New South Wales Consolidated Acts(Section 29)
I,ofbeing a mediator within the meaning of the Community Justice Centres Act 1983 do solemnly, sincerely and truly declare and affirm that I will not, either directly or indirectly, except as permitted under section 29 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.
| Subscribed atthisday of19before me- | Signature |
Justice of the Peace