Radius Childcare Reimbursement Form
for vision night

Radius will happily reimburse for childcare: $13 an hour for up to 2 hours for 1 or 2 children, and $15 an hour for up to 2 hours for 3+ children.

Name *
Name
Should not exceed $13 an hour for up to 2 hours for 1 or 2 children, or $15 an hour for up to 2 hours for 3 plus children.
$
Mailing Address *
Mailing Address
If the email address you entered is not recognized by your bank, if your bank rejects the payment or your bank does not accept payment via Zelle, we will mail you a check.