Summer Meal Form
Any child 18 years of age and under can get breakfast and lunch FREE through the Summer Food Service Program at the BBE Elementary School.  Food bags must be picked up on site at the BBE Elementary in Brooten on Wednesdays ONLY from 9:30-10:30am each week.  *Please bring a box or container to carry your packs home in since there will be a whole week’s meals distributed that day.

(New registrations must be in by 9am Friday to start the following week.)

Dates: June 1 - August 21, 2020
Pick Up: WEDNESDAYS from 9:30-10:30am
Location: BBE Elementary School Front Entrance

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Email *
Parent/Guardian Name: *
Phone Number: *
Number of children 18 years and younger needing meals: *
Dietary Restrictions (Dr note must be submitted.)
Non-Discrimination Statement
In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA.

Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.

To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: http://www.ascr.usda.gov/complaint_filing_cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by:

(1) mail: U.S. Department of Agriculture
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue, SW
Washington, D.C. 20250-9410
(2) fax: (202) 690-7442; or

(3) email: program.intake@usda.gov

This institution is an equal opportunity provider.
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