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CC-208 (5-11) ARIZONA DEPARTMENT OF ECONOMIC SECURITY Child Care Administration PROVIDER/PARENT/GUARDIAN’S AGREEMENT FOR CHILD CARE CHARGES C h i l d

C a r e

C h a r g e s

I n f o r m a t i o n DISTRIBUTION: Original (white) - for provider; Copy (canary) – for parent/guardian See reverse for EOE/ADA/LEP/GINA disclosures CC-208 (5-11) – Page 47 Arizona Department of Economic Security