Title Page

I, (Co-worker name) agree that my acceptance of the donated products/services as described above shall fully discharge and release IKEA Canada Limited Partnership and IKEA Distribution Services CA Incs., its officers, shareholders, affiliates, (including partners), advertising and promotional agencies and/or independent judging organizations, from any and all claims, damages, actions or causes of actions whatsoever which I, my heirs, executors or administrators may now or hereafter have against them or any part of them in respect to the acceptance of the donated products/parts.

  • Co-worker name

  • Quantity

  • Product name

  • Description

  • Article number

I hereby declare that:

  • I had no agency in placing this item for donation initially nor did I collaborate with other co-workers to hold this item specifically for myself.

  • I acknowledge hat the item(s) I have taken, have no monetary value and cannot be resold/ returned to IKEA Canada through its Return and Exchanges, Sell back program or any other affiliated organizations.

  • I understand that no substitutions for, or transfer of the above listed items will be allowed except at the full discretion of IKEA.

  • I am 18 years of age or older.

  • Co-worker signature

  • Signed at the date of at IKEA South Common

Witness signatures

  • Name and Signature of recipient

  • Name and signature of S&S representative

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.