PARENTAL CONSENT TO ADOPTION AND WAIVER OF PARENTAL RIGHTS
(State of Iowa)
[// GUIDANCE: This template is drafted for use by Iowa-licensed attorneys in private adoptions that do not involve ICWA, foster-care, or interstate placements. Counsel should confirm applicability of Iowa Code ch. 600 to the specific adoption and whether any additional federal or state statutes (e.g., ICWA, ICPC) apply.]
TABLE OF CONTENTS
- Document Header
- Definitions
- Operative Provisions
- Representations & Warranties
- Covenants & Restrictions
- Default & Remedies
- Dispute Resolution
- General Provisions
- Execution Block
- Notarial Acknowledgment
1. DOCUMENT HEADER
1.1 Title
Parental Consent to Adoption and Waiver of Parental Rights (Iowa)
1.2 Parties
(a) “[BIRTH PARENT]” – the biological [mother/father] of the Child identified herein.
(b) “[PROSPECTIVE ADOPTIVE PARENT(S)]” – the individual(s) petitioning for adoption of the Child.
(c) “[CHILD]” – the minor born on [DATE OF BIRTH] in [PLACE OF BIRTH].
1.3 Recitals
A. Birth Parent is the legal parent of the Child.
B. Prospective Adoptive Parent(s) desire to adopt the Child pursuant to Iowa Code ch. 600.
C. Birth Parent desires voluntarily and irrevocably to consent to the adoption of the Child, subject to the limited revocation rights provided by Iowa law.
D. In consideration of the promises herein and for other good and valuable consideration, the adequacy of which is acknowledged, the Parties agree as follows.
1.4 Effective Date & Waiting Period
This Consent is effective on the date executed below (the “Effective Date”), provided that such execution shall not occur until at least seventy-two (72) hours have elapsed since the Child’s birth. Iowa Code § 600.7(1)(a).
1.5 Governing Law & Venue
This Consent is governed by the laws of the State of Iowa. Exclusive venue for any action arising hereunder lies in the Iowa District Court sitting as the juvenile/family court for [COUNTY].
2. DEFINITIONS
“Adoption Decree” – The final order entered by the Iowa District Court granting the Petition for Adoption.
“Consent” – This Parental Consent to Adoption and Waiver of Parental Rights executed pursuant to Iowa Code § 600.7.
“Counseling” – Pre-execution counseling offered to Birth Parent concerning the meaning and consequences of adoption, as described in Section 3.3.
“Revocation Period” – The period from the Effective Date until entry of the Adoption Decree during which Birth Parent may seek court-approved withdrawal of this Consent under Iowa Code § 600.7(6).
All capitalized terms not otherwise defined have the meanings assigned by Iowa Code ch. 600.
3. OPERATIVE PROVISIONS
3.1 Grant of Consent
Birth Parent hereby voluntarily, knowingly, and permanently (subject only to Section 3.4) consents to the adoption of the Child by Prospective Adoptive Parent(s) and relinquishes all parental rights, duties, and obligations with respect to the Child, including but not limited to custody, care, control, support, and inheritance.
3.2 Condition Precedent – Statutory Waiting Period
This Consent is null and void if executed before seventy-two (72) hours have passed since the Child’s birth. Counsel must verify compliance prior to acknowledging execution.
3.3 Counseling Acknowledgment
(a) Birth Parent affirms that (i) Counseling regarding the adoption decision, alternatives to adoption, and the legal consequences of this Consent was made available by a qualified counselor or licensed attorney; (ii) Birth Parent either received such Counseling on [DATE] or knowingly declined it.
(b) Birth Parent understands that Counseling services remain available at no cost prior to entry of the Adoption Decree.
3.4 Limited Revocation Rights
(a) Birth Parent may only withdraw this Consent before entry of the Adoption Decree and only upon written application and a finding by the court that the withdrawal is in the Child’s best interests. Iowa Code § 600.7(6).
(b) After entry of the Adoption Decree, this Consent is absolute and irrevocable.
3.5 No Consideration for Consent
No payment or thing of value, other than reimbursement of statutorily permissible pregnancy-related expenses, has been offered or accepted in exchange for this Consent. Birth Parent acknowledges that any other consideration is unlawful.
3.6 Transfer of Physical Custody
Birth Parent authorizes immediate placement of the Child with Prospective Adoptive Parent(s) or their authorized agent upon execution of this Consent, subject to applicable Iowa placement orders.
4. REPRESENTATIONS & WARRANTIES
4.1 By Birth Parent
(a) Age & Capacity – Birth Parent is at least eighteen (18) years old and competent to execute this Consent.
