Students Eligible for Free or Reduced Lunch Program


I HEREBY AUTHORIZE release of my child's verification of Free or Reduced Price School Meals eligibility to the Milwaukee Rowing Club

Signature of Parent/Guardian                                                                                  Date

____________________________________                                                    ________________________


Instructions to the Principal, Administrator, or Food Services Authorized Representative:

Verify that this student is eligible for Free or Reduced price School Meals.  The student must bring this completed form to their first day of Learn to Row in order to participate. 

Is this student eligible for Free or Reduced Priced School Meals?  Circle One.               YES                 NO

Name of Authorized Representative                                                                        Title

____________________________________                                                      ________________________

Verification Signature                                                     Date Signed                                           Telephone Number

________________________________                   ____________________                     _______________________