Childcare Reimbursement Form
Rivertown Community Church is committed to removing obstacles to small group participation. To support this, we offer reimbursement to group members for childcare expenses.

Childcare expenses are processed in the following ways:
  • We reimburse only the parents or group leader at a set rate of $15 per hour/per babysitter up to 3 hours per event.
  • One childcare reimbursement form is to be filled out per event.
  • Reimbursement will be issued to the Parent/Small Group Leader within 2-3 weeks. 
  • For accounting purposes, each form must be submitted within 30 days of the event.
You will receive a confirmation email containing all your responses upon completion of this form.
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Email *
Campus *
REIMBURSEMENT PAYABLE TO:
Parent or Small Group Leader ONLY
Name *
Address *
City *
State *
Zip *
Phone Number *
Small Group Information
Small Group Name *
Small Group Leader's Name *
What date did your group meet? *
MM
/
DD
/
YYYY
Number of Children *
Number of Hours *
Reimbursement Amount Request *
Submit
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