PARENTAL CONSENT FOR ADOPTION

(Florida – Chapter 63, Florida Statutes)

[// GUIDANCE: This template is intended for use by Florida–licensed attorneys representing a birth parent who is voluntarily consenting to the adoption of a minor child. Customize every bracketed [PLACEHOLDER] and verify statutory citations against the most current version of Chapter 63, Florida Statutes, before filing.]

I. DOCUMENT HEADER

1. Title
   CONSENT OF [CONSENTING PARENT NAME] FOR THE ADOPTION OF [CHILD NAME], AND WAIVER OF FURTHER NOTICE

2. Parties
   a. Consenting Parent: [CONSENTING PARENT NAME], residing at [ADDRESS].
   b. Child: [CHILD NAME], a minor born on [CHILD DOB] in [CITY/COUNTY], Florida.
   c. Prospective Adoptive Parent(s) (if known): [ADOPTIVE PARENT NAME(S)], residing at [ADDRESS].
   d. Jurisdiction: All matters arising from or related to this Consent shall be heard exclusively by the Circuit Court, Family Division, in and for [COUNTY], Florida (“Family Court”).

3. Effective Date
   This Consent is executed on [DATE OF EXECUTION] (“Effective Date”).

4. Recitals
   a. Florida’s adoption statute, Fla. Stat. ch. 63, requires the written consent of specified persons before a final judgment of adoption may be entered.
   b. The Consenting Parent desires to permanently and irrevocably surrender all parental rights to the Child and to consent to the Child’s adoption in accordance with Fla. Stat. § 63.082 (2023).
   c. The Consenting Parent has been advised of the right to independent legal counsel and counseling services, and executes this Consent freely and voluntarily, without duress, coercion, or undue influence.

II. DEFINITIONS

For purposes of this Consent, the following capitalized terms have the meanings set forth below:

1. “Child” – The minor identified in Section I.2.b.
2. “Consenting Parent” – The individual identified in Section I.2.a.
3. “Department” – The Florida Department of Children and Families or its successor agency.
4. “Family Court” – The Circuit Court, Family Division, with jurisdiction over the adoption proceeding.
5. “Revocation Period” – Any statutory period during which this Consent may lawfully be revoked, as set forth in Section IV.3.

III. OPERATIVE PROVISIONS

1. Consent to Adoption
   The Consenting Parent hereby unconditionally and irrevocably consents to the adoption of the Child by the Prospective Adoptive Parent(s) (or any other adoptive parent(s) approved by the Family Court) and requests that the Court enter a Final Judgment of Adoption terminating all parental rights of the Consenting Parent with respect to the Child.

2. Surrender and Relinquishment of Parental Rights
   a. The Consenting Parent permanently surrenders all parental rights, powers, privileges, and obligations concerning the Child, including but not limited to custody, control, visitation, the right to notice of proceedings, and the right to receive future child support.
   b. The Consenting Parent waives any right to be notified of, or to appear in, any future hearings or proceedings regarding the adoption of the Child.

3. Timing of Execution
   a. The Child was born on [CHILD DOB] at [HOSPITAL/BIRTH LOCATION].
   b. Pursuant to Fla. Stat. § 63.082(4)(a), the Consenting Parent is executing this Consent not earlier than:
   i. Forty-eight (48) hours after the Child’s birth; or
   ii. The date and time of written medical discharge of the Consenting Parent from the hospital;
   whichever occurs earlier.

4. Consideration
   The Consenting Parent acknowledges receipt of good and valuable consideration, the adequacy and sufficiency of which are hereby acknowledged, consisting solely of allowable expenses under Fla. Stat. § 63.097.

