Please Check One (required) Deliver mealsI'll pick up mealsNo meals now, just inform of future activities Student Name (required) Delivery Address City, ST Zip Phone (required) Ok to text? YesNo Alternate phone Email address Student's Age Grade completed Names of other children needing meals--non-students 18 & under not listed on other forms Allergy Information Emergency Contact Emergency Phone Relationship Special instructions, directions to home, etc. Are you on Facebook? YesNoNA Have you "liked" JC Kids' Lunch Bunch on Facebook? YesNoNA
