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Wavier/emergency information for Jackson Hole Nannies 

I understands and agree that Jackson Hole Nannies, LLC operates solely as a referral service, acting as an agent to connect families with independent childcare providers based on availability, qualifications, and experience at the time of placement. Jackson Hole Nannies, LLC does not employ, supervise, or control the childcare providers referred, and all babysitters and nannies are independent individuals who contract directly with the Parent/Guardian.

I Agree

I request the sitter seeks 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, injury, 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 Agree

I understand there is a 4 hour minimum per visit. I can use less than the 4 hours but will be expected to pay for the full 4 hours. I understand there is a 24 hour cancellation policy. If I cancel within the 24 hour window leading up to my reservation time, I will pay for 4 hours of service. I am aware that the sitter has committed their time to my children that these two polices will be enforced. 

I Agree

Household Employment Tax Acknowledgment

The Parent/Guardian acknowledges and understands that, under applicable federal and state tax laws, individuals engaged through the Agency to provide in-home childcare services (including babysitters and nannies) may be classified as household employees. The Parent/Guardian further acknowledges that if total compensation paid directly to any such individual equals or exceeds $2,999 within a calendar year (or such other threshold as may be required by law), the Parent/Guardian may be considered a household employer and assumes all corresponding legal and tax obligations.

These obligations may include, but are not limited to: (a) verifying employment eligibility through completion of Form I-9; (b) issuing a Form W-2 to the employee and filing required copies with appropriate government agencies; and (c) withholding, reporting, and remitting applicable federal, state, and local taxes, including but not limited to Social Security, Medicare, and unemployment taxes.

The Parent/Guardian agrees that the Agency does not provide tax, legal, or accounting advice and is not responsible for the Parent/Guardian’s compliance with household employment laws. The Parent/Guardian is solely responsible for determining and fulfilling all applicable employer obligations and is encouraged to consult with a qualified tax professional regarding their specific responsibilities.

I Agree



First Children Name
First Name*
Last Name*
First Children Age Acknowledgment*
First Children Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Children Signature*
Second Children Name
First Name*
Last Name*
Children Date of Birth*
Date of Birth
Third Children Name
First Name*
Last Name*
Children Date of Birth*
Date of Birth
Fourth Children Name
First Name*
Last Name*
Children Date of Birth*
Date of Birth
Fifth Children Name
First Name*
Last Name*
Children Date of Birth*
Date of Birth
Sixth Children Name
First Name*
Last Name*
Children Date of Birth*
Date of Birth
Seventh Children Name
First Name*
Last Name*
Children Date of Birth*
Date of Birth
Eighth Children Name
First Name*
Last Name*
Children Date of Birth*
Date of Birth
Ninth Children Name
First Name*
Last Name*
Children Date of Birth*
Date of Birth
Tenth Children Name
First Name*
Last Name*
Children Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
Emergency Contact
First Name*
Last 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.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Last Name*
Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
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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