Babysitter's Name Add the Babysitter's Address? Add the Babysitter's Address? Yes (recommended)No Babysitter's Address Street Address Address Line 2 City Please SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington DCWest VirginiaWisconsinWyoming State ZIP Code Parent's Name Only 1 is required. Add the Parent's Address? Add the Parent's Address? YesNo Parent's Address Street Address Address Line 2 City Please SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington DCWest VirginiaWisconsinWyoming State ZIP Code How many Children? Select12345678910Child(ren) Number (#) of children under the supervision of the babysitter. Child's Name Child's Date of Birth 2nd Child's Name 2nd Child's Date of Birth 3rd Child's Name 3rd Child's Date of Birth 4th Child's Name 4th Child's Date of Birth 5th Child's Name 5th Child's Date of Birth 6th Child's Name 6th Child's Date of Birth 7th Child's Name 7th Child's Date of Birth 8th Child's Name 8th Child's Date of Birth 9th Child's Name 9th Child's Date of Birth 10th Child's Name 10th Child's Date of Birth Do any of the Children have Allergies? Do any of the Children have Allergies? YesNo Such as Food, Pets, etc. Name the Child and their Allergies: The Babysitter is paid: The Babysitter is paid: per Hour ($/hr)per BabysittingOther Hourly Rate $/ Hour Enter Pay $/ Babysitting The Client agrees to pay the Babysitter: When does this Agreement start? When does this Agreement end? When does this Agreement end? with Noticeon an End DateOther End Date Enter how the Agreement will end: Will the Babysitter follow a WEEKLY SCHEDULE? Will the Babysitter follow a WEEKLY SCHEDULE? YesNo Enter the Babysitter's Schedule: Other than supervision, will the Babysitter have OTHER RESPONSIBILITIES? Other than supervision, will the Babysitter have OTHER RESPONSIBILITIES? YesNo Such as changing diapers, preparing snacks/meals, household duties, etc. The Babysitter will be responsible for: The Babysitter will be responsible for: Changing DiapersHousehold Duties (cleaning, dishes, etc.)LaundryPreparing Snacks/MealsPutting the Children to SleepOther Check All That Apply Enter Any Other Responsibilities: Are there any Additional Terms or Conditions? Are there any Additional Terms or Conditions? YesNo Last chance to enter additional terms of this Agreement. Enter any Additional Terms and Conditions: Effective Date The Effective Date is when the Agreement is written. Next Save Save and finish later