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End 68 Program
Thank you for filling out this form.  By entering information in the spaces below, you are providing consent for your student to participate in the weekend backpack food program. I understand that my student(s) will receive a backpack of food every Friday afternoon during the school year and it is to be returned empty to the school every Monday morning.  
End 68 Hours of Hunger is a public not-for-profit effort to confront the approximately 68 hours of hunger that some school children experience between the free lunch they receive at school on Friday afternoon and the free breakfast they receive at school on Monday morning.
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Student First Name
Student Last Name
Parent/Caregiver Name(s)
Email Address of Parent/Caregiver
Address
Phone Number
Allergies or other food concerns
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