Echo Grove Special Diet Request Form

Echo Grove Camp
1101 Camp Road
Leonard, MI 48367
(248) 628-3108
www.echogrove.org

If you require a medical/vegetarian diet during your stay, please fill out this Special Diet Request Form. Please send all completed forms to jason.chisholm@usc.salvationarmy.org.

Your special diet request must be submitted to Echo Grove four to six weeks before your event and be confirmed by our staff.

A limited number of medical/vegetarian diets can be accommodated during any meal (usually 8-10 people).

Many preferences or weight loss menus can be accommodated within the framework of the menus planned during your stay.

We may not be able to accommodate all special diet requests.

We will not attempt to accommodate anyone with life threatening allergies due to risk and liability.

PLEASE SEND REQUESTS TO jason.chisholm@usc.salvationarmy.org

GUEST INFORMATION

Name of Participant*

First NameLast Name

If guest is a minor, please enter name of Parent/Guardian*

First NameLast Name

Phone*

Email*

example@example.com

Event you will be attending

Date of stay

DIETARY NEEDS

Medical DietVegetarian Diet

For medical diet, check all that apply:

Please use this space to include any other information that you would like us to know about your dietary requirements.