Registration Form


 The Food 4 Kids Backpack Program provides a weekend supply of nutritious food for children suffering from food insecurity to replace the school meals that children miss during their weekend or extended breaks from school.  Each weekend food bag contains 7-9 items typically enough food for two breakfasts, two lunches and several snacks.
Please provide us with the information below to enroll a child from your school/class. Please note that we MUST have the parent/guardians name and contact information so we may contact them to verify enrollment and gather additional information if needed.


Child's Name:*
Parent/Guardian Name:*
Phone Number:*