This Acknowledgement and Waiver Regarding Employee Dating is a document that
acknowledges that two employees of a company have entered into a consensual
romantic relationship and that the employees waive the legal liability of the employer in
connection with any claims or conflicts arising from the relationship. This document
should be used by the human resources department at companies and small
businesses where the company policies allow for employees to enter into romantic
Acknowledgement and Waiver Regarding Employee Dating
THIS ACKNOWLEDGEMENT AND WAIVER AGREEMENT (the "Agreement") is made and
entered into as of __________ [Instruction: Insert Date], by and between __________
[Instruction: Insert Employee 1 Name], __________ [Instruction: Insert Address] and
__________ [Instruction: Insert Employee 2 Name], __________ [Instruction: Insert
Address] (each an “Employee”), on the one hand, and __________ [Instruction: Insert
Company Name] (the “Company”), __________ [Instruction: Insert Company Address] on
the other hand.
WHEREAS, the Employees, each employees of the Company, have entered into a consensual
WHEREAS, Company is concerned about the potential for legal liability arising out of said relationship;
WHEREAS, the Employees desire to provide certain assurances to Company in connection with said
NOW, THEREFORE, in consideration of the terms and conditions contained herein and for
other good and valuable consideration, the parties hereby agree as follows:
1. As of the date hereof, the Employees acknowledge that the Employees have entered into
a voluntary dating relationship and are engaging in the relationship purely for personal reasons.
2. Neither Employee has requested or expects work-related favoritism from the other or
from Company as a result of the relationship.
3. As of the date hereof, the Employees are not aware of any conflicts related to their
relationship. Notwithstanding the foregoing, the Employees acknowledge the potential for such
conflicts to arise. In the event that such a conflict of interest arises, the Employees will jointly
report such conflict to the Company, in writing.
4. As of the date hereof, the Employees are not aware of any conduct that the Employees
would consider to be wrongful on the part of the Company, its employees, or other affiliated
entities. The Employees hereby waive any claim potentially related to such wrongfulness.
5. Should either Employee consider the other’s conduct to be sexually harassing, at any
time, said Employee will immediately inform the Company, in writing, of such behavior.
6. The continued employment of the Employees herein does not limit or waive Company’s
right to terminate the at-will employment of either Employee, to request that one or both of the
Employees leave their current position(s) and interview for a new position at Company or leave
IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and
year first written above.
__________ [Instruction: Insert Employee 1 Name],
__________[Instruction: Insert Employee 2 Name],
__________ [Instruction: Insert Company Name],
By: Authorized Signatory
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