with date of birth: __________________ (Hereafter refered to as “I”, “me” or “my”), for good and valuable consideration, understand and agree to the following terms
and conditions (the “Agreement”) relating to the au pair’s participation in Cultural Care Au Pair au pair program (the “Program”).
1. In addition to the terms of this Agreement, I agree to abide by additional reasonable terms and conditions stipulated by CC during the Program, including
the Extension program. If there is any confusion between this Agreement and the terms of any other contracts, agreements, or materials of any kind, the terms
of this Agreement shall prevail.
2. I acknowledge that any materials I submit to Cultural Care will be used to make a suitable host family match for me and therefore agree that any submitted
materials may be disclosed to prospective host families during the selection process, including my submitted medical forms.
3. I agree to comply with the Program regulations issued by the United States Department of State (22 CFR Part 62) (“Regulations”). I acknowledge receipt of
a copy of the Regulations as they apply to me. I also understand that I must comply with CC’s rules as outlined in this Agreement, the Au Pair Handbooks
and other materials that CC has supplied to me. This includes staying within the legal number of working hours per day and week without exception. This
also includes participation in all child safety and child development training and orientation sessions sponsored by CC. I will inform my Local Childcare
Coordinator or CC if I encounter anything that does not comply with the Program regulations as outlined by the U.S. Department of State Regulations.
4. I agree to perform the child care responsibilities as outlined by CC and my host family to the best of my ability. I understand that providing childcare is
my primary obligation in this Program and that any personal plans or activities will take secondary priority to caring for my host children. Should I be
found to act in a way that puts my host children at risk or is inappropriate in any way, I understand that I will be removed from the Program immediately.
I understand that my host family may ask me to respect a curfew and/or assign other reasonable restrictions designed to protect the safety and well-being
of my host children. I agree to abide by such reasonable restrictions. I also understand that I may not post photos or personal information about my host
family, host children, or host home on any web site, blog or the like without the express written consent of my host parents.
5. During my participation in the Program I will abide by all local, state and federal laws and other regulations. I understand that breaking these laws (such as
shoplifting, driving under the influence of alcohol, drinking alcohol under the age of 21, possession, or use of illegal substances, etc.) shall be grounds for my
immediate dismissal from the program and my return flight will be forfeited.
6. I understand that I may not use the family’s automobile(s) for any reason without express permission from the host family and that any agreement to use the
host family’s automobile is strictly between the host family and me. I will not use the automobile unless the host family has obtained all of the mandatory
automobile insurance coverage required under the laws of the state where the host family resides. I understand that if I have a car accident while using the car
for personal use not related to my child care duties that I will be required to pay a deductible up to $500 US.
7. I agree to pay any personal expenses I incur while participating in the Program, including but not limited to, health expenses not covered by insurance, phone
bills and/or car damages. CC is not responsible for any financial disputes I have with my host family such as outstanding money for educational component,
weekly stipend, etc. I understand that I must settle all disputes directly with my host family prior to my departure from their home.
8. I understand that my Local Childcare Coordinator and the Cultural Care staff in the U.S. are my primary contacts during the Program, and are responsible for
ensuring a positive and successful program year for me and my host family. I will notify the staff of CC in the U.S. in case of disagreement, misunderstanding
or serious problems including but not limited to my health, safety, welfare, adjustment to my host family, school, culture or language, or misunderstandings or
problems with my host family. I acknowledge that CC is solely responsible for choosing appropriate host families for me and I will not make attempts to obtain
placements on my own after my arrival in the U.S. In situations where I am having problems with my host family, I agree to consult with and meet with my
Local Childcare Coordinator and to follow CC’s mediation guidelines as outlined in the Au Pair Handbook. I understand that it is CC’s policy to try to resolve
issues in the existing placement if possible before considering a new placement.
9. If CC determines that my placement within the host family will not continue, CC shall determine whether or not to pursue a new host family match for me.
I understand that CC may not pursue a new host family for me due to safety concerns, a lack of positive recommendations or for other reasons relating to
my suitability on the Program. I acknowledge that CC has sole discretion to pursue a new placement or not. Should CC decide to pursue a new placement,
I understand that CC will use reasonable efforts for two weeks to find another host family for me. During such time, I shall continue to live with my current
host family who, in its discretion, may request me to provide, or not to provide, any childcare services and I shall remain reachable by phone/email with CC
at all times. If I do not perform childcare duties during the transition period (even if I am staying with a host family) I understand that I will not receive the
weekly stipend. CC will make every effort to match me with appropriate host families. Should I reject these host families for reasons of geographical region,
car/computer use or other non-essential reasons I understand that CC may opt to discontinue a search for replacement. I understand that CC cannot guarantee
a new family placement for me within the two-week transition period and inability to be replaced will result in my early return to my home country. Notwithstanding
the above, I further understand that the first month of any placement is a period of adjustment and therefore CC will not process any non-emergency
transitions during this period.
10. I understand that CC has the exclusive right to determine my suitability for acceptance and for my continued participation in the Program. I understand that
if CC determines that my emotional or physical state does not make me suitable for providing quality childcare, I will be removed from the Program. I also
Cultural Care (registered business name of International Care, Ltd.), with registration number CH-1003.023.491-6, having its registered address at
Haldenstrasse 4, 6006 Lucerne, Switzerland, together with its successors and assignees (“CC”), and the undersigned au pair,
Agreement
Au Pair reference number
(Please print full au pair name)
Au pair signature
Legal guardian signature
Date
Date
Au pair name printed
Legal guardian name printed
understand that should I marry or become pregnant while on the Program I will also be removed from the Program. If my performance as an au pair and/
or participation in the program is deemed unsatisfactory by CC for whatever reason, CC will reassess my suitability for future placement. I understand that
I may be terminated from the Program if I do not successfully complete the Program requirements and uphold Program expectations for reasons including,
but not limited to, the following: leaving the host family without prior consent from CC; engaging in behavior that CC deems inappropriate during the
Program duration, performance reasons including but not limited to breaking host family rules, neglectful or inappropriate behavior towards the children,
etc.; non-participation in training, not fulfilling educational credit, non-attendance at monthly meetings, or if I in any way violate this Agreement. I further
understand that should it be discovered that I have falsified or withheld critical information from my application materials including, but not limited to,
health conditions, criminal history, educational documentation, childcare experience, etc. I may be terminated from the Program. Should I be terminated
from the Program because of my actions including, but not limited to, those outlined above, I forfeit my return to my home country and must pay for this
flight on my own.
11. I understand that the Program is designated as a full year program with the possibility to extend for a further six (6), nine (9) or twelve (12) months. I confirm
receiving information about the optional Extended Insurance coverage, including a copy of the general conditions booklet. If I extend after my first program
year, I will be contacted regarding the activation of Extended Insurance coverage for my extension term under a new policy. Should I voluntarily decide to
return home before the regular end date of my program (including extension period) I understand that my flight will not be paid for by CC. The exception
to this will be in cases of my own extreme illness or the extreme illness or a death in my immediate family. Should I terminate or be terminated from the
Program for any reason as outlined in this agreement, such termination will result in the following:
a) I will forfeit the return ticket and I will be required to make my own arrangements to return to my home country at my own expense; and b) My CC
insurance coverage will no longer be valid and no part of it refunded other than the additional month optional insurance; and