Baby-sitting Information Form
Name of father_________________________ Home phone ________________________________
Pager______________________ Cell phone_____________________________
Name of mother________________________ Home phone ________________________________
Pager______________________ Cell phone_____________________________
Address you are at Street_______________________ City__________________ State_____________
Name of children 1._____________________Age_____ 2.________________________Age_______
3._____________________Age_____ 4.________________________Age_______
Location parents will be at_____________________________ Phone______________________
Cell Phone___________________________ Pager_________________________
Other people to call for help such as neighbor friend or relative of the family you are working for
1. Name____________________ Relation to child______________________ Phone__________________
Pager___________________ Cell phone______________________
2. Name____________________ Relation to child______________________ Phone__________________
Pager___________________ Cell phone______________________
3. Name____________________ Relation to child______________________ Phone__________________
Pager___________________ Cell phone______________________
Emergency Numbers
Fire____________________ Police_______________________ Ambulance____________________
Family Doctor______________________ Poison Control __________________________________
This form may not ask for all needed information, but it is intended as a guide. Some Important information may be missing. No responsibility for missing in formation is claimed by the writer or Department. This page may be copied and edited to correct any missing information, remember you are the baby-sitter and are the one responsible for the correctness and completeness of all information