Babysitter Registration Form
Huron Valley Swim Club
Member Information
Adult #1
Name
Cell Phone #
Adult #2 (if applicable)
Name
Cell Phone #
Children
Name
Age
Name
Age
Name
Age
Name
Age
Name
Age
Name
Age
Babysitter(s) Information
Babysitter #1
Name
Cell Phone #
Emergency Contact Name
Emer. Phone #
Babysitter #2
Name
Cell Phone #
Emergency Contact Name
Emer. Phone #
Babysitter #3
Name
Cell Phone #
Emergency Contact Name
Emer. Phone #
I have read and agree to abide by the Huron Valley Swim Club rules and the HVSC Babysitters Rules listed on the back of the page.
Babysitter #1 Signature
Date
Babysitter #2 Signature
Date
Babysitter #3 Signature
Date
Please stop by the front desk or pool office to drop off this form and pay the $75 registration fee.
(cash, check or debit/credit cards accepted)
Office Use Only
Date Received: ___________________
Form Complete?
Yes
No
Payment Received?
Payment Type:
cash
Yes
CC
No
check #
HVSC Babysitting Rules
Revised February 2016
1. All non-members who act as a caregiver/babysitter (in the commonly understood sense of the terms) for
member’s children must be registered with HVSC as a babysitter. This special privilege is extended to
member families to allow a non-member of your choosing to supervise member children at HVSC in the
member’s absence. Abuse of the privilege may result in the babysitting privilege being revoked and/or
suspension or termination of membership at HVSC.
2. A babysitter is not permitted to use HVSC facilities except when accompanying the member children in
his/her babysitting capacity.
3. A babysitter must be registered and the appropriate fee paid to HVSC before performing babysitter duties
at HVSC.
4. A babysitter is required to sign-in when watching member’s children at the club, and must adhere to all
club rules while at the club. It is the babysitter’s responsibility to ensure that the member’s children
obey all club rules while using the club and to monitor the activities and know the whereabouts of the
children at all times when at the club. Children must never be left unattended while they are in the
pools(s).
5. Failure to provide direct supervision may result in the babysitter pass being revoked.
6. If a babysitter accompanies the member family (i.e., not acting in the sole capacity as babysitter) the
babysitter must be registered as a guest and the daily guest fee paid.
7. All children under the age of 12 must be supervised by the babysitter at all times, except during staff supervised lessons or swim, dive, or tennis team practices. At the Club Manager’s discretion, supervision
may be required for any child.
8. A babysitter pass is valid for one season only and must be renewed each year. A babysitter can provide
service to one family per pass. If the babysitter is working for another family, a separate pass must be
purchased by that family.
9. Babysitter’s are not allowed to bring guests to the club while working as a babysitter. Member children
under the age of 12 are not allowed to bring guests while being supervised by a babysitter.
10. A member is allowed to register up to three individuals on the babysitter pass provided all individuals
are properly registered. Only one babysitter can provide care at a time, otherwise, additional passes
must be purchased.
Please visit hvsconline.com to read the Huron Valley Swim Club rules, or pick up a hard copy at the front desk
or pool office. [direct URL: http://www.hvsconline.com/docs/rules.pdf]