Week Of: _______________________________________ Number Of Children: __________________ Mon: ____________ to ___________________ Tues: ___________ to ___________________ Wed: ______________to __________________ Thurs: ____________ to __________________ Fri: _____________ to __________________ Sat: _____________ to _________________ Sun: ____________ to __________________ Diapers: $ 5.00 per week for 2 1/2 years and older  _____________ Potty Training: $ 10.00 per week _________________ Total Days/Nights ________________ Total Children _________________ Total Payment Parents Signature ___________________