World Cultures Day
SURVEY FOR STUDENTS WITH DIABETES OR FOOD ALLERGIES

Disclaimer: We cannot guarantee the absence of cross-contamination of our foods. We do not assume liability for adverse reactions to foods consumed or items that students come in contact with while eating at our school during the World Cultures Day.  
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World Cultures Day
KISKI AREA INTERMEDIATE SCHOOL
THURSDAY, NOVEMBER 16, 2023

In an effort to keep every child safe, please fill out this survey if you are concerned about your son/daughter's food sensitivities and do not want him/her to sample items offered.  

Please fill out one form for each of your children who will participate in the event. 


Please give your name:
 *
Your contact information (email or phone number)
 *
Please give your child's name. *
Your child's Homeroom Number *
Your child's Homeroom Teacher *
I do not want my child to consume..... *
Required
Please feel free to leave any additional information or comment you may have.   *
A copy of your responses will be emailed to .
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