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First Name:
Last Name:
Email:
Phone:
Receive Texts*
Secondary Contact Name:
Secondary Contact Phone:
Receive Texts*
Emergency Contact Name:
Emergency Contact Phone:
Receive Texts*
Payment Method:
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Chase QuickPay/Zelle
PayPal
Venmo
Other
Payment Account (email or user handle):
* Checking this option opts you into receiving job-related text messages from LIFEVINE Family Services. It will never be shared with any third party and will not be used for marketing purposes. Msg & data rates may apply. You may uncheck and save to opt out at anytime. Opting out of text messages will not affect receipt of service-related emails.
User Type:
Sitter
Client
Admin
Region:
NYC
Rhode Island
Age Range:
Newborn
3 mo.
6 mo.
9 mo.
12 mo.
18 mo.
2 yr.
3 yr.
4 yr.
5 yr.
6 yr.
7 yr.
8 yr.
9 yr.
10 yr.
11 yr.
12 yr.
to
Any Age
3 mo.
6 mo.
9 mo.
12 mo.
18 mo.
2 yr.
3 yr.
4 yr.
5 yr.
6 yr.
7 yr.
8 yr.
9 yr.
10 yr.
11 yr.
12 yr.
Maximum dependents per booking:
1
2
3
4
5
Pets:
Have
No
cat(s)
Have
No
dog(s)
Other Settings:
After 5pm & weekends only
Available For Bookings
Not available between these dates:
Bio:
Notes:
Your Birthday:
Secondary Contact Birthday:
Anniversary:
Staff Notes:
Admin Notes:
Alert Message:
