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Due to an overwhelming response, we cannot take

any more requests for the Lumber Bridge

pickup location.

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Note:  The Primary and Alternate email addresses you provide must be different.  Notifications will be sent to both email addresses to ensure delivery.

Note:  The box count requested is not guaranteed and will be adjusted as needed based on availability.  You will receive your final approved box count on October 31 along with your scheduled arrival time for November 21.

I accept full responsibility for all “Thanksgiving for Thousands” food boxes that are or will be released to my delivery (if any). I understand that the chicken contained therein should not go without refrigeration for more than two (2) hours.  Furthermore, as the chicken is kept refrigerated prior to my pickup, I release Mountaire Corporation, Mountaire Farms Inc., Mountaire Farms of Delaware, Inc., and Mountaire Farms, L.L.C. (collectively, “Mountaire”) and each of their officers, agents, and employees from any liability, injury, illness or death that may result from the improper storage of the chicken.

I understand that, while participating in this activity, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by Mountaire and/or any event sponsors, event organizers, and assigns. I understand that I am not required to sign this consent and am not entitled to any compensation or royalties with respect to Mountaire’s use of my likeness.

I understand that by filling out this form, neither my participation in the “Thanksgiving for Thousands” event nor the availability of the number of boxes requested below is guaranteed.

Organization Name:  {organizationName}

Organization Address:  {organizationAddress}

Your Name:  {yourName}

Contact Number for You:  {yourPhone}

Number of Boxes Requested:  {howMany44}