(to be filled out yearly)



Please initial each line below to verify your understanding and are in agreement of each item. WE UNDERSTAND…

  1. ___________I/We have read and understand to look at the CALENDAR on the sign in book AND in the handbook for upcoming events and have BACK UP CARE planned ahead of time. Please post the holidays/vacation sheet in a place that remind you of closures.

  2. ___________I/We have read and understand each section of the handbook and I/we agree to comply with all the information including the following categories:  



  • ­­___________OPEN DOOR POLICY                    

  • ___________DROP OFF & PICK UP LOCATION 

  • ___________CONTACTING ME                        

  • ___________HOURS OF CARE                         

  • ___________MEALS & NUTRITION                  

  • ___________SAMPLE MENU                            

  • ___________SAMPLE SCHEDULE                    


  • ___________OPEN COMMUNICATION               

  • ___________CHILDREN’S RECORDS               

  • ___________PETS                                            

  • ___________NON-SMOKING & PERFUMES      

  • ___________STAFFING                                    

  • ___________SECURITY                                   

  • ___________CHILD ABUSE      

  • ___________CELEBRATIONS & PARTIES & RELIGIOUS ACTIVITIES & VALUES                           

  • ___________REST TIME                                  


  • ___________BABIES SCHEDULES                   

  • ___________FEEDING BABIES 

  • ___________DIAPERING                                  

  • ___________POTTY TRAINING                        

  • ___________ABSENCES  & LATE ARRIVALS   

  • ___________LATE PICK UP & EARLY PICK UP 

  • ___________DRIVE SLOWLY                           

  • ___________CLOSURES                                  

  • ___________SICK POLICY       

  • ___________MEDICATION                              

  • ___________MEDICAL EMERGENCIES            

  • ___________DONATIONS                                

  • ___________HOLDING SPOTS                            

  • ___________TUITION                                      

  • ___________DSHS FAMILIES

  • ___________PROPER  CLOTHING

  • ___________SPECIAL NEEDS                             

  • ___________RULES OF THE HOUSE                 

  • ___________DISCIPLINE PROCEDURES           


  • ___________POLICY CHANGES                        


  • ___________PERSONAL REFFERENCES           


  • ___________CALENDAR OF EVENTS               

  • ___________TELL ME ABOUT YOUR CHILD    

  • ___________CHILDCARE CONTRACT (4 pages) 





  1. __________I/We have read and understand and agree to bring up any concerns to me. OPEN COMMUNICATION between you and me is a MUST! Therefore, if you ever have any questions please feel free to call or email me before you bring a complaint to anyone else. Respectful conversations are much easier than having a concern fester. THANK YOU!

  2. ___________I/We have read and understand the SICK POLICY

  3. ___________I/We have read and understand the LATE PICK UP FEE a minimum fee of $20 per child is due plus an additional $1 per min per child

  4. ___________I/We have read and understand I need to give 30 DAY/4 WEEK NOTICE to withdraw from childcare.

  5. ___________ I/We have read and understand that Patti’s Pre-School & Childcare does not carry liability INSURANCE

  6. ___________ I/We have read and understand and I/We give permission for Patti Julagay to SPEAK WITH MY CHILD’S TEACHER or school. On occasion it is necessary to speak with your child’s teacher if there is a concern. This is for the purpose of helping your child succeed so that if any special services are needed that the school district can be involved in the process. Early care for concerns is in the best interest for your child’s future.

  7. ___________I/We have read and understand NO PARKING ON GRASS IN ALLEY: Please do not park on the grass by the fence, the grass can be fragile and if parked on or stepped on when the weather is bad. It kills the grass and it looks bad and takes months to repair

  8. ___________I/We have read and understand TUITION is due in the morning at drop off on the last business day of the month, late fees are charged after that.   

  9. ___________ SUNSCREEN CONSENT: (for ages 6 months and up) Parents need to provide an spf of at least 25+ and PABA free. My child may have sunscreen applied to exposed skin areas before going outside.

  10. ___________ HAND SANITIZER CONSENT: (for ages 6 months and up) My child may use hand sanitizer at Patti’s Childcare to help prevent the spread of illness.

  11. ___________ TRANSPORTATION AGREEMENT: There are rare occasions when it is necessary to be in the car. I authorize PATTI JULAGAY, to provide suitable transportation for my child, ­­­­­­­____________________  as needed. Reasons may taking kids be to and from school, medical appointments, emergency errands, a trip to the park in the summertime or other reasonable trips. I understand that my child will be buckled up in the age/weight appropriate safety device at all times in the vehicle. This permission is granted on condition that the provider complies with the provision of WAC 388-155-165 Transportation. I authorize, PATTI JULAGAY, to take my child on walks, take photographs of my child used for scrapbooks, decorating of childcare room, to be in provider’s file and car in case of an emergency, and for family craft items.

  12. ___________ LIABILITY RELEASE AND CONSENT: I/We the parents of _________________________  give permission consent for my/our child to attend Patti’s Pre-School & Childcare and participate in all activities, and hold harmless and release Patti Julagay, and assistants, employees, volunteers from any and all liability whatsoever arising out of injury, sickness, or damage which may be sustained while in attendance which is over and above what your insurance coverage has or will compensate for.



Print & Signature of Mother/Guardian                    Date                        Print & Signature of Father/Guardian                     Date       

Print & Signature of Mother/Guardian                    Date                        Print & Signature of Father/Guardian                     Date