Baby Sitting Form

Baby Sitting Form

Josie's Sitter Services
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Date

MonthDayYear
Date
Time From

Hour Minutes

AM/PM Option
Time To

Hour Minutes

AM/PM Option
Number of Children
Ages of Children
BABYSITTING RATES

The Provider will charge client for the services at the rates of:

- 0-5 years: $40.00/hour

- 2 under 5: $50.00/hour

- 5-12 years: $40.00/hour

- 2 kids: $50.00/hour

- 3 kids: $55.00/hour
Do your children have any allergies, dietary requirements or special food requirements due to religion/culture?
If yes, will be required to specify these needs below. If no, please write N/A.
Please specify the above requirement here.
Do your children have any medications or diagnosis's?
If yes, will be required to specify these needs below. If no, please write N/A.
Please specify the above requirement here.
Terms & Conditions - Just the Highlights

- The Client must read the terms and conditions upon service booking.

- If services are not paid for within the 24 hours before service commencement, the Client will be required to pay a late fee.

- In the event that either party wishes to cancel services, either party will be required to provide 7 days’ written notice to the other party. The provider will charge client for a cancellation fee, which will be a percentage of the full fee of service. Cancellation fees can be found in full in the terms & conditions.
Signature
Should be Empty: