Babysitter Registration Form

Note to babysitter’s parents – your child’s listing will include just a first name and last initial (i.e. Stephanie W.) No photo or physical address will be listed. We will only list the phone number of the parent. Direct contact info of a minor will not be made available. Please understand that means you may be receiving calls from potential clients looking to hire your child.

 

Contact Information

Name *

Email Address

Phone *

Street Address *

Apartment, suite, etc

City *

Date of Birth *

Parent/Guardian Information

Name *

Phone *

Email Address *

Availability

Preferred Days Availablechoose all that applyMondayTuesdayWednesdayThursdayFridaySaturdaySunday

Preferred Times Availablechoose all that applyMorningsAfternoonsEvenings

Experience

Years of Babysitting Experience

Describe Your Babysitting Experience

Age Groups You're Comfortable Babysittingchoose all that applyInfants (0-1)Toddlers (1-3)Preschoolers (3-5)School Age (6-12)Teens (13+)

Certifications

Have You Completed a Babysitting Training Course?YesNo

Upload Certification Document

Choose FileNo file chosenDelete uploaded file

Skill CertificationsCPRInfant/Child CPRBabysitterFirst AidAED TrainingPediatric First AidSpecial Needs Childcare TrainingEpiPen/Food Allergy Response Training

Course CertificationsWhitesboro Fire Dept. Babysitter AcademyAmerican Red Cross Babysitter CertificationOther

You Are Comfortable With:Check all that applyPetsChildren with special needsMultiple childrenLast-minute/emergency babysittingWorking on holidaysLate nights (after 10pm)Long hours (4+ hours per session)

Location PreferencesBabysit in child’s homeBabysit in my own homeWilling to travel outside WhitesboroComfortable babysitting in rural/farm properties

Agreement

AgreementI certify that all information is accurate and truthful. I understand that inclusion in the registry does not guarantee employment and that families make final decisions about hiring. I understand that Heart of Whitesboro is not responsible nor liable for sitter behavior or any issues arising from arrangements. I understand that it is the responsibility of families to interview, screen, and supervise their sitters appropriately. I understand that all contact and arrangements are made directly between the family and the babysitter.I agreeI do not agree

Register