I hereby release Williamsburg Nanny Agency (WNA) from all liability whatsoever that could result from obtaining and basing a decision on such information. I further authorize WNA to provide all information contained in this application, all information obtained from references, and all information obtained from any background screening of WNA.

​ I understand that falsified statements of any kind or omissions of facts called for on this application may result in my disqualification for consideration of representation by WNA.

​WNA is acting solely as a referral agent and at no time will WNA be my employer or be responsible for paying me. I understand that I am under no obligation to accept any referral to, or employment from, any client of WNA to which I am referred. I understand that should I accept such employment; the client of WNA will be my employer. I further understand that WNA does not guarantee that it will be able to provide me with any referral or that any referral made by WNA will result in my employment by any client of WNA.

I can provide two forms of valid identification, a valid driver's license, and proof of eligibility to work legally in the U.S.

​I agree that I will not provide any client of the WNA with any childcare services, except through WNA referral. I further agree that I will not refer any third party to a client or a client to a third party for that third party providing any client with childcare services.

​I agree to protect the privacy of the WNA specifically not to discuss any business matters regarding WNA, its employees, clients, and nannies.

​Nanny agrees to use their best efforts to present himself/herself to the client/family in a professional manner and arrive on time for interviews and placements and conduct himself/herself in a manner so as not to reflect poorly on the reputation of WNA with its Clients.

I hereby hold WNA harmless from any loss, damages, costs, or illness that may occur from a job placement.