PARENTAL CONSENT TO ADOPTION
(Alabama – Ala. Code Title 26, Chapter 10A compliant)
[// GUIDANCE: This template is drafted to satisfy the Alabama Adoption Code’s core consent, timing, revocation, and counseling provisions. Customize bracketed items, confirm statutory cites, and add county-specific probate requirements before filing.]
TABLE OF CONTENTS
- Document Header
- Definitions
- Operative Provisions
3.1 Grant of Consent
3.2 Timing of Execution
3.3 Revocation Rights
3.4 Counseling Acknowledgment
3.5 Delivery of Custody & Records - Representations & Warranties
- Covenants & Restrictions
- Default & Remedies
- Risk Allocation (Not Applicable)
- Dispute Resolution
- General Provisions
- Execution Block & Notarial Certificate
1. DOCUMENT HEADER
Parental Consent to Adoption
Effective Date: [DATE]
This Parental Consent to Adoption (the “Consent”) is executed in accordance with Alabama’s adoption statutes and is made by:
(a) [LEGAL NAME OF BIRTH MOTHER] (“Birth Mother”);
(b) [LEGAL NAME OF BIRTH FATHER] (“Birth Father”) [or] “Birth Father Unknown/Unavailable”;
(c) [LEGAL NAME OF CHILD] (the “Child”), born [DATE OF BIRTH] in [COUNTY], Alabama; and
(d) [LEGAL NAMES OF PROSPECTIVE ADOPTIVE PARENT(S)] (“Prospective Adoptive Parent(s)”).
Jurisdiction: Probate Court of [COUNTY], Alabama (the “Court”).
Governing Law: Alabama Adoption Code, Ala. Code § 26-10A-1 et seq.
Recitals:
A. The Child has been born alive and is currently in the temporary care of [AGENCY/PROSPECTIVE ADOPTIVE PARENT(S)].
B. Birth Parent(s) desire to voluntarily and irrevocably consent to the Child’s adoption in accordance with Alabama law, subject to the statutory revocation period.
C. No person or entity has exerted undue influence, fraud, duress, or coercion upon Birth Parent(s) in connection with this Consent.
2. DEFINITIONS
For purposes of this Consent, capitalized terms have the meanings set forth below:
“Adoption Proceeding” – The case pending before the Court for entry of a final decree of adoption of the Child by the Prospective Adoptive Parent(s).
“Agency” – [FULL LEGAL NAME OF LICENSED ADOPTION AGENCY], if any, holding legal or physical custody of the Child.
“Consent” – This instrument, duly executed, witnessed, and notarized, by which Birth Parent(s) voluntarily surrender parental rights to facilitate the Adoption Proceeding.
“Execution Date” – The calendar date on which the last Birth Parent signs this Consent in accordance with Section 3.2.
“Revocation Period” – The statutory period during which a Birth Parent may withdraw this Consent, being the later of (i) five (5) calendar days after the Child’s birth or (ii) five (5) calendar days after the Execution Date, as provided in Ala. Code § 26-10A-13.
“Withdrawal Statement” – A written, signed, and notarized statement filed with the Court and delivered to the Prospective Adoptive Parent(s) or Agency to effectuate a timely revocation.
3. OPERATIVE PROVISIONS
3.1 Grant of Consent
Subject to the Revocation Period, each Birth Parent hereby:
a. Irrevocably consents to the adoption of the Child by the Prospective Adoptive Parent(s);
b. Surrenders to the Prospective Adoptive Parent(s) and/or Agency all legal and physical custodial rights, including the right to control the Child’s care, custody, and upbringing; and
c. Authorizes the Court to grant a final decree of adoption without further notice to, appearance by, or consent from such Birth Parent, except as otherwise required by Alabama law.
3.2 Timing of Execution
a. Statutory Compliance. This Consent is executed only after the live birth of the Child.
b. Acknowledgment. Each Birth Parent acknowledges receipt of a copy of this fully-completed Consent at the time of signing.
3.3 Revocation Rights
a. Withdrawal. A Birth Parent may revoke this Consent only by delivering a Withdrawal Statement within the Revocation Period.
b. Effect of Untimely Revocation. Any attempt to revoke after the Revocation Period shall be ineffective unless permitted by the Court upon a finding of fraud, duress, undue influence, or other grounds set forth in Ala. Code § 26-10A-14.
c. Notice. The Agency or Prospective Adoptive Parent(s) shall provide a stamped, pre-addressed envelope to the Court to facilitate timely filings.
[// GUIDANCE: Practitioners often attach a one-page “Withdrawal Form” as Exhibit A for convenience.]
3.4 Counseling Acknowledgment
Each Birth Parent:
a. Has been informed, orally and in writing, of the right to independent counseling by a licensed professional of the Birth Parent’s choosing;
b. Either (i) has received counseling services, or (ii) knowingly waives such services by signing the Waiver in Section 10; and
c. Understands that counseling expenses may be paid by the Prospective Adoptive Parent(s) or Agency as allowed under Ala. Code § 26-10A-34.
