Compulsory Dietary Requirement Form

Our Food
We take great pride in producing healthy home cooked meals which are appealing to everyone. We try and cover all preferences and dietary requirements with our menus. This form must be completed at least two weeks before arrival to allow the chefs time to accomodate your needs or offer an alternative meal where possible.

Religious & Cultural Diets
1) Halal - although not a certified Halal kitchen, we can offer certain Halal products, if we are made aware at least two weeks prior to arrival
2) Asian Vegetarian - can be catered for, if we are made aware at least two weeks prior to arrival
3) Vegan - can be catered for, if we are made aware at least two weeks prior to arrival
4) Kosher - Unfortunately we are unable to offer Kosher products. A vegan alternative will be provided, if we are made aware at least two weeks prior to arrival

First Name

Surname

Do you have any of the following dietary requirements.

Food Allergies

In order to safely provide food for our guests, please read carefully the allergens stated below and select all those that apply.

If you have an allergy to tree nuts, crustaceans or molluscs, please specify (e.g. almonds).

If you have indicated that you have a food allergy, please provide further details including severity and method of transmission (e.g. ingestion, contact or airborne).

If you have any other allergy, intolerance or sensitivity, please provide details below. Please also include symptoms and severity.

Do you carry an adrenalin auto-injector (AAI), sometimes referred to as an EpiPen? Anyone prescribed an AAI should carry two devices at all times (current guidance from Medicines and Healthcare Regulatory Agency). Guests should also ensure that these are in good working order and in-date.

If you have any specific dietary requirements or allergies, please provide below, examples of any food substitutes you can eat.

Do you require food to be soft, mashed or blended? Please select all that apply.

Do you have any other dietary requirements?

Privacy
Your privacy is important to us.
We will use this information to manage your health and safety while you participate in a course of activities with the Lake District Calvert Trust. Your information will be treated confidentially and will only be shared as required to organise and manage your visit. This could include being shared with the leader of your visit, the person who has booked your stay or, in the event of a medical emergency, this information may be shared with the emergency services.

The Lake District Calvert Trust may also produce anonymised statistical data to report on meeting our equality targets and charitable objectives or to support research. Our full Privacy Policy can be found on our website at Privacy Policy

Signed by

Print Name

Signature Below

Please provide a signature

If, for any reason, you are unable to provide a digital signature on this document—for instance, if you are using assistive technology such as a screen reader—please indicate your agreement by selecting the checkbox in lieu of a signature.