Babysitter Information Sheet
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1BABYSITTER
Information sheet
Call 911 in case of any life-threatening emergency
Poison Control
Police Department
Fi re Department
1-800-222-1222
Name:
Weight:
as of
Date of Birth:
Pediatrician:
Allergies/Medical Conditions:
Phone Number:
Mom’s Name:
Dad’s Name:
Mom’s Phone Number:
Dad’s Phone Number:
Emergency Contacts
Home Address
Name:
Relationship to child:
Phone Number:
Nearest Cross Streets:
Name:
Relationship to child:
Phone Number:
Where are we?
Location:
When we’ll be back:
Additional Notes:
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Parent category: Business