Pineview School

BACKPACK BUDDIES OF BAKER, INC.

Pineview School
Weekend Food Program Enrollment
At Backpack Buddies of Baker, we believe no child should worry about having enough food over the weekend. In partnership with Pineview, we provide free, confidential weekend food bags for students who may benefit from extra food when school is not in session.
Each bag may include cereal, macaroni and cheese, soup, fruit, granola bars, microwavable meals, snacks, and other kid-friendly shelf-stable foods. Food bags are distributed discreetly on the last school day before each weekend or holiday break.
This program is made possible through the generosity of churches, businesses, community partners, grants, and individual donors. There is never a cost to participating families.
Student Information
Child's Name:
Grade:
Parent/Guardian:
Phone Number:
Format: (000) 000-0000.
Additional Children in the Home:
Household Information
Food allergies or dietary concerns:
Parent Permission
I give permission for my child to participate in the Backpack Buddies Weekend Food Program. I understand that food bags may contain common allergens including peanuts, tree nuts, wheat, milk, eggs, and soy, and it is my responsibility to determine whether these foods are appropriate for my child. I understand participation is voluntary and provided at no cost.
Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Parent/Guardian Signature:
"Where God guides, He provides." — Isaiah 58:11
Backpack Buddies of Baker, Inc.
(850) 685-4918 • bakerbackpackbuddies@gmail.com

www.backpackbuddiesofbaker.org
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BACKPACK BUDDIES OF BAKER, INC.

Weekend Food Program Enrollment

Student Information

Parent Permission