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SAFETY FIRST We're taking extra measures to ensure your children are safe during this COVID-19 pandemic in our care. Learn More

Parent Agreement

Need A Babysitter?

Name

Phone

Address

Email

Reservation Date

Reservation Time

02:30 PM

Please list all allergies (Food, Medication, Insect Bites, Etc) No visitors are allowed in the home except for the babysitter’s, parent(s)/guardian(s), and police or emergency personnel.

Child #1

Child's Full Name

Child's Date of Birth

Child's Age

How does your child Identify themselves?

Child #2

Child's Full Name

Child's Date of Birth

Child's Age

How does your child Identify themselves?

Child #3

Child's Full Name

Child's Date of Birth

Child's Age

How does your child Identify themselves?

Child #4

Child's Full Name

Child's Date of Birth

Child's Age

How does your child Identify themselves?

Child #5

Child's Full Name

Child's Date of Birth

Child's Age

How does your child Identify themselves?

How did you hear about us?

Are the children listed above siblings?

Is anyone in the household sick?

Is late night care needed?

Does your family have any pets?

Please describe the Ideal Babysitter for your child/children:

Thanks for submitting!

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