2021-2022 Kindergarten Lunch Program
The monthly lunch (or milk only) fees listed below have been figured ($4.00 lunch/ $.50 milk only) according to the number of school days in each month.

AUGUST & SEPTEMBER Lunch Fee - $84 / milk only $10.50
OCTOBER Lunch Fee - $72 / milk only $9.00
NOVEMBER Lunch Fee - $76 / milk only $9.50
DECEMBER Lunch Fee - $52 / milk only $6.50
JANUARY Lunch Fee - $76 / milk only $9.50
FEBRUARY Lunch Fee - $72/ milk only $9.00
MARCH Lunch Fee - $60 / milk only $7.50
APRIL Lunch Fee - $80 / milk only $10.00
MAY Lunch Fee - $64 / milk only $8.00

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Important Notes
1. I understand that the monthly lunch fees will be billed to my online Smart Tuition account.
2. I also understand no credit will be given for absences or if my child chooses not to eat the lunch served on a particular day.
3. Lunch fees will not be pro-rated.
4. If you wish to cancel the program, you must fill out an Information Change Form before the first of the month that you wish to drop and submit it to the school office. Please be sure to keep a copy of the change form for your records as it will be your receipt of the change. The business office will notify the teacher of changes when the Information Change Form is processed.

I have read and understand the above information concerning this lunch program. *
2021-2022 Kindergarten Lunch Program
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Student Information
Student's First Name *
Student's Last Name *
Student's Kindergarten Teacher *
Food Allergies
Please list any food allergies your child may have below AND click on link below to complete, print, and turn in to the office The Food Allergy Action Plan Form. https://schaumburgchristian.com/wp-content/uploads/2018/06/2016-2017-Food-Allergy-Action-Plan.pdf
List Food Allergies
Parent/Guardian Information
By typing your name on the line below, you are acknowledging that you are the parent/guardian and approve the information given on this form.
Parent/Guardian's First and Last Name *
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