CONSENT OF BIOLOGICAL PARENT TO ADOPTION
(State of Georgia)
[// GUIDANCE: This template is designed to comply with Georgia adoption statutes (O.C.G.A. Title 19, Chapter 8) as of the date indicated below. Customize bracketed items, delete inapplicable options, and review local court rules before use.]
DOCUMENT HEADER
Effective Date: [MONTH/DAY/YEAR]
Governing Law & Forum: State of Georgia; exclusive jurisdiction in the [COUNTY] Superior Court, Family Division (the “Court”).
Parties:
• Biological Parent: [LEGAL NAME], residing at [ADDRESS] (“Biological Parent”).
• Child: [CHILD’S FULL LEGAL NAME], born [DOB], in [CITY, COUNTY, STATE] (the “Child”).
• Prospective Adoptive Parent(s): [NAME(S)], residing at [ADDRESS] (“Prospective Adoptive Parent(s)”).
Recitals
A. Biological Parent is the legal [mother/father] of the Child and possesses full authority under Georgia law to consent to the Child’s adoption.
B. Prospective Adoptive Parent(s) desire to adopt the Child pursuant to O.C.G.A. Title 19, Chapter 8.
C. Biological Parent desires voluntarily to surrender all parental rights and to consent irrevocably to the Child’s adoption, subject to the statutory revocation period.
TABLE OF CONTENTS
- Definitions
- Consent and Surrender of Parental Rights
- Counseling Acknowledgment
- Timing of Execution
- Revocation of Consent
- Representations and Warranties
- Covenants and Restrictions
- Default and Remedies
- Dispute Resolution
- General Provisions
- Execution Block
1. DEFINITIONS
For purposes of this Consent, capitalized terms have the following meanings:
1.1 “Child” has the meaning stated in the Document Header.
1.2 “Court” means the Superior Court of [COUNTY], Georgia, Family Division, or any successor court having jurisdiction over the adoption proceeding.
1.3 “Effective Date” means the date this Consent is executed as set forth in the Document Header.
1.4 “Revocation Period” means the statutory period commencing on the Effective Date during which Biological Parent may revoke this Consent pursuant to Section 5.
1.5 “Surrender” means the complete and permanent relinquishment of all parental rights, duties, and obligations in and to the Child.
[// GUIDANCE: Add or delete definitions to align with the final pleading style you prefer.]
2. CONSENT AND SURRENDER OF PARENTAL RIGHTS
2.1 Voluntary Surrender. Biological Parent hereby voluntarily and unconditionally surrenders to Prospective Adoptive Parent(s) all parental rights, privileges, and obligations with respect to the Child, including, without limitation, rights of custody, visitation, decision-making, inheritance, and support.
2.2 Irrevocable Consent. Subject to the Revocation Period in Section 5, Biological Parent irrevocably consents to the permanent placement and adoption of the Child by the Prospective Adoptive Parent(s).
2.3 Appointment of Custodian. Effective immediately upon expiration of the Revocation Period (unless earlier waived pursuant to applicable law), Physical and legal custody of the Child shall vest in the Prospective Adoptive Parent(s), subject to the Court’s final decree of adoption.
2.4 Consideration. Biological Parent acknowledges that this Consent is executed without receipt of any improper payment or inducement prohibited by Georgia law. Any permissible expenses paid on behalf of Biological Parent are set forth in Schedule A, attached hereto.
3. COUNSELING ACKNOWLEDGMENT
3.1 Disclosure of Right to Counseling. Biological Parent acknowledges having been advised of the right to independent counseling regarding the emotional and legal consequences of adoption.
3.2 Voluntary Election. [Choose one]
☐ Biological Parent elected to receive counseling from [COUNSELOR NAME], a licensed [social worker/counselor], and such counseling was completed on [DATE].
☐ Biological Parent knowingly and voluntarily waived the opportunity for counseling.
3.3 Certification. The undersigned Counselor/Attorney’s Certificate attached hereto as Schedule B satisfies the statutory requirement that Biological Parent receive independent advice concerning the surrender and adoption.
4. TIMING OF EXECUTION
4.1 Execution Eligibility. Biological Parent affirms that this Consent is executed not earlier than 24 hours after the Child’s birth and not while under the influence of medication or substance impairing judgment.
4.2 Waiting Period Waiver. Biological Parent acknowledges that Georgia law does not impose a mandatory waiting period beyond 24 hours post-birth; to the extent any waiting period is applicable, Biological Parent expressly waives such period to the fullest extent permitted.
5. REVOCATION OF CONSENT
5.1 Revocation Period. Biological Parent may revoke this Consent by delivering written notice to the Clerk of the Court and to Prospective Adoptive Parent(s) not later than 10 calendar days after the Effective Date (the “Revocation Period”).
[// GUIDANCE: Georgia law currently permits a statutory revocation within 10 days. Confirm the timeframe immediately before filing; insert correct period if amended.]
5.2 Method of Revocation. Revocation must be:
a. In writing, signed by Biological Parent;
b. Delivered via certified mail, return receipt requested, or hand-delivered with written acknowledgment of receipt; and
c. Received by the Clerk of the Court and the Prospective Adoptive Parent(s) within the Revocation Period.
5.3 Effect of Revocation. If timely revoked, this Consent and the Surrender of parental rights shall be null and void ab initio, and custody of the Child shall revert to Biological Parent subject to any temporary orders then in effect.
5.4 Irrevocability Post-Period. Upon expiration of the Revocation Period without timely revocation, this Consent shall become irrevocable and may be set aside only as provided under O.C.G.A. Title 19, Chapter 8 (e.g., fraud, duress, or material misrepresentation).
