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The information below is to be completed by a babysitter or nanny and updated frequently as necessary.
Date of completion:____________________
Parents contact details
Parent’s/Guardian’s name(s):____________________
_______________________________________________
Where parents/guardians will be and : _____________________
Address_______________________________________________
Phone number_______________________________________________
Mobile number _______________________________________________
Expected return time:__________________________
Parent’s/Guardian’s name(s):____________________
____________________________________________
Where parents/guardians will be and : ________________________
Address_______________________________________________
Phone number_______________________________________________
Mobile number _______________________________________________
Expected return time:__________________________
Childs details
Child’s Name:__________________________________ Age: ________________ Weight:
Medical allergies_______________________________________________
Child’s Name:__________________________________ Age: ________________ Weight:
Medical allergies_______________________________________________
Child’s Name:__________________________________ Age: ________________ Weight:
Medical allergies_______________________________________________
Child’s Name:__________________________________ Age: ________________ Weight:
Medical allergies_______________________________________________
Other emergency contacts
If an emergency situation / accident happens all reasonable endeavour will be used to first contact parents on numbers above, after which the emergency contacts below will be contacted. Please ensure that the parents are aware that they need to tell the following people that they are emergency contacts for their children.
Name ___________________________________
Phone number___________________________________
Mobile number___________________________________
Address___________________________________
Name ___________________________________
Phone number___________________________________
Mobile number
Address___________________________________
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