Associate Walmart

EMPLOYMENT OF MINORS CONSENT FORM

To be considered for employment with Wal-Mart Stores, Inc. (Walmart) an applicant must be a minimum of 16 years of age. Specified divisions of Walmart prohibit the employment of minors and require applicants to be a minimum of 18 years of age. In divisions where minors are permitted to work, Walmart's Minors in the Workplace Policy restricts the number of hours per day/week any minor may work, the time of day such work may be performed, and the type of work which may be assigned to and performed by the minor. In addition, where Federal or State law is more restrictive than this policy as to the terms and conditions of employment for minors, the applicable law will be followed.

In accordance with Walmart policy and your state law, the following restrictions will be followed: STATE:

School No School

Maximum number of work

hours per day

Maximum number of hours per

week

Work hours must fall between

Number of hours worked

before a 15-minute break is

required

Number of hours worked

before a meal period of at least

30 minutes, is required

Hazardous Work Restrictions:

Associates who are 16 or 17 years of age may not be assigned nor perform work deemed to be hazardous. Prohibited hazardous work includes, but is not limited to the following examples:

Operating power-driven equipment

Operating, loading, or unloading balers or

compactors, including placing items into the

baler

Operating a paint mixer

Working with open, damaged, leaking or

exposed hazardous chemicals (including wet

photographic chemicals and pesticides)

Operating the key cutter

Operating a motor vehicle

Operating forklifts or other power-driven

hoists

Operating baker machines (including dough

mixers)

Any meat processing work (including

operating power-driven meat slicers, knives,

cutters, saws, grinders, or mixers)

Handling firearms, ammunition, fireworks,

and other articles containing explosive

components

Working with radioactive substances

Working on ladders that exceed 4 feet in

height, or scaffolding

Working on or close to a roof

DocuSign Envelope ID: 7AC2D9CF-6B0359D0-D E5BBF6 668B-41 A618-2- 43A7-437B-49A- A3C7-995D-10C-531FC1B9DE3B B92216347768 73DD239EDE55 No more than 4 hours

8.0

6:00AM - 11:00PM

No more than 6 hours No more than 6 hours

No more than 4 hours

40.0

8.0

North Carolina

6:00AM - 11:00PM

40.0

NOTE: Your state may have additional hazardous work restrictions not mentioned. Please refer to the state specific Minors in the Workplace policy for your state’s requirements. The “Yellow Dot/Yellow Badge” program identifies associates who are under age 18. The name badge of every minor associate must be marked so that they are easily identified as a minor. By signing this, I, (Name of minor associate) acknowledge and agree to follow the above requirements. If I do not follow the above requirements, I understand that I may be subject to disciplinary action, up to and including termination. I also understand that if I am asked to perform any of the above-mentioned duties or asked to work hours that I am not allowed to work, that I may report it to the Ethics Helpline at 1-800-WMETHIC without fear of retaliation.

Date: Signature of Minor: Date: Signature of Parent/Guardian: Age Verification Section

The undersigned certifies that my son/daughter is years old and was born on . Place of Birth: (City,State). The undersigned, as parent(s) and/or legal guardian(s) of, do hereby consent to their employment by Walmart, Inc. (Walmart), a mercantile industry located at

(your facilities address): subject to applicable child labor laws, including the implementing rules and regulations thereof and further consent to an appropriate background check that seeks information relevant to the job duties and responsibilities for which will be employed. I hereby give my permission for (name of minor associate) to work in (position) in your facility. I further give permission for drug testing in compliance with Walmart policy. Date: Signature of Parent/Guardian: DocuSign Envelope ID: 7AC2D9CF-6B0359D0-D E5BBF6 668B-41 A618-2- 43A7-437B-49A- A3C7-995D-10C-531FC1B9DE3B B92216347768 73DD239EDE55 JEREMIAH WATKINS

12/3/2022

JEREMIAH WATKINS

JEREMIAH WATKINS

JEREMIAH WATKINS

Minor School Information Form

Student Name:

School Year Start Date: Application ID# School Year End Date: Time School Day Starts: Mo Tu We Th Fr Sa Su

Time School Day Ends: Mo Tu We Th Fr Sa Su

School Breaks:

Summer Break Start End Thanksgiving Break Start End Christmas Break Start End Spring Break Start End Other Start End DocuSign Envelope ID: 7AC2D9CF-6B0359D0-D E5BBF6 668B-41 A618-2- 43A7-437B-49A- A3C7-995D-10C-531FC1B9DE3B B92216347768 73DD239EDE55 8:30 8:30

JEREMIAH WATKINS

01/02/2023

11/22/2023

06/10/2023

8:30

3:40

04/28/2023

3:40

8:30

12/20/2022

3:40

11/24/2023

3:40 3:40

06/09/2023

8:30

08/21/2023

08/22/2022

04/24/2023

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