Student Dietary Accommodation Registration Form

Student Dietary Accommodation Registration Form

For Lunch Menu Sign-ups
Allergies and Dietary Restrictions

Due to potential cross contamination, Little’s Lunches recommends all children to be tested for food allergies prior to enrollment. Children at risk of unknown allergies or with diagnosed food allergies should first consult their doctor before participating in the program.

Dietary preferences such as dairy free, gluten free, and egg free items can be submitted to the chef for approval (this may involve an additional fee). Dietary preferences must be requested by completing this form and approved by the chef before any alternate lunches will be served.

Upon approval, the student’s preferences will be added to a label with their name to assure the student and staff are aware of the alternate accommodations. This label will be used each day for that specific child’s lunch.
Student Name

First NameLast Name
School Name
Grade
Birth Date

MonthDayYear
Guardian's Name Completing Form

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Please explain the student's dietary preferences below:
Should be Empty: