Children’s Cottage Child Care Monthly ACH Debits

 Use Automatic Payments and Never Write a Check Again!


Provide the following information on the checking account you want to use for tuition payments


Bank: _____________   9 Digit Routing # __ __ __ __ __ __ __ __ __   Acct # __________________

 (You can also give us a voided check and we will fill in the Routing and Account numbers for you)


Debit tuition once a month on the (pick one)     ___ 1st of each month      OR     ___ 5th of each month




Debit tuition twice a month on the (pick one)      ___ 1st & 15th of month     ___ 5th & 20th of month


Please provide your email so you receive detailed monthly statements in advance


Primary Person Name __________________________ Email:  _________________________________


Secondary (Optional)  __________________________ Email: _________________________________

Images of the Children

We put pictures/videos of the children, teachers, or parents on our Website or Facebook Page.

Most parents love this because it gives them a chance to share pictures with family and friends.

If a parent or guardian does not want images of their child on our website or Facebook page,  

please give us a written note stating your wishes so that we may place it in your child’s folder.

Behavior Conduct Contract

I have read and understand the Behavior Conduct Contract in the Parent Handbook and agree to abide by its content

Teachers Performing Outside Work

If a Children’s Cottage employee performs work or services beyond their employment hours

for a parent or guardian, client or non-client of Children’s Cottage, it is understood and agreed

that the employee does not represent Children’s Cottage in doing this work or performing

these services and that Children’s Cottage is in no way responsible or liable for this work,

service, or the actions or behavior of the employee.  This includes babysitting, etc.

Parent/Guardian Signature_______________________ Date________