Paperwork | Karenaskornerdaycare

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Child's Record

Child's Record

Child's full name

Birthdate * required

For CACFP food program purposes:

Race:

American Indian or Alaskan Native

Asian

Black or African American

Native Hawaiian or Pacific Islander

Caucasion

Child's full name

Birthdate

For CACFP food program purposes:

Race:

American Indian or Alaskan Native

Asian

Black or African American

Native Hawaiian or Pacific Islander

Caucasion

Thanks for submitting!

Health & Medical

Contract

Contract Pg 1 of 2

Contract Pg 2 of 2

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