Queensland Consolidated Acts Queensland Consolidated ActsMEDIATOR'S AFFIRMATION OF SECRECY
I, ....................................................of............................................................
being a mediator within the meaning of the Dispute Resolution Centres Act 1990, do solemnly, sincerely and truly declare and affirm that I will not, either directly or indirectly, except as permitted under section 37 of that Act, and either while I am or after I cease to be, a mediator, make a record of, or divulge or communicate to any person, court or tribunal any information, document or other matter disclosed during or incidentally to a mediation session.
| Sworn and subscribed at.................... ) | |
| this day) | |
| of 19 ..) | |
| before me-- ) | ...................................................... Signature |
..............................................................
Justice of the peace