 24 hours. Flu, if vomiting and diarrhea, make other arrangements until your child is well again. Please inform me of any medical disorders such as allergies, seizures, etc. so that I may be prepared to handle the situation.

Any damages to my home or belongings caused by your children will be paid by you. I have baby-proofed to the best of my ability, but I can only do so much.

Tell about your pets, if any, and include information about where they will be kept, if they will be around children, and their vaccine information

Field Trips
Parents will be informed of field trips in advance through newsletters and permission slips sent home for each trip. This does not include trips to the park which will be quite frequent during the summer months. If your child needs to be in a car seat or booster seat, I may ask you to provide these for field trips if necessary.

Meals and Snacks
Name of Daycare furnishes breakfast, lunch and an afternoon snack to all non-infant children, Please do not bring snacks unless you bring enough to share with everyone. These will be dispensed by the provider at the appropriate time. Food served during the day will include servings from each of the four food groups as defined by the U.S.D.A. Because of state regulations regarding the serving of food, treats you bring to share with other children must be purchased commercially, either prepackaged or from a bakery. You may bring special treats for birthdays as long as you let me know in advance as we will be celebrating all children’s birthdays here. NO GUM ALLOWED.

Name of Daycare will provide a vast array of toys to play with here. Please do not bring any toys from home as this causes jealousy and fighting among the children. A special pillow, blanket or stuffed animal may be brought for nap times if they are used to it.

Children under the age of five will take a nap after lunch. Older children will have quiet time during nap time.

Acceptable behavior is encouraged by giving positive verbal rewards. This reinforces a child’s good feeling about his/her behavior and serves as an example to the children to act in such a way as to receive this praise. Asking a child to stop and think about their behavior enables the child to work at self control. Depending on the situation, one warning is usually given and the child reminded of acceptable behavior. The next step would be a timeout. This timeout is not a punishment, but rather a time when the child may calm down, remember what behavior is acceptable, and decide when they are ready to rejoin the group with appropriate behavior. If timeouts are not effective , some sort of consequence will be imposed. This may range from a favorite toy being taken away for a period of time, to being excluded from a favorite activity. Naturally , parents will be advised. Corporal punishment is not considered to be an accepted method of dealing with young child’s behavior. Children will not be hit, slapped, or spanked in any manner while attending Name of Daycare. IF YOU ARE USING A CERTAIN METHOD AT HOME, PLEASE INFORM ME SO THAT WE CAN BE CONSISTENT.

Please inform me of your child’s favorite games, things to do, etc. Also inform me if your child has any allergies, special routines for nap time, fears, (i.e.: scared of dark, shut doors, etc.). or anything else about your child’s likes and dislikes (such as foods) that you feel would be helpful to me. I’d like to do whatever is possible to make your child’s time here more comfortable and fun. The more I know about your child, the better I can help him or her adapt to their new daycare.

Communication with Parents
You will of course be given a daily verbal report of how your child’s day was. I don’t feel it is healthy to discuss children’s problems in front of them, so either a note will be sent home, or I will call you. You will also receive a sheet each Friday which contains several things. Your weekly times for each day, your total hours for the week, your amount due, specialized sections including what we did, how behavior was, any concerns I have, and any information I need to get out to parents, and reminders of things to bring, field trips, etc. This booklet is intended to answer many of your questions. Please contact my if you have other questions. Parents are encouraged to visit Name of Daycare at any time. Because of occasional field trips and special activities, you may wish to give advance notice. If I am not free to speak with you when you come to visit, please understand that the children come first during times of operation.




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