Sue’s Home Away From Home       

                     Acceptance Form

This is to confirm that your child, _______________

Has been accepted for care by the provider Sue Conant. A spot will be reserved until the first day of care which will begin on

____________.

An enrollment fee of $____________ has been received.  When your child begins care, the enrollment fee will be applied towards the first week of care.  Your enrollment fee will be forfeited in the event that your child is not placed in the child care by the date listed above.

I/We have read and understand the above arraignment.

Signature of parent ________________

Date_______________

Signature of parent ________________

Date_______________

Signature of provider________________

Date_______________