GSLP strives to accommodate your family's ethical, cultural, or religious dietary restrictions when serving food to your child at school. Please use the following form to describe any special diet your family follows that you would like your child to follow at school. List any food allergies or restrictions due to chronic medical conditions on the Health Care Plan as well.
Child's First Name
Child's Middle Name
Child's Last Name
Child's 2017-2018 Class
Two-Day Early Pre-K 2
Two-Day Early Pre-K 3
Three-Day Early Pre-K 3
Please check below if your child should adhere to any of the following dietary restrictions:
Cultural or religious restrictions
Describe Dietary Restrictions
If you checked a dietary restriction above, please describe anything GSLP should know about your child's dietary restrictions so that we can help your child adhere to them.
Specific Food Restrictions
Check off any food items your child **SHOULD NOT** be served at school. ITEMS THAT YOU CHECK OFF BELOW WILL **NOT** BE SERVED TO YOUR CHILD AT SCHOOL. Do not check off items your child simply does not like to eat. We encourage but do not force children to try new foods at preschool as part of teaching children about health and nutrition.
Milk Products (cheese, yogurt, etc.)
Milk in Processed Food
If you checked "Milk" or "Milk Products" above: May your child have milk if it is part of a cooked or processed food, such as cake or crackers?
Eggs in Processed Food
If you checked "Eggs" above: May your child have eggs if they are part of a cooked or processed food, such as cake or crackers?
Other Foods to Avoid
Please list any other foods to avoid and state the reason they should be avoided. Be sure to list any food allergies or medical dietary restrictions on your child's Health Care Plan as well.
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Good Shepherd Lutheran Preschool.