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Club Fed Forms


Enrollment Paperwork

Authorization for Emergency Medical Treatment
PDF | Word

CACFP Enrollment
PDF | Word

CACFP Income Elegibility Form
PDF

Contract
PDF | Word

Cultural Family Assessment
PDF | Word

Delegation of Parental Authority
PDF

General Information Form
PDF | Word

Child in Care Medical Statement (State Form OCFS-LDSS 4433)
PDF | Word

Day Care Registration (State Form OCFS-LDSS 0792)
PDF | Word

Permission to Apply Sunblock, Lotions, Anti-biotic, etc.
PDF | Word


Authorization for Administration of Medication

Medication Consent Form (State Form OCFS_LDSS 7002)
PDF | Word

Individual Health Care Plan for a Child with Special Health Care Needs (State Form OCFS_LDSS 7006)
PDF | Word


Asthma Special Care Plan
PDF