Babysitting Application

What service are you looking for?*
- Babysitting Subscription
- One-time and Short-Term Placement (less than one month)
Date(s) of childcare coverage needed:*

Parent Related Information
Parent 1's Name:*
First Last
Parent 1's Email Address:*
Parent 1's Phone Number:*
Parent 2's Name:
First Last
Parent 2's Email Address:
Parent 2's Phone Number:
Family Home Address:*
Street Address Address Line 2 City State ZIP Code
Will the childcare coverage be at the family home?*
- Yes
- No
Hotel Name and City/Town Location (if applicable):
Please provide the location:
Street Address Address Line 2 City State ZIP Code

Child Related Information
Child 1's Name:*
Child 1's Birthdate:*
Child 1's Gender:*
Add a second child?*
- Yes
- No
Child 2's Name:*
Child 2's Birthdate:*
Child 2's Gender:*
Add a third child?*
- Yes
- No
Child 3's Name:*
Child 3's Birthdate:*
Child 3's Gender:*
Add a fourth child?*
- Yes
- No
Child 4's Name:*
Child 4's Birthdate:*
Child 4's Gender:*
Add a fifth child?*
- Yes
- No
Child 5's Name:*
Child 5's Birthdate:*
Child 5's Gender:*

Nanny's work schedule
As you anticipate it to be. Please allow for two consecutive days off for full-time nannies.
Monday:
Tuesday:
Wednesday:
Thursday:
Friday:
Saturday:
Sunday:
Are there any variations to this schedule?
ex. overnight or 24/7 care, travel, changes week to week, etc.

Family Agreement
Agree to our terms:*
Upon receipt of my application Boston Nanny Centre will contact me to set up a time to review the application. I agree that to enter into an agreement with Boston Nanny Centre I will sign an employer/agency contract, which further explains the payment schedule and terms. I have read the agreement above and by entering my initials in the box below, I agree to adhere to it.
Agree to our terms:*
I agree to pay for the temporary referral fees of $50/day or $50/overnight unless otherwise agreed upon in writing with Boston Nanny Centre. I agree to supply a credit card number at the time of booking and give Boston Nanny Centre authorization to make charges to my credit card for the purposes of payment for temporary nanny referral fees, unless alternative written arrangements have been made and agreed upon by the Boston Nanny Centre. I also understand that there is a no refund policy. I agree to pay the nanny directly in full at the end of each shift. If I fail to do so, I authorize the agency to charge my credit card at the end of the assignment for monies due to the nanny. I understand that the nannies referred by the Boston Nanny Centre for temporary assignments are my employees and are not employed by the Boston Nanny Centre. The Boston Nanny Centre provides referrals only. I will use the services of the nanny referred by the Boston Nanny Centre only when contracted through the agency subject to twice the daily fee if I violate this. Any sharing of Boston Nanny Centre nanny portfolios is strictly prohibited. I understand if I hear of a nanny and/or use the screening materials in the nanny portfolios, any hiring of that nanny is a placement through BNC and the applicable agency fee will come into effect. I hereby agree to hold the agency harmless of any and all loss, damage, destruction or accident claims which may arise out of or in connection with the rendering of any services by any nanny referred by the agency. If a request is filled by Boston Nanny Centre and canceled by the client, the client is still responsible for referral fees to the agency. I have read the agreement above and by entering my initials in the box below, I agree to adhere to it.
Email
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Step 1 of 6

Parent Related Information

Child Related Information

Nanny's work schedule

Additional Information

Family Agreement

Boston Nanny Centre

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