703-201-2778

Eventchildcare@nannytainment.com

To Be Completed By Parent/Guardian Of Each Family Prior To Event As Soon As Possible. We will email upon receiving this completed agreement by parent/guardian child will be registered for our Event Childcare Services to confirm we have it. If you do not get an email regarding this, please call us so that we can be sure reserve a space for your child and have adequate number of caregivers. We do need complete information on each child so please fill out all blanks on form.All requests for service including additional time needed MUST be booked directly with the Agency and NOT the Event location unless Nannytainment owner is present. Please call number listed above.

Child 1 Name ___________________________Age__________Gender___________ Parent/Guardian Name(s) ________________________________ Parent Email address: ___________________________ Cellphone number ______________________________________ If staying at a hotel, room number(s) assigned _____________________ Authorized pickup of child in care (this includes relatives) _____________________ Emergency Contact Name (other than parent)________________Phone Number____________ Briefly describe childs personality, hobbies, and interests. Please list childs medical issues, allergies, behavior concerns, medication, etc. Is child in diapers or toilet trained? _____________________ Does the child nap each day? If so when?__________________________________ When is normal bedtime for child? ______________________________________

Child 2 Name ___________________________Age__________Gender___________ Briefly describe #2 childs personality, hobbies, and interests. Please list #2 childs medical issues, allergies, behavior concerns, medication, etc. Is child in diapers or toilet trained? _____________________ Does the child nap each day? If so when?__________________________________ When is normal bedtime for child? ______________________________________

Child 3 Name ___________________________Age__________Gender___________ Briefly describe #3 childs personality, hobbies, and interests. Please list #3 childs medical issues, allergies, behavior concerns, medication, etc. Is child in diapers or toilet trained? _____________________ Does the child nap each day? If so when?__________________________________ When is normal bedtime for child? ______________________________________

Child 4 Name ___________________________Age__________Gender___________ Briefly describe #4 childs personality, hobbies, and interests. Please list #4 childs medical problems, allergies, behavior concerns, medication, etc. Is child in diapers or toilet trained? _____________________ Does the child nap each day? If so when?..__________________________________ When is normal bedtime for child? ______________________________________ Please Read the following Statement and enter your name and the date below. By entering your name you are agreeing to the following conditions. In the event of an emergency, I hereby authorize any and all medical attention to be administered, to my child (children) as is deemed necessary by an attending physician or nurse. Also in the event of an emergency I understand Nannytainers will evacuate the children from the site, if necessary. I understand and agree that I am financially responsible for any care so provided. In consideration of the opportunity to have my child (children) participate in the activities sponsored by Nannytainment Event Childcare, I hereby assume all risks and waive all claims against the corporation, its respective officers, director, employees, agents and representatives for bodil y injury or death and for damage to or loss of any property directly or indirectly arising from or in connection with any activities involving Nannytainment Event Childcare, Inc. except to the extent directly and solely caused by the willful misconduct of the corporation or its agents. I also understand and agree that management reserves the right to decline or discontinue enrollment based upon the managements assessment of physical disabilities or medical conditions requiring an amount of attention or medical expertise beyond the companys formal scope of ability. Nannytainment cannot administer medication per our insurance policy. Parent/guardian warrants that the child has no allergies, which have not been noted above. Parent has disclosed complete information regarding behavior, medical conditions, etc. Failure to do so could mean that your child may be turned away for care at your arrival. At least one parent or authorized pick up must remain at venue while their child is in care. Please inform staff if you cannot be accessed quickly, which we will need to use in the case of an emergency. Please no sick children!

If your child becomes ill, extremely unhappy or unmanageable we will contact you to come to the childcare area.

In order to maintain control, once you have dropped your child(ren) off, we ask that you try not re-enter child care unless you are paged or are picking up your child(ren) and taking them with you. If you want to check in on them you can call us on the cell phone number listed that we will present to you when you sign in. We find that it is very confusing for the little ones if parents check on them and then leave again, and other children may not see their parents at all. Nannytainment Event Childcare is not also allowed to provide care for special needs children as we are precluded by our insurance company. We are also precluded from transporting children, taking them swimming, and providing baths. Or administrating medical treatment, unless an absolute emergency. We do need you to provide your own diapers, wipes, bottles, baby food, etc. Also consider packing along a change of clothes for young children. Possibly pajamas that you can put them into at the end of the night if childcare is not done in hotel guestrooms. I hereby grant permission for Nannytainment Event Childcare Inc. to take whatever steps necessary to obtain emergency medical care if warranted. If the parent cannot be reached emergency personnel will be called. Nannytainment Event Childcare Events does not administer medication of any kind. Nannytainment Event Childcare has my permission to take photos of my children at this event. Photos may be posted on the company website and marketing material. However no names, location, or other identifying information will ever appear. We will also provide you copies of them via email.

Parent/Guardian Signature_________________________Date_____________________

Think Before You Drink!

We do hope you will enjoy yourself at the event that is happening while your child or children are in our care. We have faith that you will have fun responsibly and your family will be able to depart from your time with us safely as well. Please consider using transportation services to assist you if needed and if you would like help arranging for this please let us know.