Babysitting Safety Checklist

Child's First Name

Child's Age or Age Range

Parent/Guardian Name

First NameLast Name

Parent/Guardian Contact Number

Please enter a valid phone number.Format: (000) 000-0000.

Babysitting Date

Date

Start Time

Hour Minutes

AM/PM Option

End Time

Hour Minutes

AM/PM Option

Babysitting Location Address

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Number of Children Being Cared For

Allergy information

Dietary restrictions

Medication needs

Routine schedule notes

Nap or bedtime preference

Feeding instructions

Comfort items and important notes

Emergency Contact Name

First NameLast Name

Emergency Contact Relationship

Emergency Contact Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Preferred Hospital or Urgent Care Facility

Permission to Call Emergency Services if Needed

Evacuation Meeting Point

Home Safety Instructions

Safety checks completed before babysitting

Were all required safety checks completed?

Areas confirmed as safe for supervision

First-aid kit location confirmed

Screen and device limits followed

Notes for any safety items not completed or requiring attention