Childcare Reimbursement Form

Please fill out one form per session. Form must be submitted within 30 days of the session.
 
Childcare expenses are processed in the following ways:
  1. We reimburse parents at a set rate for the cost of an individual babysitter.
  2. One childcare reimbursement form is to be filled out by each couple/parent per session attended and submitted within 30 days of the session.
  3. A check will be issued and mailed to each couple/parent within 3-4 weeks.
Individual Reimbursement Chart(For individual sitters, please use this chart)
  1 hour 2 hours 3 hours 4 hours
1 child $9.00 $18.00 $27.00 $36.00
2 children $10.00 $20.00 $30.00 $40.00
3 children $11.00 $22.00 $33.00 $44.00
4 children $12.00 $24.00 $36.00 $48.00
Group sitting of 5 or more children will be paid at a rate of $12.00 per hour.

Your Information

Reimbursement Information

Campus *
 +