Babysitting Contracts

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					peace of mind SITTERS AND NANNIES                          p.o. box 243314, denver, colorado 80224
                                                                 phone and fax 303 322 2213

                                         Babysitting Registration
                    Client Information, Registration and Liability Release Contract
DATE_________                                                        Home
Parent’s Name_________________________________________________
                 Main Cross Streets___________________________________________
Names (children)           Date of birth     Favorite playtime activities
________________________ ____________

________________________ ____________

________________________ ____________

Any pets?# Dogs______ # Cats________ Other___________________All current with vaccinations? Yes___
               (Please provide copy of current vaccinations on all pets to be kept in our files.)
Have you or any family member living with you ever been convicted of a felony? Yes___ No____
If yes please explain__________________________________________________________________
Mother                                                                      Father
Work Phone______________________________                                    Work
Pager/Cell phone__________________________                                  Pager/Cell
                                           Medical Information
       Physician ___________________ Phone____________ Address_________________________________
       Hospital ____________________ Phone____________ Address_________________________________
       Insurance Carrier_______________________________ Policy #_________________________________
I give consent to sitter/nanny for the above name child/ren to authorize emergency medical attention if
needed.                Parent signature___________________________________________
                        In case of emergency contact: (If unable to reach either parent first)
      1. __________________________________Phone__________________Relationship__________________

        2. __________________________________Phone__________________Relationship__________________
Any medical/allergy condition to be considered? If yes please
The undersigned parent/s (“the Client”) understands that peace of mind SITTERS AND NANNIES (“The Agency”),
acts only as a service to provide sitter/nannies (“Sitter/nannies”) who have been interviewed, screened and whose
references have been verified. To the best of the Agency’s knowledge, as gained through these procedures, such
sitters/nannies are experienced and trustworthy. In addition (unlike other agencies in Colorado
and most states), we conduct criminal background checks through fingerprinting and the FBI database. All files
are maintained by the Agency. The following policies apply to all clients: Client further agrees that
Sitter/nannies who have been selected by the Client are the employees of the Client and not the Agency. The
Agency assumes no responsibility for the act(s) or omission(s) of the Sitter/nannies. Clients, at any time, have the
opportunity to first interview the Sitters/nannies. A four hour minimum charge for the Sitter/nanny will be paid
as an interview fee because of her inability to accept other jobs during this time. The Agency fee also applies.
Client agrees that Sitter/nannies or their identities provided by the agency SHALL NOT be shared or
disclosed to other persons except with prior consent of the Agency and in accordance with the Sitter/nanny’s
arrangements with the Agency. The Client agrees to pay a $2500.00 finder’s fee for contacting the Agency’s
Sitter(s)/nanny(ies) (directly) with intent to solicit their services without the Agency’s prior consent. If
finder’s fee has to be assessed, the credit card provided will be charged. Cancelled jobs anytime will be
charged a $20.00 cancellation fee. If a job is cancelled within 24 hours of the scheduled time, the Sitter/nanny’s 4
hour minimum will be charged and Agency fee is non-refundable. If an overnight job is cancelled within 3 days
of the scheduled date, a 7 hour minimum shall be paid to the Sitter/nanny. If a scheduled 8 hour job is ended
before Sitter/nanny has worked the full 8 hours, then a 6 hour minimum is owed to her. Anytime a job is
cancelled after Sitter/nanny has been confirmed the applicable fee is non-refundable. If children are sick with
colds, flu, chicken pox or other contagious sickness or experiencing special medical conditions, the service
must be notified in advance. Otherwise, Sitter/nanny has the right to leave and 4 hour charge will be paid to
the Sitter/nanny and the Agency fee is non-refundable.
Sitters/nannies are strictly prohibited from the Agency to swim or drive with the children. If Client requests
sitters/nannies to engage in any or both activities, Client assumes full and unconditional responsibility.
If payment is not collected on the credit card amounts due will be turned over to a Collection Agency.

I (The Client) understand that the provision of Sitter/nannies will be dependent upon availability and that the
Agency has the right to refuse services to Clients at its discretion.

I, the Client, hereby agree to pay an Agency fee of $15.00 each time I book the service with at least 37 hour of
notice. (Hotels or out of town clients $20.00) An additional $5.00 when 36 hour or less notice is given. Overnight 24 hr
service request and/or any requests for a period longer than 8 hour within 24 hours, Client agrees to pay a $20.00
Agency fee. Sitter/nanny hourly pay within 37 hours or more of notice is $12.50/hr and when 36 hours or less of
notice is given the hourly pay is $13.50. In addition, I am also in agreement to pay the sitter/nanny a minimum
of four hours for each service request. Overnight (10 hours) nanny flat fee is $75.00. Overnight (24 hours) nanny
flat fee is $155.00.
CANCELLATION FEE anytime is $20.00.
Agency fee is non refundable for all jobs cancelled after sitter/nanny confirmation.

I, ___________________________________, hereby release peace of mind SITTERS AND NANNIES and its
owner/manager, M. Helena Cleary, from any and all liability related to the actions or omissions of
Sitters/nannies the Agency has provided and Client has chosen to employ.

           I have read, understand and accept the above conditions of this contract.

        VISA/MC #______________________________________Exp. Date_______________

        Client Signature__________________________________Date___________________

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