2022-2023 Food Permission Form- Mrs. Sampson
Please check the box next each item that your child  CANNOT HAVE. If your child has a dietary restriction that prevents them from eating any of the items listed below, please list any substitutes that can be used in the comments section at the bottom of this form2
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Child's Name *
The following items are to be used throughout the school year for various events. These include the winter read-in, Multiplication Madness celebration, as well as area, perimeter, weight, graphing and inference activities. Please select the items your child CANNOT have. *
Required
For any child who is restricted from eating any of the above, please list items that can be used as substitutions. Type NA if they can have everything above. *
Parent's Name (by typing your name, you are allowing you child to have the items checked above as part of school and core-related activities) *
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