• Babysitting Intake Form

    Brittany Higginbotham
  • Basic Information

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  • Emergency Contact

    If unable to reach primary guardians, who should be contacted?
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  • Medical Information

    Primary guardians and emergency contact will always be contacted first in case of a medical emergency.
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  • Children's Information

  • Infant Information

    (if applicable)
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  • Agreement

  • By sumbitting this contract I/we hereby authorize Brittany Higginbotham to give consent for all emergency medical and/or surgical treatment that may be required for my/our child/children during my/our absence. Brittany Higginbotham agrees to make attempts to contact both legal guardians and the listed emergency contact should a medical emergency arise. I/we understand that I/we assume all financial responsibility for any treatment of injuries sustained to my/our child while he/she is in child care.

  • By sumbitting this form I/we agree to Brittany Higginbotham's booking and cancellation policies. Bookings must be made for a minimum of four hours. Bookings cancelled within 48 hours of the scheduled start time will be subject to a 50% cancellation fee, full hourly payment for half the scheduled hours. Bookings cancelled within 24 hours before the scheduled start time will be subject to a 100% cancellation fee, full hourly payment for all scheduled hours. Exceptions are made for circumstances out of both parties' control;

    death in the family, extreme weather, or sudden illness or injury. In these situations neither party is held responsible for cancellation fees/services. 

  • My signature below affirms that I have read and agree to both the medical consent and release agreement, and the booking and cancellation policy.

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