Childcare Reimbursement Form

please note the following:

Reimbursement for Community Group meetings is at the rate of $13 per hour not to exceed 2.5 hours
Use your discretion as to how many sitters are required based on the age and compatibility of the children. (Normally we recommend no more than 4 children per sitter)

Childcare Reimbursement Form

Group Leader*
Date Of Event
MM slash DD slash YYYY
Name*
First Last
Address
Street Address City State ZIP Code
Number Of Children*
Amount Of Reimbursement Requested*