Special Dietary Request Form

Special Dietary Request Form

Must be submitted by July 15 so that camp can purchase food supplies.
Legal name*

First NameLast Name
Preferred first name*
Gender*

MaleFemale
Birth date*

MonthDayYear
Age group*

2-4 grade division5-6 grade division7-9 grade division10-12 grade divisonCILT camperAdult counselor
Parent/Guardian Contact Information

If we have any questions about your dietary request, we need to know who to contact. If you are 18 or older, please enter your information.
Parent/Guardian name*
Relationship*
Cell Phone*

Area CodePhone Number
Email (confirmation will be sent by email)*
example@example.com
Food Allergies/Digestive Disorders/Special Diets

Note: Due to the limited availability of products near camp, please be prepared to bring some meal alternatives to camp with you (i.e. snacks, etc.) or contact Frontier Camp immediately so other arrangements can be made. At this time, our kitchen is NOT equipped to accommodate requests for VEGAN options. If your diet includes vegan items, please bring food to camp for the week.
List any food allergies and note severity. Please specify if allergy is limited to eating food alone or as an ingredient in another dish.
List any digestive disorders and specify restricted foods.
List any special diet requests or instructions.
List any diabetic instructions. Please specify if Type 1 or 2 and give any special needs.
Should be Empty: