Babysitting Registration Interest Form 🍼✨

Babysitting Registration Interest Form 🍼✨

Please provide your details to express interest in babysitting opportunities.
Full Name*

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

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Start Date*

MonthDayYear
Date
Number of Children Requiring Babysitting*
Ages of Children (separate with commas)*
Child's Name*

First NameLast Name
Child's Name

First NameLast Name
Child's Name

First NameLast Name
Preferred Babysitting Days/Times*
Yes.No.
If yes, how long? Type a label
Yes.No.N/A
Yes.No.
Usual Bedtime:    Type a label
Night Routine Details:      Type a label
Does your child wake during the night:      Type a label
Emergency Contact Name and Number:      Type a label
Pediatrician Name and Phone Number:      Type a label
Preferred hospital:      Type a label
Insurance Provider (optional):      Type a label
Sick Policy: For the health and safety of all children in my care, I do not accept children who are sick. Please keep your child home if they have any of the following: fever (100.4°F or higher), vomiting, diarrhea, persistent cough, contagious rashes, pink eye, or any known contagious illness. Children must be symptom-free for at least 24 hours without medication before returning. If a child becomes sick during care, the parent/guardian will be contacted and must arrange prompt pick-up. Thank you for understanding and helping keep everyone safe!*

I Agree.
Outdoor PlayPhotos/videosTrips to the Park
Additional Information or Requests (Allergies, food routines, night routines, behavioral concerns)
Should be Empty: