DISTRICT OF COLUMBIA
PARENTAL CONSENT TO ADOPTION
TABLE OF CONTENTS
- Document Header
- Definitions
- Operative Provisions
- Representations & Warranties
- Covenants & Restrictions
- Revocation, Default & Remedies
- Dispute Resolution
- General Provisions
- Execution Block
[// GUIDANCE: Practitioners should compare this template against the current text of D.C. Code §§ 16-301 et seq. before use. All bracketed items must be completed or deleted.]
1. DOCUMENT HEADER
1.1 Title.
Parental Consent to Adoption (the “Consent”).
1.2 Parties.
a. Consenting Parent: [CONSENTING PARENT FULL LEGAL NAME], an individual whose residential address is [ADDRESS] (“Birth Parent”).
b. Prospective Adoptive Parent(s): [ADOPTIVE PARENT(S) FULL LEGAL NAME(S)], residing at [ADDRESS] (collectively, “Prospective Parent”).
c. Adoptee: [CHILD’S FULL LEGAL NAME] (“Child”).
1.3 Effective Date.
This Consent is executed on [DATE] (the “Effective Date”).
1.4 Governing Law & Jurisdiction.
This Consent is governed by the adoption laws of the District of Columbia, including D.C. Code § 16-301 et seq., and is subject to the exclusive jurisdiction of the Superior Court of the District of Columbia, Family Court (“Family Court”).
1.5 Recitals.
WHEREAS, Birth Parent is the [mother/father] and legal parent of Child;
WHEREAS, Prospective Parent desires to adopt Child, and Birth Parent desires voluntarily and irrevocably (subject to statutory revocation rights) to consent to said adoption; and
WHEREAS, the parties intend that this Consent satisfy all statutory requirements for parental consent under District of Columbia law;
NOW, THEREFORE, in consideration of the mutual promises herein and other good and valuable consideration, the parties agree as follows.
2. DEFINITIONS
For purposes of this Consent, the following terms have the meanings set forth below:
“Adoption Petition” means the petition for adoption of the Child to be filed in Family Court by Prospective Parent.
“Adoption Proceeding” means all hearings, filings, and related matters before Family Court concerning the Adoption Petition.
“Counseling Provider” means a licensed child-placing agency social worker, attorney, or mental-health professional approved under D.C. Code § 16-304 to provide pre-consent counseling.
“Consent Revocation Period” means the statutory period, if any, during which Birth Parent may revoke this Consent under D.C. Code § 16-304 and Section 6.2 of this document.
“Final Decree” means the final decree of adoption issued by Family Court pursuant to D.C. Code § 16-308.
3. OPERATIVE PROVISIONS
3.1 Voluntary Consent.
Birth Parent hereby unconditionally and voluntarily consents to the adoption of Child by Prospective Parent and requests the Court to enter all orders necessary to effectuate said adoption.
3.2 Scope of Consent.
This Consent extends to:
a. Termination of Birth Parent’s parental rights and obligations, except as provided by law;
b. Granting Prospective Parent full parental rights upon entry of a Final Decree; and
c. Authorization for Prospective Parent to obtain medical, educational, and other records concerning Child as necessary for the Adoption Proceeding.
3.3 Consideration.
No payment or consideration of any kind, other than allowable expenses under D.C. Code § 16-308.01, has been offered or accepted by Birth Parent in connection with this Consent.
3.4 Timing of Execution.
Birth Parent affirms that (check one):
☐ Child is at least 72 hours old; OR
☐ Birth Parent is executing this Consent pre-birth, with acknowledgment that it becomes effective only upon the Child’s birth.
3.5 Counseling Confirmation.
Birth Parent certifies having received counseling from a Counseling Provider at least 24 hours prior to executing this Consent, addressing:
(i) alternatives to adoption;
(ii) the consequences of signing this Consent; and
(iii) the statutory right to revoke, if any.
4. REPRESENTATIONS & WARRANTIES
Birth Parent represents and warrants that:
a. Birth Parent is at least 18 years of age or otherwise legally competent to consent.
b. Birth Parent has full legal and physical custody of Child or has authority to execute this Consent.
c. This Consent is executed freely, knowingly, and without duress, coercion, or undue influence.
d. No other person’s consent is required, except as disclosed in Schedule 4-A [attach if applicable].
e. There is no pending litigation or protective order that would impair Birth Parent’s authority to consent.
