Florida Department of Health Child Care Food Program Child Participation Form Name of Child: _Name of Facility: Tyndall Child Development Center Dear Parent: Please fill out the following information so that your may participate in the Child Care Food Program, reimburses child care providers for serving nutritious, well-balanced meals to children in child care. If child care hours are the same every day, please complete this chart. Day Normal Hours in Care Meals Normally Received While in Care  Breakfast X AM Snack Lunch X Mon Fri – 6:00 to 5:30 a.m. p.m.   PM Snack X Supper Eve Snack OR If child care hours are not the same every day, please complete this chart.    a.m. a.m. Breakfast AM Snack Lunch Monday to    p.m. p.m. Supper Eve Snack PM Snack    Breakfast AM Snack Lunch a.m. a.m. Tuesday to    p.m. p.m. PM Snack Supper Eve Snack    Breakfast AM Snack Lunch a.m. a.m. Wednesday to    p.m. p.m. PM Snack Supper Eve Snack    Breakfast AM Snack Lunch a.m. a.m. Thursday to   p.m. p.m.  PM Snack Supper Eve Snack    Breakfast a.m. a.m. AM Snack Lunch Friday to    p.m. p.m. PM Snack Supper Eve Snack    a.m. a.m. Breakfast AM Snack Lunch Saturday to    p.m. p.m. Supper Eve Snack PM Snack    Breakfast AM Snack Lunch a.m. a.m. Sunday to    p.m. p.m. PM Snack Supper Eve Snack Check here if your child has no regularly scheduled hours of care Signature of Parent/Guardian: Date: Printed Name: Phone Number:
Florida Department of Health Child Care Food Program Child Participation Form Name of Child: _Name of Facility: Tyndall Child Development Center Dear Parent: Please fill out the following information so that your may participate in the Child Care Food Program, reimburses child care providers for serving nutritious, well-balanced meals to children in child care. If child care hours are the same every day, please complete this chart. Day Normal Hours in Care Meals Normally Received While in Care Mon – Fri 6:00 a.m. to 5:30 p.m. Breakfast X AM Snack  Lunch X PM Snack X Supper  Eve Snack  OR If child care hours are not the same every day, please complete this chart. Monday a.m. p.m. a.m. to p.m. Breakfast  PM Snack  AM Snack  Supper  Lunch  Eve Snack  Tuesday a.m. p.m. a.m. to p.m. Breakfast  PM Snack  AM Snack  Supper  Lunch  Eve Snack  Wednesday a.m. p.m. a.m. to p.m. Breakfast  PM Snack  AM Snack  Supper  Lunch  Eve Snack  Thursday a.m. p.m. a.m. to p.m. Breakfast  PM Snack  AM Snack  Supper  Lunch  Eve Snack  Friday a.m. p.m. a.m. to p.m. Breakfast  PM Snack  AM Snack  Supper  Lunch  Eve Snack  Saturday a.m. p.m. a.m. to p.m. Breakfast  PM Snack  AM Snack  Supper  Lunch  Eve Snack  Sunday a.m. p.m. a.m. to p.m. Breakfast  PM Snack  AM Snack  Supper  Lunch  Eve Snack  Check here if your child has no regularly scheduled hours of care Signature of Parent/Guardian: Date: Printed Name: Phone Number: