Summer Camps Dietary Accommodations Form

Please be aware this is only applicable for students who have a dietary accommodation need and/or allergy.

Camp/Conference Attending *

Beginning date student will be attending *

mm/dd/yyyy

Date of student departure *

mm/dd/yyyy

Participant Name *

Participant Email *

Participant Phone number

Preference on how to be contacted *

I have a food allergy

I have a Food Intolerace

I am Vegetarian

I am Vegan

Other reasons requiring a special diet

Anything else you would like to share?

If participant is a minor:

Please provide parent's contact information if we have further questions on dietary needs

*

Send me a copy of my responses

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