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Lunch Bunch Consent Form
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* Indicates required question
Date:
*
MM
/
DD
/
YYYY
Child's Name:
*
Your answer
Grade:
*
6th
7th
8th
Parent/Guardian Name:
*
Your answer
I have read, understand, and agree to the terms of the Lunch Bunch Informed Consent. Please check one:
*
I give permission for my child to participate in the Lunch Bunch program. I understand that I may withdraw my consent at any time by providing a signed and dated note to Stephenson Middle School.
I choose to decline participation in the Lunch Bunch program for my child at this time.
Required
Parent/Guardian Contact Information:
Full Name:
*
Your answer
Cell Phone:
*
Your answer
Email Address:
*
Your answer
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