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Breakfast Learning Program - 24/25 School Year

WEST BENCH BREAKFAST LEARNING PROGRAM

INFORMATION & CONSENT FORM

DEAR PARENTS AND GUARDIANS:

We are pleased to announce that the Breakfast Club will once again be offered at West Bench Elementary. Breakfast will be served Monday to Friday from 8:30 am until 8:45am in the kitchen (early bus students will be welcomed at 8am). Students are invited to enjoy breakfast at no cost to their families. When arriving for Breakfast Club, students should enter through the front door of the school, wash their hands, and then line up at the kitchen door to order their breakfast.

Student Name*

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Parent/Guardian Name*

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If your child has any food allergies, please list below:

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Please select one

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I GIVE MY CONSENT for my child to participate in the Breakfast Meal Program.

I DO NOT CONSENT for my child to participate in the Breakfast Meal Program.