Summer 2020 Gilford Got Lunch Application Form

Gilford Got Lunch Application form (2020 Summer Program)

* Indicates required field

Parent's Name(s) *

First

Last

Will someone be home to accept delivery? *

Yes No

Delivery Address *

Line 1

Line 2

City

State

Zip Code

Country

Contact Phone Number *

Email *

Special considerations we may need to know about delivering food to your address between 9 and 12 on a Monday morning? ie: Animals, specific place to leave bag, etc. *

#1 Child's Name *

#1 Child's DOB (mm/dd/yyyy) *

#1 Child's School *

#2 Child's Name *

#2 Child's DOB (mm/dd/yyyy) *

#2 Child's School *

#3 Child's Name *

#4 Child's Name *

#3 Child's DOB (mm/dd/yyyy) *

#4 Child's DOB (mm/dd/yyyy) *

#3 Child's School *

#4 Child's School *

ALLERGY and/or SPECIAL DIETARY NEEDS:
Please understand we are NOT able to accommodate allergies and/or special dietary need requests in our weekend bag program.

By checking the box below you waive all liability from your family’s participation in this program and all of the program’s sponsoring and collaborating partners. *

I agree to the terms listed above

Your Name *

First

Last

Submit