Great

Neck South Middle School

Family and Consumer Sciences Department

Dear Parent/Guardian of: _____________________________,

I am aware that your son/daughter has an allergy to ___________________________. Our class
will be starting to work in the foods lab soon. We believe that the products used in our course
are free of __________ ingredients, but would like you to review the attached product
ingredient label(s) to make sure that these items are safe for your child to work with in the lab
and/or consume. Please then complete the questions below and return this form to your childs
FACS teacher.

Check one box below:

I have reviewed the following labels, and all items are safe for my child to consume.

I have reviewed the following labels, and my child may NOT consume the following
items (list below):
_______________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________


Childs Name _____________________________________
Grade _________
Parent/Guardian Signature _____________________________

Date_________________

Please feel free to contact your childs teacher if you have any questions, concerns, or would
like to email your response.

Thank you for your assistance in making sure that your child enjoys a safe learning experience
in Family and Consumer Sciences.

Ms. Elena Teixeira

Sincerely,

eteixeira@greatneck.k12.ny.us