Champion Kidz Financial Agreement for Services
(CCDF or Government Agency Assistance Program)
Child(ren) Name(s):
Enrollment Date:
Parent(s)/Guardian Name: Phone:
Address: City:Zip:
Driver’s License Number: State Issuing:
**If no driver’s license, a social security number must be listed:
Terms:
•
Your weekly assistance voucher tuition rate is $ for
attendance on the following days:
Monday
Tuesday
Wednesday Thursday Friday
•
Your weekly co-payment/difference amount is $to paid by
Monday of each week.
•
Swipes are to be completed daily. NO EXCEPTION!
•
If for some reason you loose your voucher you will have the same financial
obligation as an out of pocket paying family with the current rate of your voucher.
•
If you are contracted for specific days or hours, you MAY NOT CHANGE YOUR
DAYS.
•
We WILL NOT allow your card to cover other children or payment for services
not rendered.
•
Your co-payment is due on Friday by 6:30 p.m., for the following week of care. If
you do not pay on Friday you will be given a waiver to pay by Monday 12:00pm.
After this there will be a $25.00 fee assessed to your account and you will not be
able to receive our childcare the following day until your balance is paid in full.
•
If you are not paying your co-payments as authorized we will contact the CCDF
office and you will not be allowed to bring your child(ren).
•
There is NO CHANGE in your obligation to swipe due to your child(ren)’s
absence-use a personal days. If you do not have any personal days you will be
required to pay for the day of care missed.
•
Co-payments can be made using CASH, CHECK (made payable to CHAMPION
KIDZ CHILDCARE) or MONEY ORDER.
•
Should it be necessary, the parent /guardian will be responsible for any court
costs involving collection of tuition.
Fees:
•
Returned Check Fee: Any returned checks will cost you $25.00, and in addition
to each late fee a $5.00 per day charge will be assessed until all balances are
Champion Kidz Financial Agreement for Services
(CCDF or Government Agency Assistance Program)
current. If a family has more than 2 returned checks in a 12-month period, you
will be required to pay by cash or money order only.
•
Late payment schedule: Payments are due every Friday for the following week of
care. If not paid by Friday there will be an additional $25.00 late fee charged for
late payments made after 12:00pm Monday. Your child will not be able to attend
in the future until the account balance has been made current regardless of
reasons for delayed payment.
•
Late Pick- Up Fee: Care is provided during the hours of 6:00 am to 6:30pm. A
Late Pick- up Fee of $20.00 between 6:30-6:45 p.m, and $5.00 within every 5
min. increment after 6:45 p.m. The time is based off of the Clock at the
childcare. If your child(ren) are not picked up by 7:00 pm and Champion Kidz
has not received a phone call, steps will be taken to call the parent/guardian’s
emergency contact people to have them pick up your child immediately. If no
one can be reached, the Child Protective Services will be contacted.
•
If childcare funds are to be paid for childcare from the government are not paid
you are obligated and understand you will be obligated to pay. You also
understand you must pay all court cost incurred for the demand of owed money
to the childcare. It is up to you to follow-up with your paying agency for your
childcare expenses to be covered when informed your voucher is no longer
active.
•
Any court ordered financial obligations between two parties is to be handled
among the two parties. We will not accept partial payments from one paying
party. We will only accept money given in one full sum and one receipt will be
given to the parent on our financial contract.
•
We will not accept partial payments to avoid late payments or penalties. All
money will be due and late payment fees will continue to accrue until all balances
have been paid in full.
•
Sick Pick Up Fee: Parents who are called to pick up their sick child have one (1)
hour from the time you are contacted by Champion Kidz Childcare to make
arrangements to have your child picked up. A fee of $10.00 per 15 minutes will
be accessed to your account if your sick child is not picked up from the daycare
after the 1 hour time has been reached.
Personal Days Holidays/Sick Days/ Closings:
• There is NO CHANGE in tuition co-payment due to your child’s absence. Tuition
is prepaid groceries and supplies have already been purchased for the week and a
credit on your account cannot be given. In child absent swipe your card for a personal day.
