++ Once the application is approved, you will receive a notification via email regarding our food delivery schedule. Please keep in mind that the application will need to be renewed every two weeks, along with an updated positive test result for COVID-19. To renew an application, simply resend the COVID-19 test result for review and approval.++
 
++ An incomplete form will not be considered for approval, so please ensure that all requirements of the application are completed.++

++ This program is open to Gwinnett county residents, US Citizens, and/or Legal Permanent Residents only. ++

++ SUBMMITTING THIS APPLICATION FORM, NO confirmed application approval.++


WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT FOR FOODS OTHERWISE TRANSPORTED, FURTHER PREPARED, AND/OR CONSUMED

Food preparation carries with it inherent risks that include but are not limited to health hazards resulting from improper transport, handling, and storage.  

WAIVER OF LIABILITY
In consideration of being permitted to participate in any related event for the COVID Home Food Delivery (an “Event”) where prepared food, cooked, perishable or otherwise are transported, further prepared, and consumed, I, for myself, my heirs, personal representatives or assigns, agents, employees and affiliates, partners, sponsors, volunteers, do hereby release, waive, discharge, and covenant not to sue Together We Can Foundation Inc, Duluth, Georgia, their affiliates, partners, sponsors, volunteers, direct or indirect, officers, employees, and agents from liability from any and all claims resulting in personal injury, accidents or illnesses (including death), and property loss arising from, but not limited to, participation in any Event.  

ASSUMPTION OF RISK
Participation in any Event carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. The specific risks vary, and can include but are not limited to cooking food thoroughly; separating and not cross contaminating foods; chilling or refrigerating food appropriately; cleaning foodstuffs, instruments and hands used in and for food preparation; fire or gas hazards. Together We Can Foundation Inc, Duluth, Georgia is not liable for products that are recalled by the manufacturer and/or producer.

INDEMNITY AGREEMENT
I agree to INDEMNIFY AND HOLD HARMLESS Together We Can Foundation Inc, Duluth, Georgia, their affiliates, partners, sponsors, volunteers, direct or indirect, officers, employees, and agents (the “Indemnitees”) from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney’s fees brought as a result of my involvement in Events, whether brought by me, my company or its agents or employees, or other third parties, and to reimburse the Indemnitees for  any such expenses incurred.
 
ACKNOWLEDGEMENT OF UNDERSTANDING  
I have read this Waiver of Liability, Assumption of Risk, and Indemnity Agreement, fully understand its terms, and understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing the agreement freely and voluntarily, am over the age of 18, and intend by my type name on this form to be a complete and unconditional release of all liability to the greatest extent allowed by law.  

Raw foods of animal origin are those most likely to be contaminated; that is, raw meat and poultry, raw eggs,  unpasteurized milk, and raw shellfish. Because filter-feeding shellfish strain microbes from the sea over many months, they are particularly likely to be contaminated if there are any pathogens in the seawater. Foods that mingle the products of many individual animals, such as bulk raw milk, pooled raw eggs, or ground beef, are particularly hazardous because a pathogen present in any one of the animals may contaminate the whole batch. A single hamburger may contain meat from hundreds of animals. A single restaurant omelet may contain eggs from hundreds of chickens. A glass of raw milk may contain milk from hundreds of cows. A broiler chicken carcass can be exposed to the drippings and juices of many thousands of other birds that went through the same cold water tank after slaughter.  

Fruits and vegetables consumed raw are a particular concern. Washing can decrease but not eliminate contamination, so the consumers can do little to protect themselves. Recently, a number of outbreaks have been traced to fresh fruits and vegetables that were processed under less than sanitary conditions. These outbreaks show that the quality of the water used for washing and chilling the produce after it is harvested is critical. Using water that is not clean can contaminate many boxes of produce. Fresh manure used to fertilize vegetables can also contaminate them. Alfalfa sprouts and other raw sprouts pose a particular challenge, as the conditions under which they are sprouted are ideal for growing microbes as well as sprouts, and because they are eaten without further cooking. That means that a few bacteria present on the seeds can grow to high numbers of pathogens on the sprouts. Unpasteurized fruit juice can also be contaminated if there are pathogens in or on the fruit that is used to make it.  

A FEW SIMPLE PRECAUTIONS TO REDUCE THE RISK OF FOODBORNE DISEASES  
Safe and careful handling of raw meat and poultry is critical to prevent harmful bacteria from multiplying and contaminating other foods. It is extremely important that proper temperatures are reached during cooking to destroy harmful bacteria. Here’s what you should do to make sure the food you cook and serve is both delicious and safe.  

COOK: meat, poultry and eggs thoroughly. Using a thermometer to measure the internal temperature of meat is a good way to be sure that it is cooked sufficiently to kill bacteria. For example, ground beef should be cooked to an internal temperature of 160° F (until juices run clear and are no longer pink). To check the temperature, insert the thermometer probe for 15 seconds in the center of the burger, at a 45° angle. Eggs should be cooked until the yolk is firm. Keep burgers and chicken (and all other perishable foods) on ice until ready to cook. Cook poultry to 165°F/74°C. Place the thermometer in the thickest part of meat (for 15 seconds).  
SEPARATE: Don't cross-contaminate one food with another. Avoid cross-contaminating foods by washing hands, utensils, and cutting boards after they have been in contact with raw meat or poultry and before they touch other food. Put cooked meat on a clean platter, rather than back on one that held the raw meat. Use only clean, sanitized food containers, cutting boards, and utensils. Never use the same utensils of food containers for handling raw meat and poultry and also for handling ready-to-eat foods (i.e., hamburger buns, cooked foods). Use separate cutting boards for raw foods and ready-to-eat foods. Never touch raw foods and ready-to-eat foods with the same utensil. Never touch ready-to-eat foods with bare hands. Use utensils or disposable gloves.

CHILL: Refrigerate leftovers promptly. Bacteria can grow quickly at room temperature, so refrigerate leftover foods if they are not going to be eaten within 4 hours. Large volumes of food will cool more quickly if they are divided into several shallow containers for refrigeration.
 
CLEAN: Wash produces. Rinse fresh fruits and vegetables in running tap water to remove visible dirt and grime. Remove and discard the outermost leaves of a head of lettuce or cabbage. Because bacteria can grow well on the cut surface of a fruit or vegetable, be careful not to contaminate these foods while slicing them up on the cutting board and avoid leaving cut produce at room temperature for many hours. Don't be a source of foodborne illness yourself. Wash your hands with soap and water for at least 20 seconds before and after handling raw meat and poultry. Avoid preparing food for others if you yourself have a diarrheal illness.  

SOME INDIVIDUALS AT PARTICULARLY HIGH RISK SHOULD TAKE MORE PRECAUTIONS  
Pregnant women, the elderly, and those with weakened immune systems are at higher risk for severe infections such as Listeria and should be particularly careful not to consume undercooked animal products. They should avoid soft French-style cheeses, pates, uncooked hot dogs, and sliced deli meats, which have been sources of Listeria infections. Persons at high risk should also avoid alfalfa sprouts and unpasteurized juices. A bottle-fed infant is at higher risk for severe infections with Salmonella or other bacteria that can grow in a bottle of warm formula if it is left at room temperature for many hours. Persons with liver disease are susceptible to infections with a rare but dangerous microbe called Vibrio vulnificus, found in oysters. They should avoid eating raw oysters.