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Wavier/emergency information for Jackson Hole Nannies good for 1 year from date of signature.

I understand that Jackson Hole Nannies, LLC is a referral service, acting as an agent between families and childcare providers to locate the best match based on availability and experience at the time.

I Agree

I request the sitter seeeks emergency medical care for my child/children if it becomes necessary and I understand that I am liable for all medical costs associated with the treatment provided. 

I hereby relinquish all claims or possible liability with Jackson Hole Nannies, LLC. At no time will JHN, LLC be held responsible for any damage, loss or illness resulting from this placement/employment with a JHN, LLC referral, including any non-negligent acts of commission or omission on my part or the part of the referred nanny. I agree that JHN, LLC will not be held liable for the reimbursement of any fees arising from any possible court costs or lawyers’ fees stemming from any claim that may be made by any person. 

I Agree

I agree to inform Jackson Hole Nannies, LLC of any additional dates/times needed for childcare in addition to the original placement.  I agree not to solicit service from or privately engage in business with the babysitter referred to me through JHN, LLC.  I understand that each sitter has signed an agreement with JHN, LLC that prohibits him/her from providing childcare on the side for a past or present client of JHN, LLC without written consent. I understand there is a 24 hour cancellation policy. If I need to cancel,  I need to do so with at least a 24 hours advance notice to avoid charges. 

I Agree

Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. Jackson Hole Nannies has put in place preventative measures to reduce the spread of COVID-19; however, Jackson Hole Nannies cannot guarantee that you or your child (ren) will not be exposed to and/or become infected with COVID-19. Further, employing a nanny could increase your risk and your child (ren)’s risk of contracting COVID-19.

By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child (ren) and I may be exposed to or infected by COVID-19 by hiring a nanny referred through Jackson Hole Nannies, and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19  may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Jackson Hole Nannies, children and families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child (ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child (ren) may experience or incur in connection with using Jackson Hole Nannies’s services.                    

On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless the agents, contractors and  representatives, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of Jackson Hole Nannies, its employees, agents, contractors, and representatives, whether a COVID-19 infection occurs before, during, or after the event or date of hire.

I Agree

First Children Name

First Name*

Last Name*
First Children Date of Birth*
I certify that I am 18 years of age or older
First Children Signature*
Second Children Name

First Name*

Last Name*
Second Children Date of Birth*
Third Children Name

First Name*

Last Name*
Third Children Date of Birth*
Fourth Children Name

First Name*

Last Name*
Fourth Children Date of Birth*
Fifth Children Name

First Name*

Last Name*
Fifth Children Date of Birth*
Sixth Children Name

First Name*

Last Name*
Sixth Children Date of Birth*
Seventh Children Name

First Name*

Last Name*
Seventh Children Date of Birth*
Eighth Children Name

First Name*

Last Name*
Eighth Children Date of Birth*
Ninth Children Name

First Name*

Last Name*
Ninth Children Date of Birth*
Tenth Children Name

First Name*

Last Name*
Tenth Children Date of Birth*
Parent or Guardian's Email Address

Email
A signed copy of this waiver will be sent to the email address you provide.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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