Food Permission Slip
Please complete this form to grant permission for food permission-related activities.
Child's Full Name
*
First Name
Last Name
Parent/Guardian Full Name
*
First Name
Last Name
Parent/Guardian Email Address
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Child's Date of Birth
*
Allergy Information or Special Dietary Needs
Type of Food Permission Granted
*
Please Select
Breakfast
Lunch
Snacks
All Meals
Date of Permission
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Permission to Participate in Food Activities
*
I consent to my child participating in food-related activities as described.
Authorization of Emergency Contact
*
Yes
No
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Additional Comments or Instructions
Submit
Should be Empty: