Meal Account Restriction Form
Meal Account Restriction Form

Meal Account Restriction Form

Please complete this form to add a food restriction to your child’s meal account.  You may limit what your child may purchase from the school cafeteria.

Parent Name (First & Last):

Parent Phone Number:

Parent Email Address:

Student Name (First & Last):

Student ID:

School Name:


Common Restrictions
Below are two common meal account restrictions.  You may select one the below options or write in a meal restriction.

 Block my child from buying ALL a la carte items unless he/she has cash (chips, snacks, a la carte beverages, Subway, Java City, Pizza Hut, Red Mango, V8 smoothie, additional entrees, additional sides or seconds)

Block my child from buying snack a la carte items, but he/she may purchase extra entrees, sides and/or get seconds.

Remove buying restriction from my child’s account.  This will allow your child to purchase all a la carte items.

Comments (please be detailed)

If you have additional questions, please contact our front office at 817-215-0007.

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