In order to utilize TLC for Kids' Temporary Services, please submit a completed registration form either by e-mail, fax, or US Mail. Upon receipt, the TLC office will charge an initial $50 membership fee to your credit card. In order to keep membership current, TLC requires an updated registration form and an annual renewal fee of $25.

Emergency phone contact (other than parents):

By entering your credit card number below you authorize TLC For Kids to charge an annual membership fee along with any additional fees for services provided by TLC For Kids. Please note we accept Mastercard or Visa only.

Please Describe your children:

2. Please list any pets:

Please describe situation:

Please add anything that you feel is important for us to know concerning you and your family.

Please update TLC regularly with new children, addresses, phone numbers, credit card numbers and pets.

How did you hear about TLC?

Would you like more information regarding other TLC services: (check all that apply)

Temporary Services Client Understanding and Release:

Understanding between parties:

1. TLC for Kids, Inc. (“TLC”) agrees to make its best effort to locate temporary child caregivers (“Caregivers”) upon request by the below-signed client (“Client”).

2. Rates: Client agrees to pay Caregivers directly for services rendered at least $10.00 per hour for 1-3 children and $11.00 per hour for 4-5 children. Newborn care and sick-child care are $11.00 per hour for 1-3 children and $12.00 per hour for 4-5 children. There is a four-hour minimum on all jobs.

3. Client understands that a non-refundable agency reservation fee will be charged to Client’s credit card upon TLC’s confirming Client’s reservation for a Caregiver.

4. If Client cancels a confirmed reservation within 24 hours of the scheduled visit, Client will be charged for four hours of the Caregiver’s time in addition to the agency reservation fee.

5. Client understands that the services provided by all TLC Caregivers must be contracted through the TLC office. Client further understands that the use of a TLC Caregiver the referral of a TLC Caregiver to a third party, without arranging the visit through TLC, is considered “theft of services” and will result in a charge of $1,000 in liquidated damages.

6. In the event that Client wishes to hire a Caregiver on a permanent basis, TLC agrees to negotiate with Client in arriving at an acceptable placement fee. TLC’s standard placement fee for a permanent Caregiver (“Nanny”) is 10% of the Nanny’s projected gross annual compensation, with a minimum of $1,000 for a part-time Nanny (under 40 hours per week) and a minimum of $1,500 for a full-time Nanny (40 or more hours per week).

7. Client understands that TLC Caregivers are not employees of TLC. Client understands that Client may be responsible for withholding and filing employment taxes for each calendar year in which the Caregiver’s payments exceed the limits set forth in the Internal Revenue Code. Social Security numbers of caregivers must be obtained directly from Caregivers.

8. Client agrees to indemnify, release and hold harmless TLC, its agents, employees and officers for any and all claims relating to or arising out of the services provided by Caregivers.

Transportation Waiver: (optional)

I  hereby give my consent for a TLC Caregiver to transport my child(ren) in her or my automobile. I understand that Caregivers with TLC are not employees of TLC and that TLC is making no representation or warranties to the Caregiver’s suitability to transport my child(ren). TLC is in no way responsible for the safety of my child(ren) while being transported in Caregiver’s or my family’s automobile. I agree to indemnify, release and hold harmless TLC, its agents, employees and officers for any and all claims including injury to Client’s car or child(ren) while being transported by a TLC Caregiver.
 

Medication Release: (optional)

I hereby give my consent for a TLC Caregiver to administer medication to my child(ren). I understand that Caregivers with TLC are not medically trained. I agree to indemnify, release and hold harmless TLC, its agents, employees and officers for any and all claims relating to a Caregivers administering of medication to my child(ren).