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LOC Food Allergies/Dietary Restrictions
This form should be filled out by the Adult Leader or Coach as representative of the whole team
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* Indicates required question
Group Name/School
*
Your answer
Email
*
Your answer
Number of students in your group? Number of adults?
*
Your answer
Allergies/Dietary Restrictions
Please specify how many of your group fall into these categories
If any of the allergies are SEVERE (anaphylactic response, etc), please specify!!!
Vegetarian
Your answer
Vegan
Your answer
No Pork
Your answer
Gluten-Free
Your answer
Gluten-Free - Celiac
Your answer
Dairy-Free
Your answer
Eggs
Your answer
Peanuts (Please specify if the allergy is airborne)
Your answer
Tree Nuts (Please specify if the allergy is airborne)
Your answer
Fish/Shellfish (Please specify)
Your answer
Any other SEVERE food allergies (Please Describe)
Your answer
For ease of meal planning, please make notes here if a student falls under multiple categories otherwise we will assume each issue is related to just the number of individuals noted. (i.e. Johnny is lactose intolerant, has celiac disease, and is also a vegetarian) *
Your answer
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