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________