Caregiver Information
Hi! Please fill out this form before attending our Babysitter Meet-and-Greet event on Sunday, October 17. We chose to not ask about pay ranges as there are too many variables to account for.

We will follow up if we have additional questions. If you want to ask us anything, please email Lindsay or Celine at info@fanwinchester.org. Thanks!
Sign in to Google to save your progress. Learn more
First and Last name: *
Birth Date *
MM
/
DD
/
YYYY
Age Range (as of 11/1/2021) *
Grade level (choose other if not applicable) *
Phone number *
Email Address *
Are you vaccinated against COVID-19? *
What is your availability (check all the applicable boxes)? *
Required
Do you drive or have reliable transportation? *
Babysitting Experience *
Other related experience *
Special trainings or certifications
Are you comfortable around pets? *
Required
Have you taken any infant / adult CPR Training courses before (it's ok if the answer is no!)? *
What is your comfort level handling children with allergies? *
What age ranges are you comfortable watching? *
Required
How many children are you comfortable watching at one time? *
Required
If you're under 18, do you have your parents' permission to be on this list? *
References: please list full names, phone numbers and/or email addresses. It's okay if you're new to babysitting! Please just note that below. *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Family Action Network of Winchester, Inc.. Report Abuse