Conference Childcare Pre-Registration

Conference:

Parent's Information:
Please leave this field empty.

Child 1 Information:





Child 2 Information:





Child 3 Information:





Please list the following for any additional children:
Name, Age, Gender, Special Needs, Allergies, Special Diet

Additional Information

Liability Release Statement
I understand and agree that Super Sitters, Inc. does not assume any liability for any incident occurring on or off of any hotel property or my residential property where I have engaged Super Sitters, Inc.’s services.

I understand and agree that Super Sitters, Inc. does not assume any liability for any incident occurring in the swimming pool, and/or the swimming pool area. I understand that the Hotel where I have engaged Super Sitters, Inc.’s services may not provide Life Guards and that Super Sitters, Inc.’s hired sitters are not trained life guards.

In the event that a Super Sitter’s, Inc.’s sitter is hired to transport and/or accompany children to any area attraction, or to any place other than where said sitter is providing primary care, I understand and agree that Super Sitters, Inc. does not assume any liability covering any incident and/or accident occurring in any vehicle, guest/client or sitter owned or in any public transportation service vehicle.

In consideration of the preceding statements, I the undersigned adult agree to place my child/children or ward in the Super Sitters Inc. childcare program. For myself, my child/children or ward, I hereby agree to release and to indemnify and hold harmless Super Sitters Inc., and their respective officers, directors, agents, employees, assigns, contract laborers, and vendors and the owners and/or lessors of the facility or facilities where the childcare will be held (collectively "The Releases") from any and all claims which may now or hereafter arise from my child/children's or ward's participation in the Super Sitters Inc. childcare program arising out of or related to any loss, damage, or injury, including death that may be sustained by my child or children while under the care of Super Sitters, Inc. and/or while participating in any Super Sitters, Inc. program or field trip. I do not release claims arising from any willful misconduct or gross negligence.

I have read the above and understand this release. Furthermore, in the event of an emergency or health concern, Super Sitters, Inc. has my permission to administer first aid and or obtain emergency medical treatment for my child/children or ward. I agree to pay all expenses incurred due to an emergency involving my child/children or ward.

Electronic Signature - this is your legal signature and confirms that you have read and agree to all policies and the Liability Release Statement as stated herein:

In order to best serve our clientele Super Sitters always complies with the standards of each hotel. We are always open to suggestions and comments to further improve our services. We want to assure complete satisfaction to all of our customers.