Company Name ______________________________________
Waiver of Lunch/Meal Period
Employee Name ________________________
As an employee of <Your Company Name Here>, I am regularly scheduled to work a <XX> hour shift.
I understand that California Law requires employers to make available a meal period of at least 30 minutes after an employee has worked 5 hours.
I have been advised that I am allowed to waive that meal period by signing a waiver with my employer.
I have further been advised that I may rescind this waiver on providing my supervisor at least one day’s (24 hours) notice of my intent to do so.
My signature below indicates that I am waiving my meal period in order to leave work at the end of 8 straight hours of work.
Employee Signature Date