Dade County Bar Association
123 NW First Avenue, Suite 214
Miami, Florida 33128
Phone: (305) 371-2220

Mentoring Program

Instructions

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Existing Mentor/Mentee Login

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MENTOR SIGN UP FORM
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Personal Information

First Name
Last Name
Gender
Company Name
Address
City
State
Zip
Business Phone Number
Mobile Phone Number
E-mail
How do you prefer to be contacted by your Mentee?
Florida Bar Number
Years in Practice
How did you learn about the program?

Career Information
Are you a member in Good Standing of the Florida Bar?
Where do you Practice?
Number Of Mentees Requested:

Practice and Mentoring
Area		Percentage	Willing To Mentor?
		%
		%
		%
		%

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RELEASE, WAIVER,AND INDEMNITY AGREEMENT
This Release, Waiver and Indemnity Agreement is by and between the undersigned ("Participant"), dated as of the date indicated below, in favor of The Dade County Bar Association, a Florida non-profit corporation, and its respective successors, assigns, members, officers, directors, employees, contractors, representatives, agents, attorneys, committee members, committee chairs, subcommittee members, subcommittee chairs, subsidiaries, or affiliates and all persons acting by, through, under or in concert with any of them in the past, present, and future("DCBA") in connection with the internet matching program pairing new lawyers (�Mentee(s)�) with more senior lawyers (�Mentor(s)�) at their request for the purposes of mentoring in matters concerning professionalism and ethics (�Mentoring Program�). WHEREAS, the DCBA is a non-profit organization dedicated to serving the needs of its members, the bar, and the community without profit; WHEREAS, the undersigned desires to pair with another lawyer as part of the Mentoring Program of the DCBA; Therefore, in consideration of the benefits and privileges associated with the Mentoring Program, and other good and valuable consideration received from or on behalf the Participant, receipt of which is hereby acknowledged, Participant agrees to the following terms and conditions of the Mentoring Program: 1. Follow the Florida Rules of Professional Conduct and the Rules Regulating the Florida Bar. Participant acknowledges that the relationship created by two lawyers who are not in the same law firm is a relationship which is NOT typically protected by attorney-client privilege. The Participant specifically acknowledges this and promises to maintain the confidences of his or her clients and shall take no actions to reveal the identity of his or her client(s) or disclose confidential, privileged or otherwise protected communications. When referring to any specific client matter, the Participant will use hypothetical information. Where a Participant�s Mentor or Mentee has identified a conflict, a potential conflict, or any appearance of impropriety, Participant acknowledges and agrees that in such instances even hypothetical information will not be used. Further, Participant warrants and represents to the DCBA that he or she shall not knowingly engage in any such other conduct which may subject the Participant to disciplinary action by the Florida Bar. Further the Participant covenants and represents that he or she will uphold the Rules Regulating the Florida Bar at all times (for the full text of the Florida Rules, see http://www.floridabar.org/divexe/rrtfb.nsf/WContents?OpenView 2. No representations or warranties; Waiver. Participant recognizes that the relationship to be created through the Mentorship Program is dependent upon the Mentor and Mentee and the DCBA is not involved and does not take part in the relationship in any meaningful way, nor does the DCBA conduct any specific verification of the qualifications of any participant in the program other than to review whether they are a member of the Florida Bar. If the Participant wishes to learn more about their respective Mentor or Mentee, then the Participant must do his or her own research and due diligence. However, to the extent the DCBA chooses to do any background investigations on the Participant, the Participant consents to same. Notwithstanding the preceding sentence, the Participant acknowledges that the DCBA, by providing a match to a fellow participant using the criteria specified by each, makes no representations, or warranties of any kind, whether such warranties are express or implied, direct or indirect, in connection with: (i) the fitness of a particular Mentor or Mentee; (ii) the nature of the relationship developed by the Participant or a relationship that failed to develop; (iii) any statements, advice, actions, inactions, omissions, negligence, malpractice, intentional wrongdoing, gross negligence or any and all such other conduct or statements of a Participant. PARTICIPANT, BY SIGNING BELOW, SPECIFICALLY ACKNOWLEDGES, AGREES AND WAIVES ANY AND ALL LIABILITY BY THE DCBA IN CONNECTION WITH HIS OR HER PARTICIPATION IN THE MENTORING PROGRAM. 3. Release, Hold Harmless and Indemnity. The Participant acknowledges that participation in the Mentorship Program is a privilege and that participation is allowed by the DCBA only where the Participant understands and agrees that the DCBA is not liable to him or her, to any client of Participant, any third party beneficiary, or any other person or persons, entity or entities, in connection with the Mentoring Program. Accordingly, the undersigned Participant hereby holds DCBA harmless and hereby indemnifies the DCBA against and forever discharges the DCBA of and from all, any and all manner of, action and actions, cause and causes of action, suits, debts, dues, sums of money, accounts, reckonings, bonds, bills, specialties, covenants, contracts, controversies, agreements, promises, variances, trespasses, damages, judgments, executions, claims, demands, losses, costs, expenses, or fees (including, without limitation, attorney�s fees through trial and any and all appeals) whatsoever, in law or in equity, known or unknown, asserted or unasserted, in connection with the Mentoring Program. Wherever used in this release the terms Participant and DCBA shall include the singular and plural, the heirs, legal representatives, and assigns of individuals, and the successors and assigns of corporations, wherever the context so admits or requires.
Enter Date You, as Participant agree to the above terms and conditions: BY ENTERING AND TYPING YOUR FULL NAME BELOW, YOU AGREE THAT YOU HAVE READ THIS AGREEMENT IN FULL, THAT YOUR TYPED NAME BELOW CONSTITUTES YOUR SIGNATURE FOR ALL PURPOSES AND THAT YOU AGREE AS A �PARTICIPANT� TO ALL OF THE ABOVE TERMS AND CONDITIONS. PLEASE ENTER YOUR FULL NAME IN THIS BOX TO CONSTITUTE YOUR AGREEMENT WITH THE ABOVE TERMS AND CONDITIONS:

The Mentoring Program of the Dade County Bar Association must not be used to establish lawyer/client relationships, reveal any client confidences, or otherwise violate the Florida Rules of Professional Conduct.