Safe & Sound Childcare Agency

Registration Form

The following form should only be filled in by families searching for childcare.
You can either fill in the one below or download one here, which you can then
print and post to us. Our is address is listed here

Family Details

Surname
First Names
Partner's Name(s)
Address

Contact Details

Daytime Tel.		Evening Tel.
Mobile Tel.		E-mail

You and Your Family

Your Occupation		Partner's Occupation
Family Religion		Nationality
Family Pets		Children's Illnesses/Allergies/Special Needs

Have the children previously been cared for by a Nanny/Mother's Help?

Yes
No

Details of The Children to be Cared For

Full Names	Age	Sex

Job Description

Please give full details of the position you are offering. For
babysitting service, please state dates and times.

Type of staff required (as many as applicable)

Nanny
Mother's Help
Babysitter
Maternity Nurse
Temporary Staff

Babysitting date(s) and time(s)

Hours required per week
Monday	A.M to	P.M
Tuesday	A.M to	P.M
Wednesday	A.M to	P.M
Thursday	A.M to	P.M
Friday	A.M to	P.M
Saturday	A.M to	P.M
Sunday	A.M to	P.M

Will your staff be required to travel with you?

Yes
No

Do you require a car driver?

Yes
No

If yes, will you provide use of a car?

Yes
No

Residential or daily?

Would you consider an nanny with their own child?

Yes
No

Salary Offered (Net)

Minimum

Maximum

Please give a brief description of the Nanny/Mother's Help you are looking for:
Please list duties required:
Any household duties required?

I confirm that the information contained in this form is accurate and to the best of my knowledge. I confirm I have received and read the agencies terms and conditions of business and agree to be bound by them and to pay the agencies fees and charges in accordance with those terms and conditions.

If you have not yet read the terms of business, please do so here , before submitting. This will open a new window so your form content will be preserved.

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