(b) Sole Parental Rights – No other individual has established legal paternity/maternity of the Child except as follows: [INSERT if applicable / “None”].
(c) Voluntariness – This Consent is executed voluntarily, without duress, coercion, or undue influence.
(d) Accuracy – All information provided herein is true, complete, and accurate.
4.2 Survival
The representations and warranties of Birth Parent survive execution of this Consent and entry of the Adoption Decree.
5. COVENANTS & RESTRICTIONS
5.1 Cooperation
Birth Parent shall execute any additional documents reasonably requested by counsel to effectuate the adoption.
5.2 Non-Interference
Birth Parent shall not challenge, directly or indirectly, the adoption of the Child except as permitted under Section 3.4.
5.3 Confidentiality
Birth Parent agrees to keep confidential all non-public information regarding the identity and location of the Prospective Adoptive Parent(s), except as required by law or court order.
6. DEFAULT & REMEDIES
6.1 Event of Default
Any breach of Sections 3, 4, or 5 constitutes an “Event of Default.”
6.2 Remedies
Upon an Event of Default, Prospective Adoptive Parent(s) may seek:
(a) Specific enforcement of this Consent;
(b) Injunctive relief to preserve the Child’s placement; and
(c) Costs and reasonable attorneys’ fees incurred in enforcing this Consent.
[// GUIDANCE: Monetary damages are generally disfavored in adoption contexts. Injunctive relief preserves the Child’s best interests.]
7. DISPUTE RESOLUTION
7.1 Governing Law
Iowa substantive law governs.
7.2 Exclusive Forum
Any proceeding relating to this Consent shall be filed in the Iowa District Court, Juvenile Division, for [COUNTY]. Arbitration is expressly unavailable.
7.3 Jury Waiver
Proceedings in Iowa juvenile/family court are non-jury; accordingly, the Parties waive any right to jury trial to the extent one might otherwise exist.
7.4 Injunctive Relief
Nothing herein limits the court’s equitable authority to grant permanent placement orders or other relief consistent with the Child’s best interests.
8. GENERAL PROVISIONS
8.1 Amendments
This Consent may be amended only by a written instrument executed by Birth Parent and approved by the court.
8.2 Assignment
Neither this Consent nor any rights hereunder may be assigned by Birth Parent.
8.3 Successors & Assigns
This Consent binds and benefits the Parties and their respective heirs, legal representatives, and permitted assigns.
8.4 Severability
If any provision is held invalid, the remainder is enforceable, and the invalid provision will be reformed to the minimum extent necessary to comply with law and effectuate intent.
8.5 Entire Agreement
This Consent constitutes the entire understanding regarding the subject matter and supersedes all prior agreements or understandings.
8.6 Counterparts & Electronic Signatures
This Consent may be executed in counterparts, each of which is deemed an original; signatures transmitted electronically or by facsimile are binding.
9. EXECUTION BLOCK
IN WITNESS WHEREOF, the undersigned executes this Parental Consent to Adoption and Waiver of Parental Rights as of the Effective Date written below.
Signature of Birth Parent: ____
Printed Name: [BIRTH PARENT]
Date of Signature (must be ≥ 72 hours post-birth): __
Address: _______
Telephone: _______
[Optional – Second Birth Parent if applicable]
Signature of Birth Parent: ____
Printed Name: ______
Date: __
Witness Acknowledgment
The undersigned witness certifies that the Birth Parent appeared to execute this Consent voluntarily and that the statutory waiting period has been observed.
Witness Signature: _____
Printed Name: _____
Date: __
10. NOTARIAL ACKNOWLEDGMENT
State of Iowa )
) ss.
County of _____ )
On this _ day of _, 20, before me, the undersigned Notary Public in and for the State of Iowa, personally appeared [BIRTH PARENT], known to me (or satisfactorily proven) to be the person whose name is subscribed to the foregoing instrument, and acknowledged that (s)he executed the same as [his/her] voluntary act and deed.
IN WITNESS WHEREOF, I hereunto set my hand and affix my official seal.
Notary Public in and for the State of Iowa
My commission expires: _______
[// GUIDANCE:
1. File the executed Consent with the court concurrently with the Petition for Adoption or as otherwise directed by local rule.
2. Retain originals pursuant to Iowa R. Elec. P. 16.201(2) and maintain for at least five (5) years post-decree.
3. If the Child may be an “Indian child” under 25 U.S.C. § 1903(4), obtain separate ICWA-compliant consent executed before a judge of competent jurisdiction.
]