Live-In Caregiver Contract - Children (Canada)

Agreement between a parent and a live-in caregiver to provide live-in caregiver services to a child or children.

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Agreement between a parent and a live-in caregiver to provide live-in caregiver services to a child or children.

Among others, this form includes the following provisions:

-Employer and Caregiver Information
-Duties and Responsibilities
-Duration, Wages, and Benefits
-Accommodation

This form includes special formatting features to assist you in completing the agreement.

This form can be used in the following provinces: Alberta, British Columbia, Manitoba, New Brunswick, Newfoundland and Labrador, Northwest Territories, Nova Scotia, Nunavut, Ontario, Prince Edward Island, Saskatchewan and Yukon.
This is the content of the form and is provided for your convenience. It is not necessarily what the actual form looks like and does not include the information, instructions and other materials that come with the form you would purchase. An actual sample can also be viewed by clicking on the "Sample Form" near the top left of this page.
Live-In Caretaker Contract
(Children)
 

 

Live-in Caregiver Contract   (Children)
Employer and Caregiver Information
Employer Name
Caregiver Name
     
     
Employer Address
Caregiver Address
     
     
Employer Telephone (Home)
Employer Telephone (Work)
 
 
     
     
 
 
Duties and Responsibilities
Address of house at which Caregiving Services provided
Description of Household (no. of rooms, members, etc.)
     
     
Number of Children:      
Age(s) of Children:      
Care Responsibilities/Duties (Describe)
     
Housekeeping Responsibilities/Duties (Describe if applicable, including Pet Care if applicable)
     
Duration, Wages and Benefits
Gross Wages
Frequency of Pay
Employment Start Date
Duration of employment
$      per
 
     
      
Hours of Work
Overtime Rate
Vacation
Sick Leave
      hours per week
$      per hour paid after       hours/week
      weeks with pay per year
      paid sick days per year
Schedule of Hours (list)
Days Off (provide details)
Paid General Holidays
Other Holidays (list any)
     
      days per week
 Statutory Holidays
     
Other Leave (describe)
Medical Coverage (describe)
Other Benefits (describe)
Airfare Included?
     
     
     
 No
 Yes (details)
 
 
 
     
Accommodation
Room and Board Included?
Cost per Week
Furnished Private Room
Locked Room?
Private Bath?
 Yes
 No
$     
 Yes
 No
 Yes
 No
 Yes
 No
General Terms
The Employer hires the Caregiver as a Live-in Caregiver in accordance with the terms and conditions of this Contract.
The Employer agrees to (i) pay the Caregiver the wages and other benefits outlined above, (ii) provide the accommodation outlined above, (iii) abide by applicable Provincial labour standards, (iv) provide the employee with information regarding wages and types and approximate amounts of deductions from pay, and (v) provide a Record of Employment on termination of employment.
The Caregiver agrees to provide the Live-In Caregiver services in accordance with the duties and responsibilities outlined above.
The Employer certifies that the wages and working conditions reflect applicable provincial employment standards and prevailing wage rates.
The Caregiver acknowledges that income tax deductions will be taken at source, and that contributions will be made by the Employer to Canada/Quebec Pension Plan and to Employment Insurance.
The Employer and the Caregiver agree to abide by all applicable Provincial labour standards regarding written notice of termination of employment.
Amendments to this contract must be made in writing and agreed to by both parties.
Signature of Employer
Signature of Caregiver
I have read this agreement, understand it, and agree to it
I have read this agreement, understand it, and agree to it
x      
x      
     Employer Signature
     Caregiver Signature
     Date:
     Date:
 
Number of Pages3
DimensionsDesigned for Letter Size (8.5" x 11")
EditableYes (.doc, .wpd and .rtf)
UsageUnlimited number of prints
Product number#29192
This is the content of the form and is provided for your convenience. It is not necessarily what the actual form looks like and does not include the information, instructions and other materials that come with the form you would purchase. An actual sample can also be viewed by clicking on the "Sample Form" near the top left of this page.
Live-In Caretaker Contract
(Children)
 

 

Live-in Caregiver Contract   (Children)
Employer and Caregiver Information
Employer Name
Caregiver Name
     
     
Employer Address
Caregiver Address
     
     
Employer Telephone (Home)
Employer Telephone (Work)
 
 
     
     
 
 
Duties and Responsibilities
Address of house at which Caregiving Services provided
Description of Household (no. of rooms, members, etc.)
     
     
Number of Children:      
Age(s) of Children:      
Care Responsibilities/Duties (Describe)
     
Housekeeping Responsibilities/Duties (Describe if applicable, including Pet Care if applicable)
     
Duration, Wages and Benefits
Gross Wages
Frequency of Pay
Employment Start Date
Duration of employment
$      per
 
     
      
Hours of Work
Overtime Rate
Vacation
Sick Leave
      hours per week
$      per hour paid after       hours/week
      weeks with pay per year
      paid sick days per year
Schedule of Hours (list)
Days Off (provide details)
Paid General Holidays
Other Holidays (list any)
     
      days per week
 Statutory Holidays
     
Other Leave (describe)
Medical Coverage (describe)
Other Benefits (describe)
Airfare Included?
     
     
     
 No
 Yes (details)
 
 
 
     
Accommodation
Room and Board Included?
Cost per Week
Furnished Private Room
Locked Room?
Private Bath?
 Yes
 No
$     
 Yes
 No
 Yes
 No
 Yes
 No
General Terms
The Employer hires the Caregiver as a Live-in Caregiver in accordance with the terms and conditions of this Contract.
The Employer agrees to (i) pay the Caregiver the wages and other benefits outlined above, (ii) provide the accommodation outlined above, (iii) abide by applicable Provincial labour standards, (iv) provide the employee with information regarding wages and types and approximate amounts of deductions from pay, and (v) provide a Record of Employment on termination of employment.
The Caregiver agrees to provide the Live-In Caregiver services in accordance with the duties and responsibilities outlined above.
The Employer certifies that the wages and working conditions reflect applicable provincial employment standards and prevailing wage rates.
The Caregiver acknowledges that income tax deductions will be taken at source, and that contributions will be made by the Employer to Canada/Quebec Pension Plan and to Employment Insurance.
The Employer and the Caregiver agree to abide by all applicable Provincial labour standards regarding written notice of termination of employment.
Amendments to this contract must be made in writing and agreed to by both parties.
Signature of Employer
Signature of Caregiver
I have read this agreement, understand it, and agree to it
I have read this agreement, understand it, and agree to it
x      
x      
     Employer Signature
     Caregiver Signature
     Date:
     Date:
 

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