Under 18 Form | SomethingDifferent

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Store Location

Manager Name

Employee First Name

Employee Last Name

Select a date

Employee: Affirm each statement below. Failure to affirm and understand will result in you not working for Something Different Grill.

I will not deliver any food using a motor veichle.

I will not make any delivery of food off the property of the store.

I will not operate or filter fryers.

I will not use, clean, assemble any motorized equipment.

I will not disassemble or use the dishwasher to clean any parts of motorized equipment.

I will not mix chemicals and will follow all labeling instructions on cleaning chemicals.

I will refuse to do any of the above even if directed by others.

I will immediately inform HR or owners if anyone asks me to perform these tasks.

I understand that if any of these policies are violated that it will result in my immediate terminiation.

I understand that these policies are in place until I turn 18 years of age.

Hiring Manager: Read and select each box. Failure to understand each statement will result in this person not being hired.

As a manager I understand that this employee may not perform any task mentioned above.

As a manager I understand that this employee cannot be asked by any other employee to perform these tasks.

I understand that if this employee performs any of these tasks it will result in immediate termination of the employee and the manager.

I will monitor, inform, direct all staff members of these policies and ensure compliance.

I understand that no negative action will be taken towards this employee due to their limitations of work areas.

I understand that I am choosing to hire someone under 18 and that Federal and State laws apply to their work enviornment and activites.

Employee Signature

Manager Signature

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