Break Waiver Form
Please fill this form out to voluntarily waive your meal/rest break(s). Please refer to the handbook for detailed break information.
Name
*
First Name
Last Name
Date
*
-
Month
-
Day
Year
Date
Restaurant location
*
Please Select
CFA La Palma
CFA Orangethorpe
Which break(s) are you waiving for your shift from the date above? Check all that apply.
*
1st Meal Break (30 minutes)
2nd Meal Break (30 minutes)
1st Rest break (10 minutes)
2nd Rest break (10 minutes)
By signing below, I am voluntarily waiving my right to the break(s) detailed above. I reserve the right to revoke this agreement in writing at any time by providing at least one (1) day's written notice to my HR Director. I will give my employer/Chick-fil-A Buena Park as much notice as possible if I exercise my right to revoke.
Team Member Signature
*
Leader Signature
*
Submit
Should be Empty: