Allergy & Dietary Information MA - Allergy & Dietary Information Child's Name* First Last Does your child currently have any of the following allergies? If yes, please describe in detail.Food Allergies* Yes No DescriptionMedication Allergies* Yes No DescriptionEnvironmental Allergies* Yes No DescriptionDescriptionPlease list any special dietary requirements your child may have. If your child has allergies or dietary needs we request that you send in a small supply of non-perishable snacks that can be kept in your child's classroom. This allows your child to be included in any class activities involving food. Classroom teaches will also communicate with parents regarding any concerns about a child's allergies or dietary needs.Parent / Guardian Signature* First Last Date* Date Format: MM slash DD slash YYYY Pin Number*CAPTCHA