Student Food Plan

Student Food Plan

This Student Food Plan ("Plan") establishes the terms under which Student receives campus dining services and the Student or Parent/Guardian agrees to payment, dietary disclosure, and administrative conditions described below. Complete all sections and sign the certification at the end.

Student Information

Date of Birth:

Parent / Guardian (If Student is Minor)

Plan Selection & Billing

Select Meal Plan (select one):

Full Board — unlimited dining hall access

Meal Swipes — specified number of meals per week

Decline Plan — student will not participate in campus meal plan

Month: Day: Year:

Credit / Debit Card Semester Billing to Student Account Monthly Installments

Dietary & Medical Information

Requires formal accommodation (physician documentation required):

Terms, Conditions, and Disclosures

Enrollment obligates the signatory to the full financial terms of the selected Plan for the stated Plan period unless cancellation is made in accordance with the written cancellation provisions set forth below. Charges for the Plan will be applied to the student account or charged to the payment method provided. Failure to pay billed amounts when due may result in suspension of meal privileges and holds on academic records.

Cancellation and Refunds: Requests to cancel the Plan must be submitted in writing to the campus dining office. Refunds, if any, will be calculated based on the institution's published refund schedule and may be prorated from the date written cancellation is received. No refunds are guaranteed for voluntary withdrawal after the refund deadline. Plan termination for disciplinary reasons does not entitle the signatory to a refund except as expressly provided by institution policy.

Dietary Accommodation: The dining services will make reasonable efforts to accommodate documented medical dietary needs. Accommodation requires timely written notice and, when requested, physician documentation specifying required dietary modifications. The institution is not liable for adverse reactions where accommodations are not feasible or where undisclosed allergies or conditions exist.

Liability and Indemnification: The institution makes reasonable efforts to provide safe food service but does not assume liability for personal injury, allergic reaction, or property loss arising from participation in the Plan, except to the extent caused by the institution's gross negligence. The signatory agrees to indemnify and hold the institution harmless from claims arising from failure to disclose allergies or medical conditions fully and accurately.

Privacy and Use of Information: Information provided in this Plan, including health-related disclosures, will be used by dining services and authorized campus personnel to administer dietary accommodations and billing. Such information will be treated as confidential and disclosed only to personnel with a legitimate need to know, except as required by law.

Governing Law and Venue: This Plan is governed by the laws of the state in which the institution is located. Disputes arising under this Plan will be resolved in the appropriate courts of that state.

Consent and Acknowledgment

By checking the boxes below and signing, the signatory certifies that all information provided in this Student Food Plan is true and complete to the best of their knowledge, authorizes assessment of charges as indicated above, and consents to the sharing of dietary and medical information with campus dining staff as necessary to provide accommodations.

I authorize charges for the selected Plan to be applied to the student account or payment method provided.

I consent to the limited disclosure of health and dietary information to dining services and authorized staff for accommodation purposes.

I have read, understand, and agree to the Terms, Conditions, and Disclosures above.

Emergency Contact

Signatory role: Student (18 or older) Parent/Guardian (signing for minor)

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