BABYSITTER INSTRUCTIONS

Thanks for taking care of [NAME(S) OF CHILD(REN] Here’s all the information you’ll need!	Click on graphic above to insert a picture. Delete placeholders that are not needed.
WHERE TO FIND US
Where we’ll be:
Address:
Phone:
Date/time expected home:
instructions
Meals and snacks:
Diapers:
Activities:
Bedtime schedule:
Allergies:
Medications:
Hiding places:
Favorite toys or games:

ADDITIONAL INFORMATION

MEDICAL EMERGENCY INFORMATION
Regular doctor (name and address):
Phone:
Emergency clinic (name and address):
Phone:
Neighbor or friend:
Phone:
We give you permission to authorize emergency medical care for our child(ren) as deemed necessary by a physician, and we will be responsible for full payment of such care.	Yes No Call us first Signature:
HOME EMERGENCY INFORMATION	Here’s information you’ll need in case you notice a break-in, fire, gas odor, flood, or electrical problem:
Police: 911	House address: [Address]
Fire department: [Phone number]	House phone number: [Phone number]
Gas company: [Name and phone number]	Nearest intersection: [Intersection]
Electric company: [Name and phone number]	Location of electrical breaker box: [Location]
Water company: [Name and phone number]	Location of water shut-off valve: [Location]
Neighbor or homeowner association contact: [Name and phone number]	Location of gas shut-off valve: [Location]
Our names: [Names]
We give you permission to authorize emergency work if necessary to prevent damage, and we will be responsible for full payment of such work.	Yes No Call us first Signature: