Grab & Go Snack Cart Permission Form

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Please complete this form for each individual child to indicate whether you give permission for them to access the Grab & Go Snack Cart when needed. If this form is not completed, we will assume that you do NOT give permission.

The following image provides the food and drink items currently available.

If you wish to change your permission at any time, please contact the school office.

Grab & Go Snack Cart Food and Drinks

What is your child's surname? *

What is your child's first name? *

What class is your child currently in? *

Prep A - Mrs Narelle Cooper

Prep B - Miss Jodie Ross

1A - Miss Shanae Stevens

1B - Mrs Hazel Van Loenen & Miss Grogan

2A - Mrs Jocelyn Pfander & Mr Smith

3/4A - Miss Dixon & Mrs Alycia Legge

3/4B - Mrs Rhiana Macrae

3/4C - Mr Stephen Franklin

5/6A - Mrs Leah Bromage

5/6B - Mr Ciaran Hanley

5/6C - Mrs Judy Haysom

Required

Do you give permission for your child to access the Snack Cart if/when required? *

Yes - I give permission for my child to access the Grab & Go Snack Cart if/when required

No - I do not give permission for my child to access the Grab & Go Snack Cart at any time

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This form was created inside of Yarra Road Primary School.

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