ISD 110 Elementary Weekend Meals Electronic Enrollment/Permission Form

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Sign up to receive a free bag of food every Friday during the school year. The bag will have non-perishable, easy to make meal options.

There are no qualification requirements and your family's privacy is protected.

I give permission for a bag of food to be provided to my child while they are at school. By submitting this form, I agree and understand:

-It is my responsibility to remove food items that my child should not consume.
-Food will be packed in a reusable bag and placed in the school's front office. The student )or parent/guardian) will pick up the bag from the office before leaving for the day on the last day of the week (typically Fridays).
-If my child cannot responsibly transport the bag of food home, I will pick up the food at the school or no longer participate in the program.

Parent/Guardian Name *

Parent/Guardian Email *

Parent/Guardian Phone Number: *

Child's Name *

Elementary School *

Teacher's Name: *

Grade *

Who will pick up the Weekend Meal Bag(s) from the school's front office? *

Your child / the student

I (their parent or guardian) will pick up the bag from school

If you have older children attending the Waconia Middle School or High School and want this meal bag included with the older siblings at that building, please indicate here:

Yes, at Waconia Middle School

Yes, at Waconia High School

No thank you, will pick up at my elementary

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This form was created inside of Waconia United Food Shelf.

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