Community Before & After School Child Care Program

Food Allergies

Nuts are progressively finding their way into more and more food products either directly, or by indirect contamination of food products during the manufacturing process. Therefore, proper hand and face washing is mandatory. Prior to dropping off your child(ren) at CAP, please help us by making sure your child has properly washed their hands and face.

Additionally, we ask that you do not allow your child to bring any food items into the CAP program.  All snacks will be provided by CAP which are USDA approved and nut and seafood free.

If you are the parent of a child with food allergies either mild or severe, please select from the table below those forms associated with your child’s allergy.  These forms are MANDATORY and must be completed and on file with the CAP office before your child’s first day at CAP.  If you have any questions about these forms, please do not hesitate to call the CAP office at 541-967-9322.

If you are registering for our 2016 Summer Program, these forms will be required as part of your registration process.

FOOD ALLERGY REQUIRED MEDICAL FORMS & POLICIES

Allergy Required Forms
Fluid Milk USDA Milk Substitute Request OR
USDA Milk Substitute Request (Spanish)
Severe Fluid Milk USDA Milk Substitute Request OR
USDA Milk Substitute Request (Spanish)
AND
CAP Severe Allergy Medication Policy
CAP Participant Health Form
CAP Release Waiver for Severe Allergies
Dairy USDA Dietary Needs Medical Statement for Participants without Disabilities OR
USDA Dietary Needs Medical Statement for Participants with Disabilities
Severe Dairy USDA Dietary Needs Medical Statement for Participants without Disabilities OR
USDA Dietary Needs Medical Statement for Participants with Disabilities
AND
CAP Severe Allergy Medication Policy
CAP Participant Health Form
CAP Release Waiver for Severe Allergies
Food (Eggs, Soybean, Wheat, etc.) USDA Dietary Needs Medical Statement for Participants without Disabilities OR
USDA Dietary Needs Medical Statement for Participants with Disabilities
Severe Food (Eggs, Soybean, Wheat, etc.) USDA Dietary Needs Medical Statement for Participants without Disabilities OR
USDA Dietary Needs Medical Statement for Participants with Disabilities
AND
CAP Unserviceable Allergy Release Waiver
Peanut/Tree Nuts
(Mild & Severe)
USDA Dietary Needs Medical Statement for Participants without Disabilities OR
USDA Dietary Needs Medical Statement for Participants with Disabilities
AND
CAP Severe Allergy Medication Policy
CAP Participant Health Form
CAP Release Waiver for Severe Allergies
Fish, Shellfish
(Mild & Severe)
USDA Dietary Needs Medical Statement for Participants without Disabilities OR
USDA Dietary Needs Medical Statement for Participants with Disabilities
AND
CAP Severe Allergy Medication Policy
CAP Participant Health Form
CAP Release Waiver for Severe Allergies

“The Community After-School Program is an equal opportunity provider.”


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