Food Allergy and Sensitivity/Dietary Needs Information

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Please complete this form if your child has special dietary needs. You will also be including this information on the health form for our camp nurse. We'd like to gather more details here to share with our kitchen staff and camp counselors.

Are trace amounts of the allergen acceptable? What if your child touches a food that contains the allergen? For example, an egg allergy might mean that a child cannot consume ANY trace amount of egg or it could mean that they must avoid eating eggs when they are served. When a child is identified as allergic, it can mean many different things. We appreciate your help in clarifying the details.

Your child must be able to safely navigate food allergies away from parents in order to be included at Camp St. Charles. Campers often bring snacks and may offer to share them, campers with special dietary needs can be included if they are able to make appropriate choices independently.

Camper's Full Name (Participant, if not a camper) *

Which Session will your child attend in 2022? *

Session 1a beginning on June 19

Session 1b beginning on June 26

Session II beginning on July 3

Session III beginning on July 17

Session IV beginning on July 31

Camp Staff Member

Required

Is your child able to safely navigate food choices away from parents? (with friends, etc) Campers MUST be able to navigate food choices in order to attend Camp St. Charles. *

Yes

No (If your child it not able to safely navigate food choices away from parents, our program is not appropriate for them)

Is your child able to ask questions about food being served? (asking about allergens/clarifying/looking at menu board) *

Yes

Tell us about foods that your child can safely enjoy while at camp. This will help our kitchen crew to create alternative meals options that your child enjoys, please list a few favorites here. (we are looking for more input than just anything without the allergen, please) *

Can your child safely be seated near others who are consuming the allergen? *

Yes

Not Applicable (for food sensitivities, other non-allergy dietary needs)

Please list the foods that your child is allergic to and the reaction in the event of exposure. Please be as clear as possible. For example, some people who are allergic to eggs may consume cooked eggs in bread, others may not. Your details are very helpful. *enter N/A if your child does not have a food allergy. *

For children with significant/severe food allergies or special dietary needs....Many parents will bring some food items (labeled with the camper's name) to check in day. Will you provide some alternatives for your child to enjoy while at camp? *

Yes

Not Applicable

If we have follow up questions about how to assist your child in navigating food choices at camp, please give us your name and contact information below. Our cook may wish to connect. *

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