Child Inclusive Family Mediation – Agreement to Mediate


in mediation with
(collectively, “we” or “the Parties”), have agreed that
(the “Mediator”) or

(the “Appointed Mediator”) who are providing Mediation Services on behalf of The Family Mediation Centre, A Division of The Mediation Centre Inc. can meet with my child(ren) under the age of 18, and that the purpose of this is to gather information from each child about their needs, concerns, perceptions, views, wishes, and preferences.

1.2. I agree that my child(ren) shall be free to express their own views and information, whatever that may be, and that I shall not, in any manner, interfere with this process, influence the child(ren), or reprimand/punish the child(ren) for sharing. 1.3. I understand and agree that it is up to each of my child(ren) what information they choose to share with me. In closed mediation, the information is confidential and is only to be used to assist with settlement discussions. I agree that the information from the child shall not be used in Court or for litigation purposes without the written consent of the Child Inclusive Mediator, whether the information/feedback is verbally presented or written. 1.4. I understand and agree that each child shall be interviewed on two separate occasions. Each parent shall bring the child(ren) to one appointment of approximately one hour in length per child, or as directed by the Child Inclusive Mediator. I agree that the circumstance around the meetings/interviews is at the discretion of the Child Inclusive Mediator. I understand and agree that any safety issues shall be reported to the appropriate authorities. I understand and agree that the Child Inclusive Mediator may terminate the Child Inclusive Mediation process at any time and may not be able to provide a reason.


2.1. Where mediation includes distance mediation, the Mediator will conduct the mediation using Microsoft Team or Zoom technology or any other technology suitable to the Parties child(ren) participating in the distance mediation. 2.2. By submitting this Agreement to Mediate, the Parties child(ren) who participate in distance mediation accept and agree to the terms and guidelines associated with distance mediation and the use of technology identified in this agreement.


3.1. I understand that there is no guarantee of resolution from mediation, and that we may not be fully satisfied with the outcome. 3.2. I understand that both parties must agree to Child Inclusive Mediation and no interviews with be conducted with the child(ren) without authorization of both parties. 3.3. I understand that the Mediation Service is being provided to the public under an arrangement with Her Majesty the Queen in right of Ontario as represented by the Attorney General (the “Ministry”). I acknowledge that the Mediation Service Provider and the Mediator are not agents, joint venturers, partners, or employees of the Ministry. I further acknowledge that the Ministry does not assume any responsibility for any service, action, and inaction provided with respect to the Mediation Service. 3.4. In no event shall I, either jointly or separately, hold the Ministry liable for any special, direct, indirect, consequential, or incidental damages or any damages whatsoever, whether in an action of contract, negligence, or other tort, arising out of or in connection with the use of the Mediation Service.