Food Allergies/Dietary Restrictions General Contact Information School/Organization Name * Primary Contact * First Name Last Name Email * Primary Contact Program Details Age or Grade(s) Participating * Number of Students * Estimated number of students participating in the program. Number of Adults Estimated number of Teachers AND Chaperones expected Program Start Date * MM DD YYYY Program End Date * MM DD YYYY Allergies/Dietary Restrictions Please specify how many in your group fall into these categories. If any allergies are SEVERE (anaphylactic response, etc.), please note this in the comments below. Vegetarian Vegan No Pork Gluten-Free Gluten-Free (Celiac) Dairy-Free Eggs Peanuts Please specify if the allergy is airborne Tree Nuts Please specify if the allergy is airborne Fish/Shellfish Please specify Note SEVERE allergies here, in addition to allergies not listed above. For ease of meal planning, please make notes here if a student falls under multiple categories. Otherwise we will assume each issue is related to just the number of individuals noted. * (i.e. Johnny is lactose intolerant, has celiac disease, and is also a vegetarian) Thank you!
