Grab N’ Go Meals Parent/Caregiver Consent Form - Thornwell

Grab N' Go Meals Consent Form

Schools and non-profit organizations providing non-congregate meals under the Summer Break Café (SFSP) and SSO have the option to provide meals through home delivery or parent pick-up. Sponsors must obtain written consent from a child’s parent or guardian to pick up meals on the child’s behalf or receive home-delivered meals. Schools and non-profit organizations must maintain accountability, program integrity, and household confidentiality.

A guardian is defined as an adult who has a direct caregiver relationship with a child and is authorized to pick up meals for that child, as part of the “SUN Meals To-Go” for non-congregate service option.

PLEASE NOTE: Childcare providers who care for whole groups of unrelated children do not fall under the category of a “guardian” and cannot collect program meals on behalf of parents or guardians for children attending their childcare.

Name of School/Non-profit Organization: Thornwell Attn: Alice James
Address: 302 S Broad St.
City, State, Zip: Clinton, SC 29325
Phone Number of Contact: 864-938-2133

Parent or Guardian First and Last Name:(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Pick Up Location(Required)

Thornwell Dining Hall | M-F, 10am-1pm

Lydia Mill (Mobile Dining Hall) |Tues., 2:30pm-5pm

List all children in the household that will receive a meal along with their current age:(Required)

Parent or Guardian Signature:(Required)

Today's Date(Required)