6. REPRESENTATIONS AND WARRANTIES
Biological Parent hereby represents and warrants to Prospective Adoptive Parent(s) and the Court that:
6.1 Capacity. Biological Parent is at least 18 years old or otherwise possesses legal capacity to execute this Consent.
6.2 Sole Parental Rights. Biological Parent has not previously relinquished or had terminated his/her parental rights to the Child, except as provided herein.
6.3 No Marital Presumption. [Check if applicable] ☐ Biological Parent is unmarried, and no individual is entitled to a presumption of paternity/maternity under Georgia law.
6.4 No Duress or Undue Influence. Execution of this Consent is voluntary and not the result of coercion, duress, fraud, or undue influence.
6.5 Accurate Information. All information provided in this document and any related disclosure schedules is true, complete, and accurate in all material respects.
6.6 Survival. The representations and warranties in this Section survive the Effective Date and, to the extent permissible, the entry of the final decree of adoption.
7. COVENANTS AND RESTRICTIONS
7.1 Non-Interference. Biological Parent shall not take any action intended to hinder, delay, or contest the Child’s adoption by Prospective Adoptive Parent(s) after the Revocation Period expires.
7.2 Future Contact. Except as permitted under any separate Post-Adoption Contact Agreement approved by the Court, Biological Parent shall refrain from contacting the Child or Prospective Adoptive Parent(s).
7.3 Confidentiality. Biological Parent agrees to maintain the confidentiality of the adoption proceedings, subject to statutory disclosure obligations.
7.4 Record Updates. Biological Parent shall promptly notify the Court and Prospective Adoptive Parent(s) of any change in address during the Revocation Period.
8. DEFAULT AND REMEDIES
8.1 Events of Default. The following constitute Events of Default:
a. Revocation attempted after the Revocation Period;
b. Filing of any pleading inconsistent with this Consent after the Revocation Period;
c. Material breach of Section 7 (Covenants and Restrictions).
8.2 Remedies. Upon an Event of Default, Prospective Adoptive Parent(s) and/or the Child (through a guardian ad litem) may seek:
a. Specific performance and injunctive relief to enforce this Consent;
b. An order striking or dismissing any inconsistent pleading; and
c. Reimbursement of reasonable attorney fees and costs incurred in enforcing this Consent.
8.3 Cumulative Remedies. The remedies described are cumulative and not exclusive of any other remedy available at law or in equity.
9. DISPUTE RESOLUTION
9.1 Governing Law. This Consent is governed by and construed under the laws of the State of Georgia without regard to conflict-of-laws principles.
9.2 Exclusive Forum. The parties submit to the exclusive jurisdiction of the Court for any action arising out of or relating to this Consent.
9.3 Arbitration. Arbitration is not available for disputes relating to the adoption of a minor child under Georgia law; any such dispute shall be resolved exclusively by the Court.
9.4 Jury Waiver. To the extent a jury trial could otherwise be available, the parties acknowledge that adoption matters are non-jury proceedings before the Court.
9.5 Injunctive Relief. The Court retains authority to enter immediate and permanent injunctive relief to protect the Child’s best interests, including enforcement of placement.
10. GENERAL PROVISIONS
10.1 Entire Agreement. This Consent constitutes the entire agreement of the parties concerning the subject matter and supersedes all prior agreements, oral or written.
10.2 Amendment; Waiver. No amendment or waiver of any provision is effective unless in writing signed by the party against whom enforcement is sought and, where required, approved by the Court.
10.3 Severability. If any provision of this Consent is held unenforceable, the remaining provisions shall remain in full force so long as the essential purpose is not frustrated.
10.4 Assignment. Neither this Consent nor any rights herein may be assigned by Biological Parent without Court approval; Prospective Adoptive Parent(s) may not assign rights herein except in connection with any lawful change in adoptive placement approved by the Court.
10.5 Successors. This Consent binds and benefits the parties and their respective heirs, legal representatives, and permitted successors.
10.6 Counterparts; Electronic Signatures. This Consent may be executed in counterparts, each of which is deemed an original and all of which together constitute one instrument. Signatures transmitted via electronic means (e.g., PDF, e-signature platform) are deemed original for all purposes unless local rules require otherwise.
11. EXECUTION BLOCK
[// GUIDANCE: Georgia law requires execution in the presence of ONE witness and a Notary Public. Attach the Attorney/Counselor Certificate (Schedule B) as required by O.C.G.A. Title 19, Chapter 8.]
11.1 Biological Parent
[LEGAL NAME], Biological Parent
Date: _______
State of Georgia )
County of ____ )
Acknowledged before me on this _ day of _, 20, by [LEGAL NAME], who is personally known to me or has produced ____ as identification.
Notary Public
My Commission Expires: ____
Witness: ____
Printed Name: _____
11.2 Prospective Adoptive Parent(s)
(acknowledging receipt, not constituting a contract of adoption)
[NAME]
[NAME]
Date: _______
Schedule A – Permissible Expenses Paid (if any)
[Itemize all medical, legal, and living expenses paid on behalf of Biological Parent.]
Schedule B – Counselor/Attorney Certificate
I, ___, a licensed [attorney/counselor/physician] in the State of Georgia, certify that on ___ (date) I counseled [LEGAL NAME] concerning the meaning and consequences of executing this Consent to Adoption and Surrender of Parental Rights, including the Revocation Period, and I am satisfied that the Consent was executed knowingly, voluntarily, and without duress.
Signature & Professional Title
License/Bar No.: ____
Date: _________
[// GUIDANCE: Review Georgia Code for any amendments to the revocation period, formatting, or witnessing requirements before filing. Always file the original with the Clerk of the Court and provide conform-stamped copies to all interested parties.]