IV. REPRESENTATIONS & WARRANTIES

The Consenting Parent represents and warrants, under penalty of perjury, that:

1. Authority – The Consenting Parent is legally entitled to give this Consent pursuant to Fla. Stat. § 63.062.
2. Identity & Capacity – The Consenting Parent’s identity, age, and relationship to the Child are as stated herein, and the Consenting Parent is not under the influence of any substance impairing capacity.
3. Revocation Rights – The Consenting Parent understands:
   a. If this Consent is executed prior to 48 hours after birth or before medical discharge (whichever occurs first), the Consenting Parent may revoke it at any time until the earlier of those two events.
   b. Once the applicable time period has expired, or if this Consent is executed after 48 hours/discharge, it is binding and irrevocable, except upon a finding by the Court that it was obtained by fraud or duress.
4. Counseling – The Consenting Parent has been offered counseling services as required by Fla. Stat. § 63.082(6) and:
   ☐ has received counseling ☐ has knowingly and voluntarily declined counseling.
5. No Duress or Fraud – This Consent is executed voluntarily, without duress, coercion, misrepresentation, or fraud.
6. Legal Advice – The Consenting Parent:
   ☐ is represented by independent legal counsel, [ATTORNEY NAME]; or
   ☐ has been advised of the right to such counsel and knowingly waives that right.
7. No Undisclosed Payments – No payment or thing of value has been promised or received except those allowed by law and disclosed to the Court.

V. COVENANTS

1. Cooperation – The Consenting Parent shall execute any additional documents reasonably required to complete the adoption.
2. Non-Interference – The Consenting Parent shall not interfere with the custody, care, or adoption of the Child.

VI. DEFAULT & REMEDIES

[// GUIDANCE: Because this is a statutory consent rather than a bilateral contract, “default” is limited to fraudulent or coerced execution. Remedies are governed by Fla. Stat. §§ 63.082(7)–(8).]

In the event the Court determines that this Consent was obtained by fraud or duress, the Court may set aside the Consent and order such equitable relief as justice requires.

VII. RISK ALLOCATION

Indemnification, limitation of liability, and insurance provisions are not applicable to this statutory Consent.

VIII. DISPUTE RESOLUTION

1. Governing Law – This Consent shall be governed by and construed in accordance with the laws of the State of Florida, without regard to conflict-of-laws principles.
2. Exclusive Forum – Any action relating to the validity or enforcement of this Consent shall be filed exclusively in the Family Court for [COUNTY], Florida.
3. Arbitration / Jury Trial – Arbitration is not available, and jury trial is not applicable in Chapter 63 proceedings.
4. Injunctive Relief – The Family Court retains authority to enter any orders necessary to protect the best interests of the Child, including permanent placement orders.

IX. GENERAL PROVISIONS

1. Entire Agreement – This document constitutes the entire agreement of the Consenting Parent regarding consent to adoption of the Child.
2. Amendments – No amendment or revocation is effective unless permitted by law and executed with the same formalities as this Consent.
3. Severability – If any provision is held invalid, the remaining provisions shall continue in full force to the maximum extent permitted by law.
4. Counterparts / Electronic Signatures – This Consent may be executed in counterparts and by electronic signature, each of which shall be deemed an original.

X. EXECUTION BLOCK

I, [CONSENTING PARENT NAME], have carefully read (or had read to me) and fully understand this Consent. I sign it freely and voluntarily on the Effective Date stated above.

A. Consenting Parent

[CONSENTING PARENT NAME], Consenting Parent

Date: ____

B. Witnesses (two required)

1. ---

   [PRINT NAME] – Witness #1
   Date: ____

2. ---

   [PRINT NAME] – Witness #2
   Date: ____

C. Notarization

STATE OF FLORIDA
COUNTY OF ________

The foregoing instrument was acknowledged before me this _ day of _, 20__, by [CONSENTING PARENT NAME], who is personally known to me ☐ or produced _________ as identification, and who did/did not take an oath.

Notary Public, State of Florida
Print Name: _____
Commission No.: ____
My Commission Expires: __

[SEAL]

XI. OPTIONAL ATTACHMENTS

1. Exhibit A – Counseling Acknowledgment Form
2. Exhibit B – Disclosure of Allowable Expenses
3. Exhibit C – Medical & Social History of Child and Birth Family

[// GUIDANCE: Attach completed exhibits if required under Fla. Stat. §§ 63.082 & 63.085. File the executed Consent with the Clerk of the Circuit Court in compliance with local administrative orders.]

© [YEAR] [LAW FIRM NAME]. All rights reserved.