Bean Bag Food Program Registration 2023-2024

Dear Parent/Guardian,

We would like to invite your child to participate in a program called the Bean Bag Food Program (BBFP).  This program provides students with food for the weekend that is placed in a bag and delivered to your home by volunteers each Thursday afternoon. We will leave the food bag by the door. There is no cost to the participant’s family for the food.  If you are interested in having your child participate in the BBFP please complete the information below.  Feel free to contact the school counselor at your child’s school regarding any questions.

Please complete ONE FORM per CHILD

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Child's LAST name
Address (Street Name & Number, Apt. #)
City or Town
Please give any specific directions for delivery.
Child's School
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Child's Grade
Child's Age
Child's Birthdate  
MM
/
DD
/
YYYY
Child's Gender
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Known Food Allergies
Parent/Guardian Name(s)
Parent Phone Number(s) xxx-xxx-xxxx
Parent E-mail(s)

By signing this form, I agree to allow my child to participate in the Bean Bag Food Program.  I understand that I can withdraw my child at any time from this program with a written note sent to the school coordinator. I understand that for children with food allergies, the BBFP items may contain possible allergen-containing ingredients.  Parents and guardians concerned with food allergies need to be aware of this risk.  The BBFP nor the school will assume any liability for adverse reactions to food consumed.  By signing this form, I agree to assume any and all risks associated with my child’s participation in the BBFP, including any adverse reaction my child may have to foods consumed.


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