Office use only REGISTRATION NUMBER
Sunset Babysitting Agency Family Application Form
Parent/ Guardian details Title: Surname: Address: First Name:
E-mail address: Home telephone number: Mobile telephone number: Work telephone number:
Title: Surname: Address: (If different from above)
First Name:
E-mail address: Home telephone number: (If different from above) Mobile telephone number: Work telephone number:
Is the position in your
Home
Hotel
Holiday home
Hotel Name: Hotel Address:
Your room number:
Suite 2, 117 Nortoft Rd Bournemouth, BH8 8QB
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Tel: 01202 267768 www.sunsetbabysittingagency.com
Sunset Babysitting Agency
Children's Details Name: Gender: Hobbies and Interests: Date of Birth: Age:
Name: Gender: Hobbies and Interests:
Date of Birth: Age:
Name: Gender: Hobbies and Interests:
Date of Birth: Age:
Name: Gender: Hobbies and Interests:
Date of Birth: Age:
Do any of your children have Special needs, medical problems or allergies? If yes please give details
Is there anything else you feel we should know about your children i.e/ wets bed regulary? If yes please give details
Is English their first Language? What other languages do the children speak? If English isn't their first language. What is there level of English?
Do you have any pets? If yes what animals do you have? Suite 2, 117 Nortoft Rd Bournemouth, BH8 8QB Tel: 01202 267768 www.sunsetbabysittingagency.com
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Sunset Babysitting Agency
In the unlikely event of a emergency where is the location of your Electricity supply? Gas supply? Fire Exits?
In the unlikely event of an emergency we request you give us details of a person we could contact If you are unreachable Name: Relation to you: Address:
Telephone number: Mobile Telephone number:
The date I require the babysitter is: The times I require the babysitter are: From: Until
I wish to book a qualified and experienced babysitter I wish to book an experienced babysitter
Sunset Babysitting Agency always try and provide the same babysitter, if your main babysitter is unavailable then we will provide details of another suitable babysitter
Please use this space to provide us with any additional information which will help us provide the right babysitter for your family
Suite 2, 117 Nortoft Rd Bournemouth, BH8 8QB
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Tel: 01202 267768 www.sunsetbabysittingagency.com
Sunset Babysitting Agency
Payment Details I wish to pay using a credit/debit card I wish to pay using a standing order I wish to send a cheque I wish to make a direct transfer
I wish to pay a yearly registration of £150 I wish to pay a monthly fee of £13.50 I wish to pay on a 1 off basis of £15
How did you hear about Sunset Babysitting Agency?
Would you like details of our Nanny Agency?
Do you know any other Families who may be interested in registering with the Agency? If yes please give their name and phone number:
Any further comments:
I give permission for my details to me passed onto the babysitter's) who will be caring for my children I will always follow the terms and conditions of Sunset Babysitting Agency Signed: Print Name: Date:
Thank you for completing Sunset Babysitting Agencies Application form. Suite 2, 117 Nortoft Rd Bournemouth, BH8 8QB Tel: 01202 267768 www.sunsetbabysittingagency.com
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