Surrogate Parenting Agreement

SURROGATE PARENTING AGREEMENT This Agreement is made on ( Date ), by and between , a married woman ( Referred to as Surrogate ), , her husband ( Referred to as Surrogate ' s Hu sband ), who both reside at ( Address ) and , ( Referred to as Natural Father ), who resides at (Address). RECITALS This Agreeme nt is made with reference to the following facts: A. Natural Father is a married man over the age of () ( Eighteen (18) or Applicable Age Required by Statute) years who desires to enter into this Agreement, the sole purpose of which is to e nable the Natural Father and his wife, who cannot conceive, to have a child who is biologically related to the Natural Father. B. Surrogate and Surrogate222s Husband are over the age of () ( eighteen (18) ) years and both desire and are willing to enter into this Agreement subject to the terms and conditions contained in this Agreement. NOW THEREFORE, in consideration of the mutual promises, representations, terms and conditions contained in this Agreement, the parties agree as follows: SECTION ONE Surrogate represents that she is capable of conceiving children. Surrogate understands and agrees that in the best interests of the child she will not form or attempt to form a parent - child relationship with any child or children she may conceive, car ry to term, and give birth to, pursuant to this Agreement. SECTION TWO Surrogate and Surrogate's Husband have been married since ( Date ). Surrogate's Husband agrees with the purposes and provisions of this Agreement and acknowledges that his wife, Surrogate, shall be artificially inseminated pursuant to the provisions of this Agreement. Surrogate's Husband agrees that in the best interests of the child he will not form or attempt to form a parent - child relationship with any child or children S urrogate may conceive by artificial insemination, as described in this agreement, and agrees to freely and readily surrender immediate custody of the child to Natural Father. Surrogate's Husband further agrees to terminate his parental rights to such child . Surrogate's Husband acknowledges he will do all acts necessary to rebut the presumption of paternity of any offspring conceived and born pursuant to this Agreement as provided by law, including blood testing and/or HLA testing. 2001 251 American LegalNet, Inc. SECTION THREE Surrogate shall be artificially inseminated with the semen of Natural Father by a physician. Surrogate, upon becoming pregnant, agrees she will carry the embryo ( or fetus ) until delivery. Surrogate and Surrogate's Husband, agree that t hey will cooperate with any background investigation into Surrogate's medical, family, and personal history and warrants the information to be accurate to the best of their knowledge and belief. Surrogate and Surrogate's Husband agree to surrender custody of the child to Natural Father, to institute, and cooperate, in proceedings to terminate their respective parental rights to such child, and to sign any and all necessary affidavits, documents, and papers in order to further the intent and purposes of this Agreement. Surrogate and Surrogate's Husband understand that the child is being conceived for the sole purpose of giving such child to Natural Father, its natural and biological father. Surrogate and Surrogate's Husband agree to sign all necessary affidav its and other documents, prior to and subsequent to the birth of the child, and to voluntarily participate in any paternity proceedings necessary for the Natural Father's name to be entered on the child's birth certificate as the natural or biological fath er. SECTION FOUR The consideration for this Agreement which is compensation for services and expenses, and should in no way be construed as a fee for the termination of parental rights or as payment in exchange for a consent to surrender the child for ado ption, in addition to other provisions contained in this Agreement, shall be as follows: 1. ($) dollars shall be paid to Surrogate, for services and expenses in carrying out Surrogate's obligations under this Agreement, immediately upo n surrender to Natural Father custody of the child born pursuant to the provisions of this Agreement. 2. The consideration to be paid to Surrogate shall be deposited with ( Referred to as Custodian ), the representative of Natural Father, at th e time of the signing of this Agreement and shall be held in escrow until completion of the duties and obligations of Surrogate as provided for in this Agreement. 3. Natural Father shall pay the expenses incurred by Surrogate, pursuant to her pregnancy, wh ich are specifically defined as follows: (a) All medical, hospitalization, pharmaceutical, laboratory, and therapy expenses, incurred as a result of Surrogate's pregnancy, not covered or allowed by her present health and major medical insurance, including all extraordinary medical expenses and all reasonable expenses for treatment of any emotional, mental, or other problems related to such pregnancy. In no event, however, shall any such expenses be paid or reimbursed after a period of () month s has elapsed since the date of the termination of the pregnancy. This agreement specifically excludes expenses for lost wages or other non - itemized incidentals related to such pregnancy. (b) Natural Father shall not be responsible for any medical, hospit alization, pharmaceutical, laboratory, or therapy expenses occurring () months after the birth of the child, unless the medical problem incident to such expenses was known and treated by a physician prior to the expiration of the () month period and written notice advising of this treatment is given to Custodian, as representative of Natural Father, by certified mail, return receipt requested. 2001 251 American LegalNet, Inc. (c) Natural Father shall be responsible for the to tal cost of all paternity testing. Such paternity testing may, at the option of Natural Father, be required prior to release of the Surrogate fee from escrow. If Natural Father is conclusively determined not to be the biological father of the child as a re sult of an HLA test, this Agreement will be deemed breached and Surrogate shall not be entitled to any fee, and Natural Father shall be entitled to reimbursement of all medical and related expenses from Surrogate and Surrogate's Husband. (d) Natural Fathe r shall be responsible for Surrogate's reasonable travel expenses incurred at the request of Natural Father pursuant to this Agreement. SECTION FIVE Surrogate and Surrogate's Husband are aware, understand, and agree to assume all risks, including the risk of death, which are incidental to conception, pregnancy, childbirth, and includes, but is not limited to, complications subsequent to such childbirth. SECTION SIX Surrogate and Surrogate's Husband, hereby agree to undergo psychiatric evaluation by , a psychiatrist, as designated by Natural Father. Natural Father shall pay for the cost of such psychiatric evaluation. Prior to their evaluations, Surrogate and Surrogate's Husband shall sign a medical release permitting di ssemination to Custodian or Natural Father and his wife copies of the report prepared as a result of such psychiatric evaluations. SECTION SEVEN Surrogate and Surrogate's Husband hereby agree it is the exclusive and sole right of Natural Father to name su ch child born pursuant to this agreement. SECTION EIGHT Child, as referred to in this agreement, shall include all children born simultaneously pursuant to the inseminations contemplated in this Agreement. SECTION NINE In the event of the death of Natura l Father prior or subsequent to the birth of such child, it is understood and agreed by Surrogate and Surrogate's Husband, the child will be placed in the custody of Natural Father's wife. SECTION TEN In the event the child is miscarried prior to the () ( Fifth or as the Case May Be ) month of pregnancy, no compensation, as enumerated in Section Four, Paragraph 1, shall be paid to Surrogate. However, the expenses enumerated in Section Four, Paragraph 3 shall be paid or reimbursed to Surrogate. In the event the child is miscarried, dies, or is stillborn subsequent to the () ( Fourth or as the Ca