Temporary and Sitter Services Application

Please fill out the form below

Date:
Guardian 1 Occupation
Place of Employment Work # Cell #
Guardian 2 Occupation
Place of Employment Work # Cell #
Home Address:
Email Address:
Home Phone Emergency Contact (other then parents)
 
I am interested in using Babies to Boomers for: Sick Care    back-up care
day/evening sitting     24 hour care    1-4 week placement
 
Please describe your children:
Name: Birth date: Gender:
Name: Birth date: Gender:
Name: Birth date: Gender:
Name: Birth date: Gender:
 
Please list any pets:
Does anyone in your home smoke?
Please add anything that you feel is important for us to know concerning you and your family.
How did you hear about Babies to Boomers?
 

The Babies to Boomers Temporary Services Client Understanding and Release:

Understanding between parties:

  1. Babies to Boomers agrees to make its best effort to locate temporary child caregivers for client's child care needs on an as requested basis.
  2. Client agrees to pay caregivers directly for services rendered at least $14.00 per hour for 1 child, $15 per hour for 2 children, $16 per hour for 3 children, $17 per hour for 4 children, and $18 per hour for 5 children, with a four-hour minimum. If you are requesting sick care, add $3.00 per hour. Holiday requests start at $25 per hr with a 5 hour minimum (Thanksgiving, Christmas Eve, Christmas Day, New Years Eve, New Years Day, Easter, 4th of July).
  3. Client understands that an agency fee will be charged to their credit card for every confirmed reservation.
  4. Client understands that if s/he cancels a caregiver who has already been confirmed by Babies to Boomers s/he will be charged the agency reservation fee. Client further understands that if canceling with less than 48-hour notice, s/he will be charged the four-hour minimum for the caregiver in addition to the agency reservation fee. If holiday reservations are made and canceled the 4 hour minimum will be charged and paid to the caregiver.
  5. Client understands that the services provided by all caregivers referred by Babies to Boomers must be contracted through the Babies to Boomers office. Client further understands that the use of a Babies to Boomers caregiver, or referral of a Babies to Boomers caregiver to a third party, without arranging the visit through the agency, is considered “theft of services” and will result in a charge of $1000 for liquidated damages.
  6. In the event that Client wishes to hire a Caregiver referred by Babies to Boomers on a permanent basis, Babies to Boomers agrees to negotiate with the client in arriving at an acceptable placement fee.
  7. Client understands that caregivers working with Babies to Boomers are not employees of Babies to Boomers. Client understands that if they pay more than $1,700 per calendar year to any one caregiver they are responsible for withholding and filing employment taxes for that person. Social Security number of caregivers must be obtained directly from caregivers.
  8. Client agrees to forever indemnify, release and hold harmless Babies to Boomers, its agents, employees, and officers for any and all claims relating to services provided by caregivers.
I have read and understand the terms of the agreement
I Agree
I disagree
Client Signature Date
 
Transportation Waiver: (optional)
I , hereby give consent for a Babies to Boomers caregiver to transport my child(ren) in her or my automobile. I understand that caregivers with Babies to Boomers are not employees of Babies to Boomers. Babies to Boomers is in no way responsible for the safety of my child(ren) while being transported in caregivers or our family's automobile. I agree to forever indemnify, release and hold harmless Babies to Boomers, its agents, employees and officers for any and all claims including injury to client's car of child(ren) while being transported by a Babies to Boomers caregiver
I understand and agree to the above transportation waiver
I do not agree to the above transportation waiver
Client Signature Date
 
Medication Release: (optional)
I , hereby give my consent for a Babies to Boomers caregiver caring for children in my home, to administer medication to my child(ren). I understand that Babies to Boomers caregivers are not medically trained. I hereby release, discharge and hold harmless Babies to Boomers, its employees, agents, and officers from any and all claims relating to the administering of medication to my child(ren).
I understand and agree to the above medication waiver
I do not agree to the above medication waiver
Client Signature Date
 
 
Home | About Us | VT Families | CO Families | Temp / Sitter | Temp / Elder Care | Event Services | Hotel Services | Caregivers | Testimonials | Policies | Contact
© Copyright 2010-2017 Babies to Boomers
Graphics and Website Design by Off the Page Creations, Tampa