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Babysitting Release Form Template

Ensure clear permission and peace of mind when babysitting

Not having a proper release form can leave you and the parents feeling uneasy about babysitting arrangements. This babysitting release form template helps parents grant clear permission for you to care for their children, ensuring both safety and trust. Whether you're a budding babysitter looking to establish professionalism, a parent wanting to provide a safe environment, or a caregiver needing to fulfill legal requirements, this template covers it all-streamlining documentation, improving communication, and providing peace of mind. Explore the template and customize it to meet your needs with ease.

Use this Template (FREE) Live Preview
Parent/Guardian full name
Relationship to child
Email address
Mobile phone number
Preferred contact method during care
Phone call
Text message
Email
No preference
Child 1 full name
Child 1 date of birth
Additional children names and dates of birth (if any)
Allergies and current medications (include dosing instructions if applicable)
Physician name and phone
Health insurance provider and policy number
Primary emergency contact full name
Primary emergency contact relationship to child
Primary emergency contact phone
Date(s) of care
Location of care address
Authorized pickup person(s) full name(s) and phone number(s)
Special instructions or routines (meals, nap times, activities, restrictions)
I authorize the babysitter to seek emergency medical treatment for my child if I cannot be reached
Yes
No
I authorize the babysitter to administer over-the-counter medication that I have listed and provided
Yes
No
List approved over-the-counter medications and dosing limits (if authorized)
I authorize the babysitter to transport my child by car when necessary for safety or agreed activities
Yes
No
I consent to the babysitter taking photos or videos of my child for private updates to me only (not for public use)
Yes
No
Liability release: I release the babysitter from liability for ordinary negligence arising from childcare services, except in cases of gross negligence or willful misconduct
Yes
No
Parent/Guardian full legal name (as signature)
Signature date
I am the parent or legal guardian of the child named above
True
False
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Paper art illustration depicting a babysitting release form with checkboxes and signature lines for FormCreatorAI article

When to use this form

Use this form when you leave your child with a sitter, nanny, neighbor, or after-school helper. It covers date nights, weekend trips, school holidays, and recurring care. You record medical consent, emergency contacts, allowed activities, and pickup rules so the caregiver can act fast and safely. If you are still choosing a caregiver, collect details with the Babysitter and nanny application form and confirm history with a Nanny reference request form. Agencies or HR teams that help families can document checks through their standard process. The outcome: fewer panicked calls, faster care in an emergency, and clear ground rules that protect your child and your sitter.

Must Ask Babysitting Release Questions

  1. What is the caregiver's full legal name, date of birth, and contact information?

    This ties your authorization to the right person and prevents confusion with similarly named sitters. If you hire through a company, you can confirm these details using an Employee reference check form.

  2. Who has legal authority to consent to medical treatment, and what are your primary and backup contacts?

    Clear consent and reachable contacts let providers act fast in an emergency. Listing a backup avoids delays if your phone is off or out of range.

  3. What medical conditions, allergies, medications, and exact dosage instructions apply to your child?

    Specific instructions reduce risk and ensure safe care. Writing dosages and timing prevents mistakes when stress is high.

  4. Which activities and transportation are permitted or restricted (e.g., swimming, car rides, rideshares, screen time)?

    Boundaries keep expectations clear and lower liability for everyone. The sitter can plan the day without guessing or texting for every decision.

  5. Who may pick up your child, and what verification (photo ID or a pickup password) is required?

    Defining authorized adults prevents mistaken releases. Requiring ID or a password adds a simple layer of safety.

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