BCMS Youth Service Center Weekend Backpack Program

Your child was enrolled in the BCMS YSC Backpack program last school year. The program helps to meet the needs of students on the weekend when school breakfast and lunch are not available. With Bath County Schools starting the school year off virtual the weekend bags will be ready for either pick up at BCMS or if your family has signed up for school meals then the bags can be delivered by bus on Fridays. If you choose to pick up your child's weekend bag you will need to come to BCMS between 9-2:30 on Friday. The first weekend bags will be available on September 11th. As we approach September 28th, we will keep you informed to any changes regarding current delivery of the weekend bags. If you have any questions, you may contact BCMS YSC at 674-2110.

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* 1. Please check one below:

My child/children does not need to be on the backpack program.

My child/children needs to be on the backpack program.

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* 2. For this school year what learning option did you decided for your child/children?

Returning to school for in person instruction

Virtual learning

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* 3. Select meal delivery method.

will be participating in the school lunch delivery program on Friday.

will picking up from BCMS YSC on Friday.

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* 4. Student Information

Name

Address

City/Town

Email Address

Phone Number

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* 5. Student Information

Name

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* 6. Student Information

Name

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* 7. How would like to receive information regarding community programs and reminders about backpack deliveries. Please check one

by text message

by cell or phone call

email information

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* 8. Does your child/children have any food allergies?

Yes

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* 9. If you check yes to question # 8, list the child(ren) name and his /her food allergies

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* 10. Electronically consent for the 2021 Backpack Program: I give consent for my child/children to participate in the Bath Co. Middle School YSC Backpack Program. I also understand, that the bags may include products containing peanuts, wheat, milk or other common food allergens and that it is my responsibility to ensure the items are appropriate for my child/children to consume. I acknowledge that by typing my name below I'm giving consent for the Bath Co. Middle School Youth Service Center to provide my child/children with a weekend backpack.

Parent Signature

Child or children first and last names:

Date: