Disclaimer - By submitting this form, you understand that you are only eligible to receive childcare reimbursement for the timeframe that you and your spouse are required to be present for a Lifepoint staff function. You also understand that the amount of your reimbursement is based on Lifepoint's reimbursement rates and that any amounts reimbursed to you will be reported on your W2 and are subject to taxation pursuant to IRS tax regulations.