Last updated: 19 May 2026
This is a template only. It is not legal advice. Use official country-specific forms where required. Do not use this template where a recognised sponsor, licensed agency, government form, employment contract, or visa-specific agreement is required.
1. Parties
Host Family:
Full name(s): __________________________________
Address: ______________________________________
Email: ________________________________________
Phone: ________________________________________
Au Pair Candidate:
Full name: ____________________________________
Date of birth: ________________________________
Nationality: __________________________________
Current residence: ____________________________
Email: ________________________________________
Phone: ________________________________________
2. Nature of arrangement
The parties intend a lawful au pair / cultural exchange arrangement under the laws of:
Host country: __________________________________
Region/canton/state: __________________________
Applicable visa/permit route: __________________
This agreement does not override mandatory local law.
3. Term
Start date: ___________________________________
End date: _____________________________________
Trial period, if any: __________________________
4. Visa, residence, and work permission
The arrangement will not start until all required visas, residence permits, work permissions, registrations, and sponsor approvals are obtained.
Responsible party for checking requirements: ___________________________
Required sponsor / agency, if any: ___________________________________
5. Duties
Permitted duties:
Prohibited duties:
The Au Pair Candidate will not be required to perform duties outside this agreement or outside applicable law.
6. Working hours and schedule
Maximum hours per day: _________________________
Maximum hours per week: ________________________
Regular schedule: ______________________________
Babysitting / evening duties: ___________________
Rest breaks: ___________________________________
7. Time off and holidays
Weekly days off: _______________________________
Monthly free Sundays, if applicable: ____________
Holiday entitlement: ___________________________
Language-course time: __________________________
8. Pocket money / pay
Amount: _______________________________________
Currency: _____________________________________
Payment interval: ______________________________
Payment method: _______________________________
Deductions, if legally permitted: _______________
9. Accommodation and meals
Private room provided: Yes / No
Room description: ______________________________
Meals provided: ________________________________
House access rules: ____________________________
Internet/phone access: _________________________
10. Insurance
Health insurance: ______________________________
Accident insurance: ____________________________
Liability insurance: ___________________________
Travel/repatriation insurance: _________________
Responsible payer: _____________________________
11. Travel and local transport
International travel costs: ____________________
Local transport costs: _________________________
Use of family car: Yes / No
Driving licence and insurance checked: Yes / No
12. Documents and personal autonomy
The Au Pair Candidate keeps possession of passport, ID, bank cards, phone, medication, and travel documents at all times.
The Host Family must not restrict freedom of movement or communication.
13. Children and childcare safety
Children covered by this agreement:
Age range(s), not full names: ___________________
Special childcare requirements:
The Au Pair Candidate must not be left responsible for children where local law, visa rules, training, health, age, or experience requirements are not met.
14. Language course and cultural exchange
Language course arrangements:
Cultural exchange arrangements:
15. House rules
Reasonable house rules:
House rules must not violate privacy, dignity, freedom of movement, or local law.
16. Confidentiality and privacy
The parties must respect each other’s privacy and must not publish private photos, documents, children’s details, or personal information without lawful permission.
17. Problems and escalation
If problems arise, the parties agree to discuss them promptly and respectfully.
Emergency contacts:
Au Pair emergency contact: ______________________
Host emergency contact: ________________________
Local authority / hotline: _____________________
18. Termination
Ordinary notice period: ________________________
Immediate termination grounds:
After termination, the parties will cooperate on lawful departure, transfer to another family, payment of amounts due, and return of personal property.
19. Governing law
Mandatory law of the host country applies.
Additional governing law, if permitted: _______________________________
20. Signatures
Host Family signature(s):
Au Pair Candidate signature:
Date and place: