BABY SITTER REQUEST FORM

Please use the following form to request a onetime baby sitter. The one time babysitting agency fee is $40.00 per day/ $50.00 if there is less than 24 hour notice. Please call for an overnight rate. You will be charged once a baby sitter is found and payment is due immediately. There is no refund. There is also a 4 hour minimum charge if you do not cancel your sitter with at least 24 hours' notice.

Name

Address

Phone

Email

Age of your children

Do your child/children have any medical conditions or special situation that we need to be aware of ? If so please explain.
*Please describe the date, time and place where you will need a baby sitter.
*Please list the best days, times and means of our contacting you regarding your search.
Relationship to Client and Nanny: A.) Nanny Poppins, is a referral service, and does not train, employ, or exercise control, authority or discretion over applicants referred to clients. Nanny Poppins, disclaims any and all responsibility for any conduct or omissions of any applicant, including any applicant hired by the client. The agency is not responsible for losses or damages resulting directly or indirectly from its Clients relationship with any applicant or nanny. Nanny Poppins, is not responsible for providing insurance or withholding any payroll taxes, and has no employment relationship with its applicants or nannies. B.) Clients are responsible for making sure their nannies are aware of all rules they want to her to follow as well as safety concerns and hazards. C.) The Client agrees to pay the appropriate baby-sitting service fee to The Agency for each use of the service. Client acknowledges verbal and/or written receipt of the fees charged by the agency. The client, agrees and understands that the baby-sitting services fees are not refundable to them. Client agrees to pay the cancellation fee to the baby-sitter in the event that they cancel the sitter without 48 hours' notice. The cancellation fee is 4 hours paid to the sitter. Client understands that they are to pay the baby-sitter directly at the end of her shift. The Agency does not assume any responsibility to pay the sitters. D.) The Client, by signing this agreement, agrees to pay the appropriate referral fee and follow the appropriate policies in the event the client hires any of the applicants referred by the Agency. I understand and agree to the above:*

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