Child Care Payment • Pathways Community Church

Child Care PAYMENTS are to be made ONE week prior to group/event unless it is a last minute emergency. WHY do we ask this? It helps us to properly staff our rooms and keep in proper kid to worker ratio determined by CA law.

Thank you for your support and understanding. If you have any questions or need last minute child care (if you are requesting date less then 1 week to event), please contact Kelly Gaylord kelly@pathways.cc or 619-495-9371 (call or text).

NOTE: Please ignore the Dec date at thet top of the form please fill in date needed in the body of the form.

Date

December 15, 2024

Type

Price

Quantity

One Time Payment - 1 child

Price
$5.00

Quantity
One Time Payment - 2 children

Price
$7.00

Quantity
One Time Payment - 3 or more children

Price
$10.00

Quantity
4 weeks: 1 child

Price
$20.00

Quantity
4 weeks: 2 children

Price
$28.00

Quantity
4 weeks: 3 or more children

Price
$40.00

Quantity
6 weeks: 1 child

Price
$30.00

Quantity
6 weeks: 2 children

Price
$42.00

Quantity
6 weeks: 3 or more children

Price
$60.00

Quantity
8 weeks: 1 child

Price
$40.00

Quantity
8 weeks: 2 children

Price
$56.00

Quantity
8 weeks: 3 or more children

Price
$80.00

Quantity
10 weeks: 1 child

Price
$50.00

Quantity
10 weeks: 2 children

Price
$70.00

Quantity
10 weeks: 3 or more children

Price
$100.00

Quantity

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One Time Payment - 1 child 0

Parent Information:

First Name *

Last Name *

Email Address

Mobile Number *

Group or Event Attending *

Date(s) of Group/Event: *

Tip: Please let us know date(s) you are paying for childcare so we can staff appropriately. If there is less than 3 days until group, please contact Kelly 619-495-9371 to see if we can add another child to Child Care that week.

Comments/Questions:

Child Care Payment

Child 1 - Name

Child 1 - Age / Grade

Child 2 - Name

Child 2 - Age / Grade

Child 3 - Name

Child 3 - Age / Grade

Child 4 - Name

Child 4 - Age / Grade

Any specific needs we need to be aware of?

One Time Payment - 2 children 0

Parent Information:

First Name *

Last Name *

Email Address

Mobile Number *

Group or Event Attending *

Date(s) of Group/Event: *

Tip: Please let us know date(s) you are paying for childcare so we can staff appropriately. If there is less than 3 days until group, please contact Kelly 619-495-9371 to see if we can add another child to Child Care that week.

Comments/Questions:

Child Care Payment

Child 1 - Name

Child 1 - Age / Grade

Child 2 - Name

Child 2 - Age / Grade

Child 3 - Name

Child 3 - Age / Grade

Child 4 - Name

Child 4 - Age / Grade

Any specific needs we need to be aware of?

One Time Payment - 3 or more children 0

Parent Information:

First Name *

Last Name *

Email Address

Mobile Number *

Group or Event Attending *

Date(s) of Group/Event: *

Tip: Please let us know date(s) you are paying for childcare so we can staff appropriately. If there is less than 3 days until group, please contact Kelly 619-495-9371 to see if we can add another child to Child Care that week.

Comments/Questions:

Child Care Payment

Child 1 - Name

Child 1 - Age / Grade

Child 2 - Name

Child 2 - Age / Grade

Child 3 - Name

Child 3 - Age / Grade

Child 4 - Name

Child 4 - Age / Grade

Any specific needs we need to be aware of?

4 weeks: 1 child 0

Parent Information:

First Name *

Last Name *

Email Address

Mobile Number *

Group or Event Attending *

Date(s) of Group/Event: *

Tip: Please let us know date(s) you are paying for childcare so we can staff appropriately. If there is less than 3 days until group, please contact Kelly 619-495-9371 to see if we can add another child to Child Care that week.

Comments/Questions:

Child Care Payment

Child 1 - Name

Child 1 - Age / Grade

Child 2 - Name

Child 2 - Age / Grade

Child 3 - Name

Child 3 - Age / Grade

Child 4 - Name

Child 4 - Age / Grade

Any specific needs we need to be aware of?

4 weeks: 2 children 0

Parent Information:

First Name *

Last Name *

Email Address

Mobile Number *

Group or Event Attending *

Date(s) of Group/Event: *

Tip: Please let us know date(s) you are paying for childcare so we can staff appropriately. If there is less than 3 days until group, please contact Kelly 619-495-9371 to see if we can add another child to Child Care that week.

Comments/Questions:

Child Care Payment

Child 1 - Name

Child 1 - Age / Grade

Child 2 - Name

Child 2 - Age / Grade

Child 3 - Name

Child 3 - Age / Grade

Child 4 - Name

Child 4 - Age / Grade

Any specific needs we need to be aware of?

4 weeks: 3 or more children 0

Parent Information:

First Name *

Last Name *

Email Address

Mobile Number *

Group or Event Attending *

Date(s) of Group/Event: *

Tip: Please let us know date(s) you are paying for childcare so we can staff appropriately. If there is less than 3 days until group, please contact Kelly 619-495-9371 to see if we can add another child to Child Care that week.

Comments/Questions:

Child Care Payment

Child 1 - Name

Child 1 - Age / Grade

Child 2 - Name

Child 2 - Age / Grade

Child 3 - Name

Child 3 - Age / Grade

Child 4 - Name

Child 4 - Age / Grade

Any specific needs we need to be aware of?

6 weeks: 1 child 0

Parent Information:

First Name *

Last Name *

Email Address

Mobile Number *

Group or Event Attending *

Date(s) of Group/Event: *

Tip: Please let us know date(s) you are paying for childcare so we can staff appropriately. If there is less than 3 days until group, please contact Kelly 619-495-9371 to see if we can add another child to Child Care that week.

