Elizabeth Henry Nannies, Nanny Agency



Babysitting Service Registration

Please complete the below registration form, we will then contact you and arrange for the relevant payment to be made.

If you require immediate cover please call us on 01732 851313 or 01892 836435

Click here to view our Babysitting Service Terms and Conditions.

* Indicates the mandatory fields.

Your Details
Title*
First Name*
Last Name*
Address 1*
Address 2
Town / Village*
County*
Postcode*
Telephone*
Mobile
Email
Confirm Email

Mother's Occupation
Father's Occupation
Other Parents Name
Emergency Contact: Neighbour or Relative
Name*
Telephone Numbers*
Relationship to Children*

Children's Names* D.O.B.*

Do you have any pets?*
If so please state which

Do the children have any special requirements? e.g. Strict Religious Practices, Special diet (Vegetarian/Vegan/Kosher), Children with special needs, please detail:

Do the children have any special medical requirements or allergies?


Smoking preferences
Hourly rate offered

Date of first babysit required (if applicable)
From (time)
to (time)

How frequently do you anticipate you will use our baby sitting service?
(Please ignore if this is a one off sit)

Any other information?


How did you hear about Elizabeth Henry Nannies?*

I wish to register


I confirm that the information I have supplied is accurate to the best of my knowledge and I have read, understood and agree to abide by Elizabeth Henry Nannies Babysitting Terms and Conditions.

Tick here to confirm you agree to the above statement