Nanny Services Registration

Nanny Services Registration

Please complete your registration to our nannying services
Is your child registered in one of our nurseries? *

Yes No
Full Name *
Email *
Phone Number *
Address *
City *
Postcode *
Current Hours per Week *
Current Fees *
Nanny Service *
Required Hours / Week *
Will you be at home? *

Yes No
Potential Start Date *

Day Month Year
Date

Booking Pattern *

Morning

Afternoon

Overnight

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Requirements or Additional Comments *
Driving License, Qualification Required, Experience, Special Needs...
Number of children *
Languages Spoken at Home *
Child Name *
Child Age *
Dietary Needs, Allergies, Medical Notes or Special Needs *
Child 2 Name *
Child 2 Age *
Dietary Needs, Allergies, Medical Notes or Special Needs *
Child 2
Child 3 Name *
Child 3 Age *
Dietary Needs, Allergies, Medical Notes or Special Needs *
Child 3
Type of Lead

Payment *

Registration Fee £ 50.00 GBP

Total £ 0.00 GBP

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Agreement

Information Security
By clicking "Submit" you agree to us electronically recording and storing this information. All information is secure and will be encrypted using 256-bit encryption technology.

Accurate Information
You confirm that the information you have provided is both complete and accurate and you understand that the giving of false information could invalidate your childcare contract terms and conditions.

Confirmation and Digital Signature
I confirm I have read the terms and conditions of the Nannying Service and agree to comply with them and any updated regulations and instructions where necessary.
Signature *

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