Special Dietary Requirements Notification Form


This form should be completed by a parent or guardian.

Our Process

The Medical Team at Seaford College work in collaboration with our catering partner Holroyd Howe. Together, we have taken the approach that senior school pupils will be encouraged to manage their own dietary requirements within the school environment. This will enable pupils to develop the life skills to help them manage their requirements in the wider world. Pupils will be required to self-identify with the catering team at mealtimes.

Children in Years 1-3 will be chaperoned by class teachers who will assist the catering team by identifying pupils with dietary requirements

Children in Years 3-6 are required to remove their name from the board on the wall and hand it to a member of the catering team. This is the first step in teaching the children to take responsibility for their dietary requirements. School staff are always on hand to assist children identify themselves to the catering team.

Holroyd Howe have trained staff and processes in place to protect our community from harm. Allergy information for the 14 listed allergens in the Food Information Regulations 2014 is available at each point of service. Trained ‘allergy champions’ are on hand to advise and support pupils with their special dietary needs.

Name of Pupil *
Child Year Group *
Is your child a boarder or day pupil? *


Part 1: Allergies and Intolerances

Does your child have an allergy or intolerance to any of the following allergens?

Peanuts *
Is this one or more of the following? *
Milk *
Is this one or more of the following? *
Crustacean *
Is this one or more of the following? *
Soybeans *
Is this one or more of the following? *
Fish *
Is this one or more of the following? *
Nuts *
Is this one or more of the following? *
Sesame Seeds *
Is this one or more of the following? *
Celery *
Is this one or more of the following? *
Mustard *
Is this one or more of the following? *
Lupin *
Is this one or more of the following? *
Eggs *
Is this one or more of the following? *
Molluscs *
Is this one or more of the following? *
Gluten *
Is this one or more of the following? *
Suphites *
Is this one or more of the following? *
Do you allow your child to consume foods with terminology; such as 'May Contain' or 'Made in a factory that also handles' *
Other (please give details below) *
Other *

Part 2: Religious Preferences/Lifestyle

Does your child have non-permitted foods due to religious faiths or beliefs? *
Please provide details of non- permitted foods due to religious faiths or beliefs
Does your child have any lifestyle dietary requirements? *
If yes, please provide details of your child lifestyle dietary requirements. E.g. Vegetarian/Vegan etc.

Part 3: Management of Special Diet Meals

There are two options available for how meals can be provided. Please tell us your preferred option.

  • Separate Plated Meal

(Recommended for children with severe allergies)

This is a single (2 course) meal adapted from the main menu to ensure it is safe for consumption. It is prepared, pre-plated, and covered separately from other meals and stored away from other foods. Your child will be required to request this from the allergy champion, who will perform final checks to ensure the food is safe for consumption prior to handing the meal over.

This option minimises the risk of contamination/cross contamination and goes through the three step-process to ensure that it is safe for consumption. This option does limit access to salad bars, pasta and dessert stations where the risk of cross contamination is higher.

  • Choose from counters with/without assistance

Your child is free to choose a suitable meal from the counters with or without assistance from the catering team. If assistance is required, then the pupil will be required to ask for advice from the Allergy Champion.

I would like my child to receive a separate plated meal *
I would like my child to be able to choose from the counters with/without assistance of the Allergy Champion *

Part 4: Data Protection

I am happy for my child’s allergen information and photo (where provided) to be passed to Holroyd Howe to enable them to assist the school in correct food provision *

All information will be shredded when either confirmation of no allergies or intolerances, or when your child leaves the school.

Part 5: Parent/Guardian Acceptance

Whilst we can provide meals which do not include nominated allergens, we cannot guarantee that dishes do not contain traces of allergens, as they may be stored and prepared in the same areas as nominated allergens. For example, Holroyd Howe do not use nuts in any of the food we prepare and serve. We are however unable to guarantee that dishes/products served are totally free from nuts/ nut derivatives, this is because ingredients, for example, curry paste, may be made in a factory containing nuts, bread may be baked in a factory handling nuts, or some production lines have machines lubricated with nut oil.

I confirm that the information supplied within this document is correct. Should any changes in my child’s allergy/intolerance status occur I will immediately resubmit this form.

Name of Parent/Guardian completing this form *
Parent/Guardian telephone number *
Parent/Guardian email address *
I would like to meet with the Catering Management Team to further discuss my child's food requirements *
I accept the above information *

Send me a copy of this form

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