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Private Adoption Agreement

[READ CAREFULLY. THIS IS A LEGALLY BINDING agreement TO RELEASE ALL RIGHTS IN REGARD TO THE CHILD TO BE BORN.]

---------------------, the BIOLOGICAL MOTHER, and ---------------------, the BIOLOGICAL FATHER; referred to collectively as the BIOLOGICAL PARENTS,

and ---------------------, the ADOPTIVE MOTHER, and ---------------------, the ADOPTIVE FATHER, referred to collectively as the ADOPTIVE PARENTS,

agree:

BIOLOGICAL PARENTS are the parents of a child, which is now being carried by BIOLOGICAL MOTHER, who is approximately months pregnant. BIOLOGICAL PARENTS are aware that the ADOPTIVE PARENTS are specifically reliant on BIOLOGICAL PARENTS for these representations.

BIOLOGICAL PARENTS desire to allow the child to be adopted by the ADOPTIVE PARENTS. BIOLOGICAL PARENTS understand that:

(a) their parental rights will be lost and terminated by this agreement;

(b) that they will have no legal rights as to the child as a result of this agreement whatsoever, including visitation of any kind;

(c) that the ADOPTIVE PARENTS by this Private Adoption Agreement will become the only legal parents of the child;

(d) that this Private Adoption Agreement is binding and legally valid, and there will be no opportunity to change decisions made; and,

(e) that this is a final legal agreement for BIOLOGICAL PARENTS to turn over all rights as to the child to be born.

BIOLOGICAL MOTHER agrees to obtain medical advice from qualified practitioners throughout her pregnancy. BIOLOGICAL MOTHER agrees that ADOPTIVE PARENTS may have full and complete access to such records.

And, in consideration of this agreement, that BIOLOGICAL PARENTS will receive the following reimbursement of expenses from ADOPTIVE PARENTS:

$ (dollars)

This fund will be deposited by ADOPTIVE PARENTS within three days of the final signature to this agreement, with (referred to as AGENT); and, prior to any disbursement from the funds, BIOLOGICAL PARENTS will each be required to sign an affirmation of this agreement before any disbursements are made. The agent will pay from this fund the actual costs of the pregnancy of the BIOLOGICAL MOTHER. BIOLOGICAL PARENTS will provide bills for all such expenses to agent. The maximum amount of such reimbursement shall be $ (& no/100 dollars). ADOPTIVE PARENTS shall upon exhaustion of the fund at any time replenish the fund to the limit agreed upon.

BIOLOGICAL PARENTS shall provide any and all reasonable cooperation required by ADOPTIVE PARENTS on request including execution of any legal documents required by ADOPTIVE PARENTS, and attendance at any legal hearings required.

This agreement shall be confidential, and all parties hereto agree that the existence of this agreement and adoption shall be private and confidential.

The nature of this agreement is for unique and personal services and modification of legal rights, and the parties agree that this agreement may be specifically enforced.

This Private Adoption Agreement shall be binding on any successors of the parties.

Any disputes pertaining to said contractual arrangement being affairs that cannot be settled amicably shall be submitted to an arbitrator under the Rules of the American Arbitration Association or like organization in the City of [city], whose award may be reduced to judgment in any court of competent jurisdiction.

If any provision of this Private Adoption Agreement shall be held to be invalid or unenforceable for any reason, the remaining provisions shall continue to be valid and enforceable. If a court finds that any provision of this agreement is invalid or unenforceable, but that by limiting such provision it would become valid or enforceable, then such provision shall be deemed to be written, construed, and enforced as so limited.

The failure of either party to enforce any provision of this Private Adoption Agreement shall not be construed as a waiver or limitation of that party's right to subsequently enforce and compel strict compliance with every provision of this agreement.

Neither party has made any representations nor promises, other than those contained in this Private Adoption Agreement or in some further writing signed by the party making the representation or promise.

This Private Adoption Agreement will in all events be construed as a whole, according to its fair meaning, and not strictly for or against a party merely because that party (or the party's legal counsel) drafted the agreement. The headings, captions, and titles in this agreement are merely for reference and do not define, limit, extend, or describe the scope of this agreement or any provision herein. Unless the context requires otherwise, (a) the gender (or lack of gender) of all words used in this agreement includes the masculine, feminine, and neuter, and (b) the word including means including without limitation.

