• Nanny Intake Form

    For back up care, date nights, weekends, and overnights.

  • Nanny Request

  • Date*
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  • Date*
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  • Basic Information

  • Children's Information

  • Date of Birth*
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  • Date of Birth*
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  • Date of Birth*
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  • Date of Birth*
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  • Contact Information

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  • Preferred Contact?*

  • Emergency Contact

    If unable to reach primary guardians, who should be contacted?
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  • Medical Information

    Primary guardians and emergency contact will always be contacted first in case of a medical emergency.
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  • Agreement

  • I/we agree to have Paisley Bedford Parker take photos of my/our child/children during my/our absence. I/we acknowledge that the photos will not be posted to any form of social media with identifying factors, real names, or locations. Specific permission must be granted for photos to be posted otherwise. I/we acknowledge that photos are taken specifically for professional use; for updates to listed guardians and/or to documents activities for portfolio/website.*

  • By submitting this contract I/we hereby authorize Paisley Bedford Parker to give consent for all emergency medical and/or surgical treatment that may be required for my/our child/children during my/our absence. Paisley Bedford Parker agrees to make attempts to contact both legal guardians and the listed emergency contact should a medical emergency arise. I/we understand that I/we assume all financial responsibility for any treatment of injuries sustained to my/our child/children while he/she is in child care.

  • By submitting this form I/we agree to Paisley Bedford Parker's booking and cancellation policies. Booking must be made for a minimum of four hours. Bookings cancelled within 48 hours of the scheduled start time will be subject to a 50% cancellation fee, full hourly payment for half the scheduled hours. Bookings cancelled within 24 hours of the scheduled start time will be subject to a 100% cancellation fee, full hourly payment for all scheduled hours. If booking is cancelled by Paisley Bedford Parker within 48 hours of a scheduled start time, parents are entitled to one free hour of services to be used within 60 days. If booking is cancelled by Paisley Bedford Parker within 24 hours of a scheduled start time, parents are entitled to two free hours of services to be used within 60 days. Exceptions are made for circumstances out of both parties' control; death in the family, extreme weather, or sudden illness or injury. In these situations neither party is held responsible for cancellation fees/services.

  • My signature below affirms that I have read and agree to both the medical consent and release agreement, and the booking and cancellation policy.

  • Date*
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  • How would you like to recieve confirmation?*
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  • Should be Empty: