Summer Feeding Program

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please fill out this form to opt in or opt out of the Summer Feeding Program. Deliveries will take place on Wednesdays and Fridays, you will receive 3 meals per child, per delivery day. Meals are available to children in the District 18 years old and younger. Please note that we recommend you have a tote or cooler visible for delivery due to the summer heat, this ensures food maintains appropriate temperatures. Please allow 24 hours once you fill out this form to be placed on the list.

Email *

I am *

Requesting Delivery of the Summer Feeding Program

Opting out of the Summer Feeding Program

Parents Name *

Delivery Address *

Names and ages of children in household *

Contact Number

Are there any food allergies we should be aware of? *

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of St. Regis Falls Central School District. Report Abuse

Forms