Common Contracts

1 similar Child and Adult Care Food Program Enrollment Agreement contracts

Institution Name: Lejeune-New River Child and Youth Program Agreement Number: 7422
Child and Adult Care Food Program Enrollment Agreement • January 7th, 2016

Participant’s Name: Date of Birth: Typical Days of Care: Mon Tues Wed Thurs Fri Sat Sun Typical Hours of Care: Arrival Time AM PM Departure Time AM PM(use military time or mark AM/PM) Meals Normally Breakfast AM Snack Lunch PM Snack Supper Evening SnackEaten in Child Care: If participant is an infant (0-11 months), please complete this box. Check all applicable choice(s) below:Facility/Provider offers Specify Name formula for infants through the CACFP. It is your choice whether or not to use this formula based on your infant’s needs. Baby foods provided by the facility must be in compliance with the infant meal pattern as required by 7CFP 226.20.I will use the formula offered by this facility/provider, and I will prepare ready to fee bottles for my infant. I will not use the formula offered by this facility/provider.If not, which formula will you send in ready-to-feed bottles for your infant? If the formula you provide is a special formula, a medical statement must be sub

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