Purpose. This document acknowledges my agreement to abide by the following terms and conditions for the purpose of resolving disputes through mediation administered by Mediation Solutions: Workplace Matters, LLC (“Mediator”).

Nature of Mediation. Mediation is a voluntary and private dispute resolution process. The Mediator’s role is to facilitate communication, identify issues, explore options, and, if possible, assist the Parties in negotiating a mutually acceptable resolution. The Mediator is a neutral third party and will not make binding determinations of fact or law.

Cancellation and Rescheduling. I acknowledge that the mediator’s fee is nonrefundable. However, the parties may agree to reschedule a session, provided electronic rescheduling is accomplished no less than 3 business days in advance of the scheduled appointment.

Authority as a Participant. I affirm that I am the sole participant with full authority to engage in the mediation session and negotiate a settlement agreement with the other Party. No other person/representative shall attend without advance written notice to and acknowledgement by the other Party and coordination with the Mediator (See Consent / Acknowledgement Form).

Confidentiality. I agree that I will not record, save, or otherwise capture any audio, video, files, documents, chat texts, or any other data that I would not have had access to but for the mediation, unless all parties to the mediation provide written consent to do so. I agree that all communications, statements, documents, proposals, and materials made, provided, or generated for the purpose of the mediation are confidential and shall not be disclosed to third parties, offered as evidence, or used for any purpose in any judicial, administrative, arbitral, or other adjudicative proceeding, except as provided below.

Exceptions: Confidential information may be disclosed (a) to the extent necessary to enforce any mediation settlement agreement, (b) to the extent required by law (including mandatory reporting obligations), (c) to evidence a threat of imminent harm or criminal activity, or (d) with the express written consent of all Parties.

I agree that the Mediator will not be called as a witness or required to produce records or notes of the mediation in any forum, unless explicitly required by law.

Expectations. I affirm my good faith intention to explore options for mutually acceptable agreement through mediation. However, I understand that mediation is voluntary, so either party may withdraw from or suspend the mediation process at any time for any reason. Likewise, I understand that the Mediator may suspend or terminate the mediation due to belief that the parties are unable or unwilling to effectively participate in the session or due to belief that the Mediator can no longer perform the facilitative role effectively.

I agree to communicate openly and honestly to enable informed decision-making regarding all aspects of the matter(s) in dispute and to make a good faith effort toward effective communication and exploration of opportunities to resolve the matter(s) in dispute.

I affirm that I will not participate in reprisal or retaliation against any participant due to their participation in mediation or based upon any information shared during mediation.

Agreement. If the parties reach agreement on any and/or all issues, a written agreement may be prepared by the parties and/or the Mediator. Any agreement signed by the parties will become a legally binding contract. If necessary, copies of any signed agreement(s) will be submitted to any party required to receive a copy (e.g., a court, corporation, etc.).

Additional Mediation Sessions. All mediation sessions, including any follow-up sessions, must be paid in full at the time of booking and prior to the commencement of the session, normally no less than 3 business days in advance. The terms for cancellation and rescheduling are stated above.

Records and Retention. The Mediator may retain a confidential file summarizing the mediation. Such file shall remain confidential and shall not be disclosed unless explicitly required by law. Any notes and records of the mediation content, if any, are routinely destroyed.

Disclaimers. Nothing said nor any document produced during the mediation shall constitute an admission or be construed as an admission by any Party in any subsequent proceeding. Settlement proposals, offers, and/or concessions made during mediation shall not be used against any Party.

The Mediator does not provide legal or financial advice. The parties may seek independent professional advice as needed and appropriate before signing a binding agreement.

The Mediator is not a party to, and will have no liability under, any agreement between the parties. The Mediator shall not be liable to any Party for any act or omission in connection with the mediation. The Parties agree to indemnify and hold the Mediator harmless from any claims arising from the mediation to the extent permitted by applicable law.

Last updated 12.18.25