Babysitter Checklist
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Child
Information Last name: _______________ First name:______________ Middle name:_____________ Date of Birth:____/___/_____ Weight: _________________ Health insurance: ___________ Allergies / Special Medications? Yes No If so, ?_________________________________________________________________ ______________________________________________________________________ Address: _____________________ City:_____________ Zip:_________ State: ______
Mother's mobile
number:(____)____-______ Father's mobile
number:(____)____-______
Foods
not allowed:
______________________________________________________________________ Child's
dislikes: Child's
likes: Snacks:_____________________________________________________
______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________
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