3.5 Delivery of Custody & Records
a. Physical Custody. Birth Parent(s) authorize immediate transfer of physical custody of the Child to the Prospective Adoptive Parent(s) or Agency.
b. Medical & Social Records. Birth Parent(s) shall deliver, within five (5) business days, all prenatal, medical, and social history records in their possession concerning the Child.
4. REPRESENTATIONS & WARRANTIES
4.1 Authority. Each Birth Parent represents that he/she is the Child’s [biological/legal] parent and has full legal authority to execute this Consent.
4.2 No Prior Termination. Parental rights have not been previously terminated or restricted by any court.
4.3 Voluntariness. Execution is knowing, voluntary, and free from coercion.
4.4 Accuracy of Information. Information provided herein and in related disclosures is true, complete, and not misleading in any material respect.
4.5 Age and Capacity. Each Birth Parent is at least nineteen (19) years old [OR] emancipated and is of sound mind.
4.6 Survival. Representations and warranties in this Section survive the Revocation Period and the finalization of the adoption.
5. COVENANTS & RESTRICTIONS
5.1 Further Assurances. Birth Parent(s) shall execute any additional documents the Court deems necessary.
5.2 Confidentiality. Birth Parent(s) agree not to disclose identifying information about the Prospective Adoptive Parent(s) except as permitted by Ala. Code § 26-10A-31.
5.3 No Interference. After the Revocation Period, Birth Parent(s) shall not interfere with or contest the Adoption Proceeding except as allowed under Alabama law.
6. DEFAULT & REMEDIES
6.1 Event of Default. A material breach includes any false representation, violation of confidentiality, or failure to deliver required records.
6.2 Remedies. In addition to statutory remedies, the non-breaching party may seek:
a. Specific performance;
b. Injunctive relief to enforce confidentiality; and
c. Recovery of reasonable attorneys’ fees and costs awarded by the Court.
7. RISK ALLOCATION
Indemnification, liability caps, and insurance provisions are not applicable to this Consent, consistent with the metadata and public policy governing adoption matters.
8. DISPUTE RESOLUTION
8.1 Governing Law. This Consent is governed by the laws of the State of Alabama.
8.2 Exclusive Forum. The Probate Court of [COUNTY], Alabama shall have exclusive jurisdiction over all matters arising from or relating to this Consent and the Adoption Proceeding.
8.3 Arbitration. Arbitration is not available for matters governed by this Consent.
8.4 Jury Waiver. Pursuant to Alabama law and Probate Court practice, jury trial is not available in adoption proceedings.
8.5 Injunctive Relief. The Court retains authority to enter orders necessary to protect the Child’s welfare, including permanent placement orders.
9. GENERAL PROVISIONS
9.1 Entire Agreement. This Consent constitutes the entire agreement of the parties concerning the subject matter and supersedes all prior agreements.
9.2 Amendments. No amendment is valid unless in writing, signed by the party against whom enforcement is sought, and approved by the Court.
9.3 Severability. Any unenforceable provision shall be severed, and the remainder enforced to the fullest extent permitted by law.
9.4 Successors and Assigns. This Consent binds and benefits the parties’ respective heirs, legal representatives, and permitted assigns.
9.5 Counterparts & Electronic Signatures. This Consent may be executed in counterparts, each deemed an original. Signatures transmitted electronically (e.g., via PDF or secure e-signature platform) shall be deemed originals for all purposes.
10. EXECUTION BLOCK & NOTARIAL CERTIFICATE
10.1 Birth Mother
Signature: _____
Printed Name: ____
Date: _______
□ I received counseling. □ I knowingly waive counseling.
Witness 1: ____ Witness 2: ______
10.2 Birth Father
Signature: _____
Printed Name: ____
Date: _______
□ I received counseling. □ I knowingly waive counseling.
Witness 1: ____ Witness 2: ______
10.3 Prospective Adoptive Parent(s) Acknowledgment (optional)
We acknowledge receipt of this executed Consent and agree to accept custody subject to final decree.
Parent 1 Signature: ____ Date: _
Parent 2 Signature: ____ Date: _
10.4 Notarial Certificate
State of Alabama )
County of [__] )
On this ___ day of _, 20, before me, the undersigned Notary Public, personally appeared [NAME(S) OF SIGNING BIRTH PARENT(S)], known to me or satisfactorily proven to be the person(s) whose name(s) are subscribed to the foregoing instrument, and acknowledged that he/she/they executed the same voluntarily for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
Notary Public Signature: ____
Printed Name: _______
My Commission Expires: ________
(Seal)
[// GUIDANCE:
1. File the executed original with the Probate Court clerk; provide copies to all parties.
2. Attach any required disclosures, medical/social history forms, and the optional Withdrawal Form Exhibit A.
3. Confirm county-specific witness requirements—many Alabama judges require two disinterested witnesses.
4. If an agency is involved, insert its acknowledgment section and update custody language.
]