Clone of Feeding South Florida's 2025 Summer BreakSpot Interest Form

Feeding South Florida's Summer BreakSpot Application

Summer Food Service Program 2026
Please complete this form if you are a summer camp in Palm Beach, Broward, or Miami-Dade counties interested in becoming a Summer BreakSpot site in 2026.

Selected sites will receive meals from Feeding South Florida to serve children ages 0–18 during scheduled meal times. Sites may choose two of the following: breakfast, lunch, or afternoon snack.

Sites must have enough staff available during meal service and submit weekly meal counts/reporting to Feeding South Florida.

Please note this is an interest form only. Submission does not guarantee participation in the Summer BreakSpot Program.

We are all part of each other’s success!

To learn more about Feeding South Florida, visit our website: https://feedingsouthflorida.org/

QUESTIONS?
Please contact:

Adriana Moncada: email - amoncadax@feedingsouthflorida.org or call 954.518.1818 x1827, OR
Xavier Parker: email - xparker@feedingsouthflorida.org or call 954.518.1818 x1815
Contact Person Name

First NameLast Name
Contact Person Email
example@example.com
Agency/Organization Name*
Agency/Organization Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County*
What type of organization will run your summer programs? (For-profit organizations may qualify if they are open to the public.)*

Non-proft organizationFor-profit company
Does your organization/site currently operate any government meals programs under the Child Care Food Program? (Afterschool Meals, National School Lunch Program, Summer Meals, etc.)*

YesNoUnsure
Describe your Site (select closest description)*
Do you operate multiple sites*

YesNo
If yes to previous question, how many sites?
What is the age range of children will you expect to serve (Age 0-18)?*
Days of the week will your program expect to serve (select all that apply):*

MondayTuesdayWednesdayThursdayFriday
Do you plan on having field trips?*

YesNo
Do you have food storage equipment for field trips? (e.g. coolers)*

YesNoN/A
Are you planning any closures during the program? (Select all that apply)

JuneteenthJuly 4thN/AOther
What date may your program begin meal services? (As early as...)*
What is the last date your program may provide meal services? (Not after...)*
Do you have on-site access to refrigeration?*
Have your volunteers/staff passed background checks?*

YesNo
Approximately how many children do you anticipate serving per meal? *
Which meals do you expect to serve during your Summer Program? (Please select ONLY 2)*

BreakfastLunchAfternoon Snack
Please list your meal service times (for example: Breakfast: 8:00–10:00 AM; Lunch: 1:00–2:00 PM OR Lunch: 12:00–2:00 PM; Snack: 3:00–5:00 PM).
Who will be your Site Supervisor?*

First NameLast Name
Position/Title of your Site Supervisor*
Email Address for your Site Supervisor*
Phone Number for your Site Supervisor*

Area CodePhone Number
Who do you expect to be your ALTERNATE Site Supervisor?*

First NameLast Name
Position/Title of Alternate Site Supervisor*
Email address for Alternate SiteSupervisor*
Phone number for Alternate Site Supervisor*

Area CodePhone Number
Should be Empty:

Feeding South Florida's Summer BreakSpot Application