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REGISTRATION FORM 
The YMCA will be distributing FREE Grab n Go meals every Wednesday and Thursday in your community!

PICK UP LOCATIONS:
Luttrell Elementary - Wednesday's 10am to 12pm
Washburn School - Wednesday's 1pm to 2pm
Rutledge Elementary - Thursday's 10am to 12pm

WHO'S ELIGIBLE?   All children 18 and under

WHAT WILL BE DISTRIBUTED?
7 Day Meal Bag (7 breakfasts/7 lunches) will be distributed each week to each child 

You will be given a menu at pick up for the week. Please note that some items may be listed however they were unavailable so the items has been replaced with another food item.

Meals will be provided while supplies last.

Once you submit your request you will be added to our pick up list. Please come to location requested on day and given time above.  We look forward to meeting you!

Email *
SITE YOU WILL BE PICKING UP FOOD *
LAST NAME *
QUANTITY FOR MEAL PICK-UP
How many children will you be picking meals up for  ...
*
CHILD'S NAME AND AGE (first name only)
Example:  Hannah 3, Mary 7, Lucas 15
*
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