Name of participant *

First Name

Last Name

If yes, please name every allergy from the following allergens *

N/A

Milk (in butter, cheese, cream, custard, yogurt, ice cream and more)

Nut (all nuts and in sauces such as pesto, curry sauce etc, dips, soups, dairy-free alternatives and more)

Mustard (in condiments, sauces and salad dresses)

Sesame (in houmous, sushi,prawn toast, breadsticks, bread rolls, bagels etc)

Lupin (e.g. certain types of bread, pasta, pastries etc)

Molluscs (in sauces containing oyster, stews, stock, fish, cakes, pies, soups)

Sulphur dioxide and sulphites (e.g. canned and dried fruits & vegetables, jams, vinegars, grape juice)

Cereals containing gluten (e.g. flour, bread / breadcrumbs, batter, cereals etc)

Celery (in stock, soups and stews, salads, sauces, spice mixes, seasoning)

Crustaceans (in dishes contains crustaceans, shrimp paste, Thai curries and salads etc)

Fish (in dishes containing raw or cooked fish, sauces, relishes, salad dressing etc)

Eggs (in cakes, mayonnaise, mousses, pasta, sauces etc)

Peanuts (raw and cooked peanuts, flour, butter & oil with peanuts, in curry sauces powder and some biscuits and cereal etc)

Soya (in soy sauce, and others like Worcestershire and dishes containing soybeans, bean curd, soups & stews)

Other