CUSTOMER INFORMATION

Service Address Information

Child Care Information

Housekeeping Information

I hereby authorize Family Care Options by filling out and signing this credit card authorization form to charge the credit card provided for any and all services rendered and/or ordered by Family Care Options, Inc. The credit card provided will be charged in such a manner as if I were paying in person and signing a transaction slip. I understand there will be a 4% service fee for all phone and internet credit card orders.

Transportation Policy: Client is responsible for return car transportation after 10pm

Cancellation Policy:

If cancellation is not received by the agency within 24 hours of the start time of reservation the client will be charged for the entire confirmed reservation.

Method of Payment:

All major credit cards accepted and due upon confirming the care.