Comments/Questions:

Child Care Payment

Child 1 - Name

Child 1 - Age / Grade

Child 2 - Name

Child 2 - Age / Grade

Child 3 - Name

Child 3 - Age / Grade

Child 4 - Name

Child 4 - Age / Grade

Any specific needs we need to be aware of?

6 weeks: 2 children 0

Parent Information:

First Name *

Last Name *

Email Address

Mobile Number *

Group or Event Attending *

Date(s) of Group/Event: *

Tip: Please let us know date(s) you are paying for childcare so we can staff appropriately. If there is less than 3 days until group, please contact Kelly 619-495-9371 to see if we can add another child to Child Care that week.

Comments/Questions:

Child Care Payment

Child 1 - Name

Child 1 - Age / Grade

Child 2 - Name

Child 2 - Age / Grade

Child 3 - Name

Child 3 - Age / Grade

Child 4 - Name

Child 4 - Age / Grade

Any specific needs we need to be aware of?

6 weeks: 3 or more children 0

Parent Information:

First Name *

Last Name *

Email Address

Mobile Number *

Group or Event Attending *

Date(s) of Group/Event: *

Tip: Please let us know date(s) you are paying for childcare so we can staff appropriately. If there is less than 3 days until group, please contact Kelly 619-495-9371 to see if we can add another child to Child Care that week.

Comments/Questions:

Child Care Payment

Child 1 - Name

Child 1 - Age / Grade

Child 2 - Name

Child 2 - Age / Grade

Child 3 - Name

Child 3 - Age / Grade

Child 4 - Name

Child 4 - Age / Grade

Any specific needs we need to be aware of?

8 weeks: 1 child 0

Parent Information:

First Name *

Last Name *

Email Address

Mobile Number *

Group or Event Attending *

Date(s) of Group/Event: *

Tip: Please let us know date(s) you are paying for childcare so we can staff appropriately. If there is less than 3 days until group, please contact Kelly 619-495-9371 to see if we can add another child to Child Care that week.

Comments/Questions:

Child Care Payment

Child 1 - Name

Child 1 - Age / Grade

Child 2 - Name

Child 2 - Age / Grade

Child 3 - Name

Child 3 - Age / Grade

Child 4 - Name

Child 4 - Age / Grade

Any specific needs we need to be aware of?

8 weeks: 2 children 0

Parent Information:

First Name *

Last Name *

Email Address

Mobile Number *

Group or Event Attending *

Date(s) of Group/Event: *

Tip: Please let us know date(s) you are paying for childcare so we can staff appropriately. If there is less than 3 days until group, please contact Kelly 619-495-9371 to see if we can add another child to Child Care that week.

Comments/Questions:

Child Care Payment

Child 1 - Name

Child 1 - Age / Grade

Child 2 - Name

Child 2 - Age / Grade

Child 3 - Name

Child 3 - Age / Grade

Child 4 - Name

Child 4 - Age / Grade

Any specific needs we need to be aware of?

8 weeks: 3 or more children 0

Parent Information:

First Name *

Last Name *

Email Address

Mobile Number *

Group or Event Attending *

Date(s) of Group/Event: *

Tip: Please let us know date(s) you are paying for childcare so we can staff appropriately. If there is less than 3 days until group, please contact Kelly 619-495-9371 to see if we can add another child to Child Care that week.

Comments/Questions:

Child Care Payment

Child 1 - Name

Child 1 - Age / Grade

Child 2 - Name

Child 2 - Age / Grade

Child 3 - Name

Child 3 - Age / Grade

Child 4 - Name

Child 4 - Age / Grade

Any specific needs we need to be aware of?

10 weeks: 1 child 0

Parent Information:

First Name *

Last Name *

Email Address

Mobile Number *

Group or Event Attending *

Date(s) of Group/Event: *

Tip: Please let us know date(s) you are paying for childcare so we can staff appropriately. If there is less than 3 days until group, please contact Kelly 619-495-9371 to see if we can add another child to Child Care that week.

Comments/Questions:

Child Care Payment

Child 1 - Name

Child 1 - Age / Grade

Child 2 - Name

Child 2 - Age / Grade

Child 3 - Name

Child 3 - Age / Grade

Child 4 - Name

Child 4 - Age / Grade

Any specific needs we need to be aware of?

10 weeks: 2 children 0

Parent Information:

First Name *

Last Name *

Email Address

Mobile Number *

Group or Event Attending *

Date(s) of Group/Event: *

Tip: Please let us know date(s) you are paying for childcare so we can staff appropriately. If there is less than 3 days until group, please contact Kelly 619-495-9371 to see if we can add another child to Child Care that week.

Comments/Questions:

Child Care Payment

Child 1 - Name

Child 1 - Age / Grade

Child 2 - Name

Child 2 - Age / Grade

Child 3 - Name

Child 3 - Age / Grade

Child 4 - Name

Child 4 - Age / Grade

Any specific needs we need to be aware of?

10 weeks: 3 or more children 0

Parent Information:

First Name *

Last Name *

Email Address

Mobile Number *

Group or Event Attending *

Date(s) of Group/Event: *

Tip: Please let us know date(s) you are paying for childcare so we can staff appropriately. If there is less than 3 days until group, please contact Kelly 619-495-9371 to see if we can add another child to Child Care that week.

Comments/Questions:

Child Care Payment

Child 1 - Name

Child 1 - Age / Grade

Child 2 - Name

Child 2 - Age / Grade

Child 3 - Name

Child 3 - Age / Grade

Child 4 - Name

Child 4 - Age / Grade

Any specific needs we need to be aware of?