[// GUIDANCE: Add survival language if practitioner wants reps to survive beyond Final Decree.]
5. COVENANTS & RESTRICTIONS
5.1 Cooperation.
Birth Parent shall execute any additional documents reasonably requested to complete the Adoption Proceeding.
5.2 Non-Interference.
Except as permitted under Section 6.2, Birth Parent shall not challenge, obstruct, or otherwise contest the Adoption Petition.
5.3 Confidentiality.
Birth Parent shall keep confidential all identifying information regarding Prospective Parent and Child obtained through the Adoption Proceeding, except as required by law.
6. REVOCATION, DEFAULT & REMEDIES
6.1 Condition Precedent.
Entry of a Final Decree is a condition precedent to permanent transfer of parental rights.
6.2 Statutory Revocation Rights.
Birth Parent may revoke this Consent only as permitted under D.C. Code § 16-304 and must do so by delivering a written, notarized revocation to Family Court and to Prospective Parent within the Consent Revocation Period of [14] calendar days after the Effective Date, unless Birth Parent has executed a valid waiver of the revocation period pursuant to D.C. Code § 16-304(e).
[// GUIDANCE: Confirm the precise number of days under current statute; substitute if different.]
6.3 Effect of Revocation.
If a timely and valid revocation is filed, this Consent is void ab initio, and all parties revert to their pre-Consent legal status.
6.4 Challenge for Fraud or Duress.
After expiration of the Consent Revocation Period, Birth Parent may seek to set aside this Consent only upon a showing of fraud or duress under D.C. Code § 16-304(f).
7. DISPUTE RESOLUTION
7.1 Governing Law.
This Consent and all related disputes are governed by the laws of the District of Columbia, without regard to conflict-of-law principles.
7.2 Exclusive Forum.
Any dispute arising under or relating to this Consent shall be heard exclusively in Family Court.
7.3 Arbitration & Jury Trial.
Arbitration is not available for adoption matters. Jury trial is waived by operation of D.C. family-law practice; all issues shall be determined by the presiding judge.
7.4 Injunctive Relief.
Family Court retains authority to issue orders necessary to secure Child’s permanent placement and best interests.
8. GENERAL PROVISIONS
8.1 Entire Agreement.
This Consent constitutes the entire agreement among the parties with respect to the subject matter and supersedes all prior understandings.
8.2 Amendments.
No amendment to this Consent is valid unless in writing, signed by the party against whom enforcement is sought, and approved by Family Court.
8.3 Severability.
If any provision is found unenforceable, the remaining provisions shall be enforced to the fullest extent permissible.
8.4 Assignment.
Rights hereunder are personal and may not be assigned.
8.5 Counterparts; Electronic Signatures.
This Consent may be executed in counterparts, each of which is an original. Electronic signatures and notarizations compliant with D.C. law are permitted.
9. EXECUTION BLOCK
IN WITNESS WHEREOF, the undersigned have executed this Parental Consent to Adoption as of the Effective Date.
9.1 Consenting Parent
[CONSENTING PARENT NAME]
Date: _____
State/District of ____
County of ____
On this _ day of _, 20__, before me, the undersigned Notary Public, personally appeared [Consenting Parent], who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed herein and acknowledged that he/she executed the same for the purposes therein contained.
Notary Public
My Commission Expires: ____
9.2 Prospective Adoptive Parent(s)
a. _____
[ADOPTIVE PARENT #1 NAME]
Date: _____
b. _____
[ADOPTIVE PARENT #2 NAME]
Date: _____
[// GUIDANCE: Prospective Parent signatures are customary but not always statutorily required. Delete if local practice omits.]
9.3 Agency / Attorney Certification (if applicable)
I, ____, as [Licensed Agency Representative / Attorney at Law], hereby certify that I provided the counseling described in Section 3.5 and explained Birth Parent’s rights and obligations under D.C. Code § 16-304.
Signature & Title
Date: _____
End of Document