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Form-CACFP To be completed by parent or guardian only Center Name: In the chart below, please indicate the normal days and hours your child(ren) is in care, and the meals received while in care Children s Names Date of Birth Age Normal hours in child care Please check ( ) meals your child normally receives while in care Breakfast AM Snack Lunch PM Snack Supper Breakfast AM Snack Lunch PM Snack Supper Breakfast AM Snack Lunch PM Snack Supper Breakfast AM Snack Lunch P.

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