1st & 2nd Grade
Will he/she be eating from the school’s menu?
Does he/she have teeth?
Can he/she chew solid food?
List any allergies or digestive problems:
Please outline a schedule of feeding times:
Time: 6:45 am Ounces 6 ozs Type: Formula
Time: 6:45 am Amount 1 jar Type Peaches Special Instructions: mix with cereal
Please place my child on their to sleep.
He/she can rollover?
List a nap schedule
Would you like diaper cream applied at changing?
Parent / Guardian Signature
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