Each individual party to this Private Adoption Agreement represents and warrants to each other party that such party has read and fully understands the terms and provisions hereof, has had an opportunity to review this agreement with legal counsel, and has executed this agreement based upon such party's own judgment and advice of independent legal counsel.

If any provision of this Private Adoption Agreement is held to be illegal, invalid, or unenforceable under any present or future law, then that provision will be fully severable. This agreement will be construed and enforced as if the illegal, invalid, or unenforceable provision had never comprised a part of this agreement, and the remaining provisions of this agreement will remain in full force and effect and will not be affected by the illegal, invalid, or unenforceable provision or by its severance from this agreement. Furthermore, in lieu of each such illegal, invalid, or unenforceable provision, there will be added automatically, as a part of this agreement, a provision as similar in terms to such illegal, invalid, or unenforceable provision as may be possible and be legal, valid and enforceable.

Any notice to be given or to be served upon any party hereto must be in writing and may be given by certified or registered mail, but shall be deemed to have been given and received when a certified or registered letter containing such notice, properly addressed with postage prepaid, is deposited with the United States Postal Service. If notice is given in some manner other than by certified or registered mail, it shall be deemed to have been given when delivered to and received by the party to whom it is addressed, Such notices shall be given to the parties hereto at the following addresses:

In connection with this Private Adoption Agreement and the transactions contemplated hereby, each party to this agreement will execute and deliver any additional documents and perform any additional acts that may be necessary or appropriate to effectuate and perform its obligations under this agreement and the transactions contemplated hereby.

All costs incurred in enforcing this Private Adoption Agreement and in collection of sums due, to include, without limitation, reasonable attorney fees through all trials, appeals, and proceedings, to include, without limitation, any proceedings pursuant to the laws of the United States and any arbitration proceedings, shall be paid by [------].

Cooperation. Each party, at the request of the other, will execute and deliver all documents which may be reasonably necessary to give full effect to this Private Adoption Agreement.

Breach and Waiver. Should either party incur any expense or legal fees as a result of the breach of any portion of this agreement by the other party, the Court shall award reasonable attorney's fees and suit expenses to the non-defaulting party which are reasonably incurred. No breach, waiver, or default of any of the terms of this agreement shall constitute a waiver of any subsequent breach or default of any of the terms of agreement.

Severability. Should any Court hold that any portion of this Private Adoption Agreement is invalid, the remainder shall be in full force and effect, and the invalid portion shall be struck from the agreement or modified as the Court shall order.

Representations. Each party acknowledges that this Private Adoption Agreement has been entered into of his or her volition with full knowledge and information including tax consequences. In some instances, it represented a compromise of disputed issues. Each believes the terms and conditions to be fair and reasonable under the circumstances. No coercion or undue influence has been used by or against either party in making this Private Adoption Agreement. Each party acknowledges that no representations of any kind have been made to him or her as an inducement to enter into this Private Adoption Agreement other than the representations set forth herein.

Modifications. A modification or waiver of any of the provisions of this Private Adoption Agreement shall be effective only if made in writing and executed with the same formality as this agreement. Failure of either party to insist upon strict performance of any of the provisions of this agreement shall not be construed as a waiver of any subsequent default of the same or similar nature.

No Harassment. Both parties agree not to molest, harass, interfere with, or impose any restraint upon the other, except as set out in this agreement.

This agreement contains the entire agreement of the parties and there are no other promises or conditions in any other agreement whether oral or written. This agreement supersedes any prior written or oral agreements between the parties.

Time of the Essence. Time is of the essence of this agreement.

This agreement shall be governed by the laws of the State of [------].

READ CAREFULLY PRIOR TO SIGNING.

Dated: ___________.

[Signature]

[Signature]

[Signature]

[Signature]

[Witnessed by (Full Name)]

[Signature]

[Address]

[Alternative/Optional]

ACKNOWLEDGEMENT BY NOTARY PUBLIC

State of ________)

) SS.:

County of________)

On ________, before me, ________, Notary Public, personally appeared ________, [Name(s)] who proved to me on the basis of satisfactory evidence to be the person(s) whose names(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies) and that by his/her/their signatures on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.

I certify under the PENALTY OF PERJURY under the laws of the State of _________ that the foregoing paragraph is true and correct.

WITNESS my hand and official seal.

[signature]

Name of Notary

Notary Public

My Commission Expires