SECURE BOOKING 

 

 
Extended Validation Certificate

 

 

      

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
Extended Validation Certificate

 

How did you hear about us?

 

Personal Information

 

 

First Name:               

Last Name:            

Cell Phone:               

Alternate Contact:  

Email address:        

 

Children Information

 

                         Name                     Age

Child 1:  

Child 2:  

Child 3:  

Child 4:  

Child 5:  

 

Appointment Information

 

Local Lodging Name or Address:           

 

Location (Name of Town or Resort): 

 

Please enter the appointment date(s), sitter arrival time and expected appointment end time (4 hour minimum per appointment): 

Date 1:     From :   To :

Date 2:     From :   To :

Date 3:     From :   To :

Date 4:     From :   To :

Date 5:     From :   To :

Date 6:     From :   To :

Date 7:     From :   To :

 

Sitter Preference

No preference      Male       Female

 

 

Other comments, questions, requests or extra dates:

 

Deposit Information

 

Your credit card information is needed to reserve a sitter.  This information will be held until 1 week before your first appointment, when you will be charged a non-refundable deposit per appointment (the deposit is deducted from your total, and the remaining balance is paid to the sitter).  If you wish to cancel, please do so before this time to avoid penalty.

 

This is a Secure Site.

 

 

      Card type:  

Name on card:   

Card Number:        Exp:

CVV (security code on back of card):     

 

Billing address:    

             City:      

(If in US) State:   Zip: