Work Entry

Childcare Reimbursement Form

Childcare Expenses are processed in the following ways:

We reimburse parents at a set rate for the cost of an individual babysitter.
One childcare reimbursement form is to be filled out by each couple/parent per gathering attended.
For accounting purposes, each form must be submitted within 15 days of gathering.

Parent First Name

Parent Last Name

Phone Number

Address

Date of Event

Gathering

Community Group (if applicable)

Total Hours of Event

Number of Children