New Membership Application Please fill out the information below, and someone from the Easy Care Sitters team will follow up with you in 24 hours or less! New Client Membership InformationPlease fill out the information below and be sure to hit SUBMIT at the bottom. Without clicking submit, your information will not be sent to our servers. Thanks!Parent Name* First Last Child Information*Click the plus sign to add additional childrenChild NameChild AGE Address of where babysitting will occur* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Does your entrance have any buzzer/entry requirements we should know about?*Please let us know any special instructions for getting into your building.Primary Phone*Email* Do you have any pets?*YesNoIf yes, please specify what animal and how many.*Membership Desired*Pay-as-you-go: $15/bookingBooking Bundle: $125 for 10 bookingsUnlimited: $150/month for unlimited bookingsDo you have a credit card with a US billing zip code?*YesNoMedical Conditions or AllergiesMiscellaneous/Helpful InformationIf you have a date in mind that you need a sitter for, include that here, along with a start and end time (bear in mind we have a 3 hour minimum). Name the person who referred you so they get a free booking!*If it was from an online search, let us know if it was google, yelp, bing, whatever!Would you like to sign up for the ECS e-newsletter?You will only receive around 6 emails per year, and we'll never share you address with anybody else. Yes CommentsThis field is for validation purposes and should be left unchanged.
