This form is for if you are requesting an elderly companion in your home or hotel.
3 hour minimum is required
Please note: We are NOT a homecare or nursing agency. Our sitters are NOT responsible for personal hygiene, bathing or assisting the member in the bathroom. All elderly members MUST be independent in the bathroom and be able to ambulate independently with or without an assistive device. If the member is in a wheelchair, they must be able to transfer in and out of the wheelchair, if need be, independently. Anyone taken out to a Doctors visit or outing MUST be independent in transfers in and out of the car as well as independent in ambulation with or without an assistive device. Our sitters are not trained in transfers or ambulation and they are not nurses. Our sitters are professionally screened, have a clear background check and have multiple references that are checked. They have experience and enjoy spending time with the elderly. It is our primary concern that both our sitters and your loved ones remain safe at all times. It is our goal to provide you with a responsible, compassionate, personable, fun-loving sitter who will help enhance and improve the life of your loved one!
Terms and ConditionsApplicant (Cardholder if different) acknowledges and accepts full responsibility and guarantees payment for all services requested by me or on my behalf, either verbally or in writing, whether or not such services are authorized by Applicant, (or Cardholder if different). Applicant (or Cardholder if different) agrees that Guardian Angels Sitting Service of Broward and Miami- Dade County LLC (“Agency”) may pursue all avenues of collection, including use of collection agencies, and authorizes Agency to prepare and submit credit card charges using any of the charge cards listed above to recover all charges and all other unpaid amounts due including those for failure to pay on time for services rendered through membership, damages for returned check charges in the amount of $30.00 per check, and cancellation fees.
I, Applicant, give my permission for this information about my family and my children to be shared with babysitters that may be caring for my children. I, Applicant understand that the Agency is not responsible for any damage, theft, or negligence that may occur as a result of having a sitter care for my children. I understand that the Agency performs background checks based on the information that the sitter provides to Agency. The Agency is not responsible if the sitter does not provide accurate and true information and is not responsible for any history that may not come up when the background check is completed.
I have read and understand that there is a 24-hour cancellation notice required or a cancellation fee in the amount of the 4-hour minimum for both the Agency and the sitter will apply. The undersigned represents that he or she has read and fully understands that this document is a release of liability.
RELEASE OF LIABILITY AND INDEMNIFICATION Applicant releases and forever discharges Guardian Angels Sitting Service of Broward and Miami- Dade County LLC ("Agency") and their officers, directors, agents, (collectively, the “Released Parties”) from any and all actions, costs, suits, demands, claims, damages, losses and liabilities (including reasonable attorney fees) of any type or kind whatsoever occurring from or connected with the issuance, receipt, or use of such Information by Agency and agrees to indemnify, defend, and hold harmless the Released Parties from and against any and all demands, claims, damages to persons, losses and liabilities (including reasonable attorney fees), arising out of, caused by, resulting from, or in any way related to the issuance, receipt, or use of such information.
ADDITIONAL TERMS AND CONDITIONS
No Waiver of Breach and Entire Agreement. TIME IS OF THE ESSENCE IN THIS AGREEMENT. The failure of either party to this agreement to insist upon the performance of any of the terms and conditions of this agreement, or the waiver of any breach of any of the term and conditions of this agreement, shall not be construed as thereafter waiving any such terms and conditions, but the same shall continue and remain in full force and effect as if no such forbearance or waiver had occurred. This agreement constitutes the entire agreement between the parties and any prior understanding or representation of any kind preceding the date of this agreement shall not be binding upon either party except to the extent incorporated in this agreement. Modifications of this agreement shall be binding only if evidenced in writing signed by Applicant and Agency.
By submitting this application, we the guardians/parents request the Agency refer a childcare worker (Independent Contractor) for our employment of same.
Applicant (Cardholder if different) acknowledges and accepts full responsibility and guarantees payment for all service requested, either verbally or in writing, whether or not such services are authorized by applicant, (or cardholder if different). Applicant (or cardholder if different) agrees that Guardian Angels Sitting Service LLC. May pursue all avenues of collection, including use of collection agencies, and authorizes GASS to prepare and submit credit card charges using any of the charge cards listed above to recover all charges and all other unpaid amounts due including failure to pay on time for services rendered through membership, damages for returned check charges in the amount of $30.00 per check and cancellation fees.
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