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Human ResourcesDiscipline & Conduct

Acknowledgment and Waiver About Employee Dating

This template is an acknowledgment and waiver form for employees who are in a romantic relationship, confirming their understanding of company policy and waiving certain rights related to their employment and relationship.

Updated 15d ago
acknowledgmentwaiveremployee relationsdating policyHR documentconflict of interest

{{company_name}}

{{company_address}}

Phone: {{phone}} | Email: {{email}} | Web: {{website}}

Acknowledgment and Waiver About Employee Dating

Acknowledgment and Waiver About Employee Dating

{{company_name}} {{company_address}} Phone: {{phone}} Email: {{email}} Website: {{website}}

ACKNOWLEDGMENT AND WAIVER REGARDING EMPLOYEE DATING

I, {{employee_full_name}}, hereby acknowledge that I am currently engaged in a romantic relationship with {{other_employee_full_name}}, who is also an employee of {{company_name}} (hereinafter referred to as 'the Company').

COMPANY POLICY ON EMPLOYEE DATING

I have received, read, and understand the Company's policy regarding employee dating and relationships, as outlined in the Employee Handbook or communicated through other official channels.

I understand that the Company's policy aims to prevent actual or perceived conflicts of interest, favoritism, harassment, and other workplace disruptions that may arise from relationships between employees, particularly when there is a reporting relationship or significant power differential.

AFFIRMATION OF VOLUNTARY RELATIONSHIP

I affirm that my relationship with {{other_employee_full_name}} is entirely consensual and voluntary. I further acknowledge that I am not, and have not been, subject to any form of coercion, pressure, or undue influence regarding this relationship.

Should the nature of our relationship change, or should either party feel that the relationship is no longer consensual or becomes a source of discomfort or harassment, I agree to immediately inform {{HR_department_contact}} or another designated Company representative.

DISCLOSURE OF RELATIONSHIP

I confirm that I have disclosed the existence of this relationship to {{HR_department_contact}} or my direct supervisor, as required by Company policy, on {{disclosure_date}}.

AGREEMENT TO ABIDE BY COMPANY POLICIES

I agree to adhere strictly to all Company policies and procedures, including but not limited to those pertaining to harassment, discrimination, conduct, and conflict of interest, both within and outside the workplace. I understand that any violation of these policies may result in disciplinary action, up to and including termination of employment.

WAIVER OF CLAIMS

In consideration of my continued employment and the Company's permission for me to continue my relationship with {{other_employee_full_name}} while abiding by Company policies, I hereby irrevocably and unconditionally waive any and all claims, demands, actions, causes of action, liabilities, costs, expenses, and damages arising out of or related to my romantic relationship with {{other_employee_full_name}} and its impact on my employment, including but not limited to, claims of sexual harassment, discrimination, retaliation, emotional distress, or wrongful termination.

This waiver specifically covers any claims I may have against {{company_name}}, its officers, directors, employees, agents, and representatives, now or in the future, concerning the employment relationship as it relates to my romantic involvement with {{other_employee_full_name}}.

GOVERNING LAW

This Acknowledgment and Waiver shall be governed by and construed in accordance with the laws of {{country_name}}.

EFFECTIVE DATE

This Acknowledgment and Waiver is effective as of {{effective_date}}.

SIGNATURES

_____________________________

{{employee_full_name}}

Date: {{signature_date}}

_____________________________

{{other_employee_full_name}} (acknowledging receipt and understanding of policy)

Date: {{signature_date}}

_____________________________

{{HR_representative_full_name}}

HR Department Representative

Date: {{signature_date}}

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