Mealtime Drink Preference

Mealtime Drink Preference

In accordance with the USDA's Child and Adult Food Program, White Plains Children's Center is expected to serve unflavored whole milk to 1 year olds and unflavored low-fat or fat-free milk to children ages 2 through 5 years old at breakfast and lunch (water is served at afternoon snack). Please complete and sign the form below to allow White Plains Children's Center to serve anything other than the milk listed above.

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Child's Name *

First Name Last Name
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Child's Date of Birth *

Month Day Year
Date
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I, Parent/Guardian's First Name* Parent/Guardian's Last Name* request that White Plains Children's Center serve my child, Child's First Name* Child's Last Name* , Beverage of Choice (ex: water, soy milk, etc)* at * .

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Any additional information you want to provide (EX: special cup; thickening agent; etc.)
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Date *

Month Day Year
Date
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Parent/Guardian's Name *

First Name Last Name
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Signature *

Clear

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Should be Empty: