St. Luke's Academy

Inspiring Excellence

St. Luke's Academy

FOOD CONSUMPTION/OMISSION FORM

TO BE COMPLETED BY PARENT/GUARDIAN

Fields marked with an * are required

My Child/Ward
Has no food sensitivities or food allergies and is permitted to consume any food and/or beverage items brought to, or made on school grounds.
Please select and fill in appropriately below:
Mother/Female Guardian
Father/Male Guardian