Handpicked Babysitter Request

Babysitter Request

Complete the form below to request your Handpicked babysitter.
🌟 MEMBER EXCLUSIVE: Join The Village Circle for $45/month & Save! Why pay per request? Membership gives your family:
- Unlimited Babysitting Requests (No individual booking fees!)
- Priority Placement during high-demand weekends and holidays
- Urgent Backup Care Access when primary childcare falls through
*It pays for itself in just 2 bookings!*

👉 Click HERE to Join The Village Circle membership
Personal Information
Your Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Have you booked a babysitter through The Handpicked Household before?
How did you hear about us?
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Residence Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please Upload a Photo of Your Government-Issued ID.

Cancelof
Emergency/Secondary Contact Information
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Children
Babysitting Job Information
Date of Babysitting Request

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Location (Where the Babysitting will Take Place)
Babysitting Location

Street Address

Street Address Line 2

CityState

Zip Code
Timeframe (start and end time)

Hour Minutes

AM/PM Option

until

Hour Minutes

AM/PM Option
Who will your babysitter be caring for?
Child(ren)'s Information
Select Sitter Type (You will pay the sitter directly.)
Will there be any other adults on the premises during the care hours?
Please specify who will be present and their relation to the household (e.g., WFH parent, grandparent, housekeeper):
Please type any other important information or special requests. Please note, in each case we do our best to honor requests but cannot guarantee this.
Safety Information
Are there firearms/weapons on the premises?
Are they locked up securely?
Are there pets/animals on the premises?
Will they be fenced/crated/caged?
Please specify types of animals, how many of each, and any other important information.
Are there working smoke detectors on the premises?
Signature
Confirm booking type.

Should be Empty:

Debit or Credit Card
Credit Card Number	Security Code
Expiration Month	Expiration Year

Enter coupon

Babysitter Request

Personal Information

Emergency/Secondary Contact Information

Babysitting Job Information

Safety Information

Payment*

Payment