Birdie Childcare Nest Waiver

Please complete below…

I/We, the undersigned, are the parent(s) of the below named child/children and we agree, in taking advantage of this child care services, to release and hold harmless Birdie Break from any and all claims, demands, suits, cost, and charges in connection with or arising out of the child care service, including, but not limited to, bodily harm or injury to our children.

We agree to release and hold harmless Birdie Break from any and all claims for damage to or loss of any of your property resulting from or arising from being present on the premises.

I hereby grant permission for Birdie Break and its Birdie Sitters full authority to take whatever actions they deem necessary regarding my child’s health and safety in the event I cannot be reached or in the situation where time is of the essence; and fully release Birdie Break and its Birdie Sitters from any liability in connection with those decisions, I grant permission for emergency treatment by a rescue squad, private physician and/or hospital or emergency health care facility staff if needed. Any such action will be taken in the best interest of my child and will be reported to me as soon as possible.

Child Name

Use a new line for each child

First Name

Last Name

Age

Child Name 2

First Name

Last Name

Age

Child Name 3

First Name

Last Name