New Membership Application - Easy Care Sitters

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 Information
Please 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 children
Child Name Child AGE
Address of where babysitting will occur*
Street Address Address Line 2 City 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?*
- Yes
- No
If yes, please specify what animal and how many.*
Membership Desired*
- Pay-as-you-go: $15/booking
- Booking Bundle: $125 for 10 bookings
- Unlimited: $150/month for unlimited bookings
Do you have a credit card with a US billing zip code?*
- Yes
- No
Medical Conditions or Allergies
Miscellaneous/Helpful Information
If 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
Phone
This field is for validation purposes and should be left unchanged.

Child Name	Child AGE

New Client Membership Information