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Home
Our School
Head’s Welcome
Admissions
Vision, Ethos and Aims
Mayfield Staff
Mayfield Governors
Vacancies
Key Information
Safeguarding
SEND
OFSTED Report
Pupil Premium
PE and Sport Premium Funding
Financial Information and Executive Pay
Policies
Parents
Term Dates
Our School Day
School Uniform
School Meals
Supporting Transition
New Starter Information & Forms
Attendance
Parent Wellbeing
Break Time Holiday Club
Curriculum
Our Curriculum
Careers Programme Information
Enhancements & Enrichments at Mayfield
Swimming
News & Events
News
Events
Newsletters
Galleries
SEN Teach Meet
Contact Us
Click to search using the term added
Translate
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Parents
New Starter Information & Forms
Medical Forms
Food Allergy & Dietary Restriction Form
Food Allergy & Dietary Restriction Form
Food Allergy Form
Child's Name
(Required)
First
Last
Is your child a new starter?
(Required)
Yes
No
Class
(Required)
Please select
Rainbow
Gold
Red
Green
Violet
Yellow
Pink
Blue
Orange
Indigo
Dream
Believe
Parent/Guardian Name
(Required)
Contact Number
(Required)
Email
(Required)
Type of Dietary Restriction
Check all that apply and provide details in the space below each selection.
Medical
(Required)
Examples: Diabetes, Celiac Disease, Kidney Disease, etc.
Yes
No
Please specify condition and required dietary modifications:
(Required)
Religious
(Required)
Examples: Halal, Kosher, Hindu Vegetarian, Vegan etc.
Yes
No
Please specify your religious dietary needs:
(Required)
Allergy
(Required)
Examples: Peanut allergy, Shellfish, Gluten, Dairy, etc.
Yes
No
List all known allergies and severity (e.g., mild, moderate, life-threatening)
(Required)
Is an EpiPen or other emergency medication required?
(Required)
Yes
No
Other
(Required)
Examples: Ethical vegan, Intolerances, etcExamples: Ethical vegan, Intolerances, etc Please describe your dietary needs:
Yes
No
Please describe your dietary needs:
(Required)
Does the child have a medically diagnosed allergy?
(Required)
Yes
No
Please specify and send in any letters you have that states this allergy
(Required)
Please provide any additional notes or instructions:
Consent
Name of the person filling out this form
(Required)
First
Last
Consent
(Required)
By signing this form, I acknowledge the above to be true and I confirm that I have read and comprehended the information provided, and that any information I have provided is accurate and truthful to the best of my knowledge.
