Small Group Child Care Reimbursement Read the: Rock Bridge Child Care Reimbursement Policy Reimbursement Check Payable To:Childcare Reimbursement Policy* I have read and agree to the Childcare Reimbursement Policy Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone*Email* Other Information Needed To Process Your Request:Date(s) of Group Meetings Requiring Reimbursement:*Number of Total Hours* Number of Children* Amount Requested* Was child care arranged by the Small Group Leader for the small group:*YesNoThird ChoiceSmall Group Leader Name* Δ
