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This form is used to enroll children in the Child and Adult Care Food Program (CACFP), which provides nutritious meals and snacks to children in care. Parents need to provide information about the
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How to fill out Child and Adult Care Food Program Enrollment Form

01
Obtain the Child and Adult Care Food Program Enrollment Form from your local agency or online.
02
Fill out the top section with the name of the child or adult being enrolled.
03
Provide the date of birth and the age of the child or adult.
04
Fill in the address of the care facility or home.
05
Complete the section regarding the income eligibility of the enrolling party, if applicable.
06
Include any necessary parent or guardian information, including names and contact details.
07
Sign and date the form to certify that all information is accurate.
08
Submit the completed form to the designated local agency or care provider.

Who needs Child and Adult Care Food Program Enrollment Form?

01
Parents or guardians of children who attend daycare or early childhood programs.
02
Adults attending adult day care or similar programs.
03
Care providers seeking reimbursement for meals served under the Child and Adult Care Food Program.
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The Child and Adult Care Food Program (CACFP) is a federal nutrition education and meal reimbursement program. CACFP partially reimburses participating agencies providing healthy meals and snacks at Adult Day Service Centers under the Community Care Program.
To be eligible for participation in CACFP, a sponsor must be a licensed or approved child care provider or a public or nonprofit private school which provides organized child care programs for school children during off-school hours.
Please fill out the CACFP Meal Benefit Income Eligibility form. It helps us find out if your household qualifies for free or reduced-price meals. This lets us know how much money CACFP will give to support your day care home or center. Here are instructions to help you fill out the form.
ENROLLMENT FORM. Required Form for use by Child Care Centers and Head Start Programs. CACFP programs exempt from having an enrollment form on file are: Emergency Shelters, Outside School Hours, Youth Development & After School at Risk.
The Child and Adult Care Food Program (CACFP) is a federal program that provides reimbursements for nutritious meals and snacks to eligible children and adults who are enrolled for care at participating child care centers, day care homes, and adult day care centers.
A fruit and vegetable can be served as the two components at a CACFP snack. For example, you can serve carrots and grapes or apple slices and jicama sticks. Serve a rainbow of colors. The different colors provide an array of vitamins and minerals essential for good health.
How CACFP Works. The Child and Adult Care Food Program provides healthy meals to preschool children in day care centers and child care homes at a free or reduced-price. CACFP also provides free meals to children experiencing homelessness residing in eligible emergency shelters.

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The Child and Adult Care Food Program Enrollment Form is a document used by child care centers, family child care homes, and adult care facilities to enroll participants in the Child and Adult Care Food Program (CACFP), which provides nutritious meals and snacks.
Child care facilities, family child care providers, and adult care centers participating in the CACFP are required to file the Enrollment Form for each participant they serve to ensure they receive meal reimbursement.
To fill out the Enrollment Form, providers must provide information such as the participant's name, date of birth, eligibility category, and household size. Additional details may include income information or participation in other assistance programs, depending on eligibility requirements.
The purpose of the Enrollment Form is to document the eligibility of participants for meal reimbursement under the CACFP, ensuring that they receive nutritious meals, while also helping providers comply with federal regulations.
The information that must be reported includes the participant's name, date of birth, parent's or guardian's name, household size, income information or participation in assistance programs, and the type of care provided.
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