PARENTAL CONSENT TO ADOPTION
(Maryland – Private/Independent or Agency Placement)
TABLE OF CONTENTS
- Document Header
- Definitions
- Operative Provisions
- Representations & Warranties
- Covenants & Restrictions
- Revocation, Default & Remedies
- Dispute Resolution
- General Provisions
- Execution Block
[// GUIDANCE: This template is drafted to comply with Maryland Family Law Article, Title 5 (Adoption). Confirm current statutory waiting periods, counseling mandates, and revocation timelines before finalizing. Replace all bracketed text with deal-specific information. Attach all required statutory disclosures.]
1. DOCUMENT HEADER
Parental Consent to Adoption and Waiver of Parental Rights
This Parental Consent to Adoption and Waiver of Parental Rights (this “Consent”) is entered into and made effective as of [EFFECTIVE DATE] (the “Effective Date”) by and among:
a. [BIRTH PARENT FULL LEGAL NAME], residing at [ADDRESS] (“Consenting Parent”);
b. [ADOPTIVE PARENT(S) FULL LEGAL NAME(S)], residing at [ADDRESS] (“Prospective Adoptive Parent(s)”); and, if applicable,
c. [LICENSED CHILD-PLACING AGENCY/ATTORNEY NAME], a [STATE] [corporation/LLC/professional entity] (“Agency/Attorney”).
Recitals
A. Consenting Parent is the legal [mother/father] of [CHILD’S FULL LEGAL NAME], born [DOB] in [CITY, COUNTY, STATE] (the “Child”).
B. Consenting Parent desires to voluntarily and irrevocably (subject to statutory revocation rights) relinquish all parental rights with respect to the Child and to consent to the placement and adoption of the Child by Prospective Adoptive Parent(s).
C. Prospective Adoptive Parent(s) desire(s) to accept such placement and to proceed with an adoption petition in the [NAME OF CIRCUIT COURT], Family Division (the “Court”).
NOW, THEREFORE, in consideration of the mutual promises herein and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows:
2. DEFINITIONS
Unless otherwise expressly provided, capitalized terms have the meanings set forth below.
“Adoption Proceeding” means the case to be filed in the Court seeking a final decree of adoption of the Child by Prospective Adoptive Parent(s).
“Counseling” means the statutorily required counseling session(s) conducted by a qualified counselor prior to execution of this Consent, covering the legal, emotional, and practical consequences of adoption and alternative parenting options.
“Revocation Period” means the period during which Consenting Parent may revoke this Consent pursuant to Section 6.1.
“Waiting Period” means the statutorily required minimum period that must elapse after the Child’s birth before this Consent may be validly executed, currently [INSERT HOURS/ DAYS PER STATUTE].
3. OPERATIVE PROVISIONS
3.1 Consent and Surrender of Rights.
(a) Subject to Section 6, Consenting Parent hereby voluntarily, knowingly, and intentionally:
(i) surrenders all parental rights, powers, privileges, immunities, obligations, and duties with respect to the Child, including any right to custody, visitation, decision-making, or to receive notice of Court proceedings, and
(ii) consents to the permanent placement of the Child with, and adoption of the Child by, Prospective Adoptive Parent(s).
3.2 Consideration.
Consenting Parent acknowledges receipt of lawful consideration consisting of pre-birth and post-birth living expenses, medical care, counseling, and legal services as permitted under Maryland law. No other consideration has been or will be paid or received.
3.3 Counseling Certification.
Consenting Parent certifies that:
(a) Counseling occurred on [DATE] with [COUNSELOR NAME & CREDENTIALS];
(b) Counseling complied with Maryland statutory standards; and
(c) Consenting Parent was informed of alternatives to adoption, the Revocation Period, and the irrevocable nature of this Consent after such period.
3.4 Independent Legal Advice.
Consenting Parent acknowledges that [he/she] had the right to, and either (i) did consult or (ii) knowingly waived the opportunity to consult, independent counsel prior to execution of this Consent.
3.5 Timing; Waiting Period Compliance.
Execution of this Consent occurs no earlier than the expiration of the Waiting Period, and at least [INSERT HOURS/DAYS] after completion of Counseling.
4. REPRESENTATIONS & WARRANTIES
4.1 By Consenting Parent. Consenting Parent represents and warrants that:
(a) Legal Capacity. Consenting Parent is at least 18 years of age or otherwise has legal capacity to execute this Consent.
(b) Voluntariness. This Consent is executed freely, voluntarily, and without duress, coercion, or undue influence.
(c) Exclusive Parental Rights. Consenting Parent has not previously relinquished or had terminated parental rights to the Child.
(d) Accuracy of Information. All information provided herein is true, correct, and complete in all material respects.
4.2 Survival. The representations and warranties in this Section survive execution and remain in effect through the conclusion of the Adoption Proceeding.
5. COVENANTS & RESTRICTIONS
5.1 Non-Interference. Consenting Parent covenants that, except as permitted during the Revocation Period, [he/she] will not:
(a) file or support any action contesting the adoption;
(b) communicate with the Child in a manner contrary to any openness agreement or Court order; or
(c) otherwise interfere with the placement or Adoption Proceeding.
5.2 Cooperation. Consenting Parent shall execute and deliver all additional documents reasonably requested to effectuate the adoption.
6. REVOCATION, DEFAULT & REMEDIES
6.1 Revocation Period.
(a) Consenting Parent may revoke this Consent by delivering a signed, written notice of revocation to the Clerk of the Court and to Agency/Attorney (or Prospective Adoptive Parent(s) if no Agency/Attorney) within [##] days after the later of:
(i) execution of this Consent; or
(ii) filing of the adoption petition with the Court.
(b) Upon timely revocation, all parental rights are restored and placement of the Child shall immediately revert to Consenting Parent unless otherwise ordered by the Court for the Child’s safety.
[// GUIDANCE: Maryland’s default statutory period is currently 30 days. Verify before finalizing.]
6.2 Irrevocability After Revocation Period.
If the Revocation Period expires without timely revocation, this Consent becomes final, irrevocable, and binding.
6.3 Events of Default. Any breach of Section 5 constitutes an Event of Default.
6.4 Remedies.
(a) Specific Performance. The parties acknowledge monetary damages are inadequate; therefore, non-breaching parties may seek specific performance, including injunctive relief, to enforce this Consent.
(b) Costs and Fees. The prevailing party in any enforcement action shall be entitled to reasonable attorneys’ fees and costs.
7. DISPUTE RESOLUTION
7.1 Governing Law. This Consent is governed by the laws of the State of Maryland without regard to conflict-of-laws principles.
7.2 Forum Selection. The parties irrevocably submit to the exclusive jurisdiction of the [NAME OF CIRCUIT COURT], Family Division for any dispute arising out of or relating to this Consent or the Adoption Proceeding. Jury trial is unavailable in Maryland family matters.
7.3 Injunctive Relief. Nothing herein limits any party’s right to seek emergency or injunctive relief necessary to protect the best interests of the Child or to enforce Section 6.
8. GENERAL PROVISIONS
8.1 Entire Agreement. This Consent, together with any statutory disclosures attached hereto, constitutes the entire agreement of the parties and supersedes all prior or contemporaneous understandings.
8.2 Amendments; Waivers. No amendment or waiver is effective unless in writing and signed by the party against whom enforcement is sought and approved by the Court.
8.3 Severability. If any provision is held invalid or unenforceable, the remaining provisions shall remain in full force, and the Court is authorized to reform this Consent to effectuate the parties’ intent.
8.4 Successors; No Assignment. This Consent binds the parties and their respective heirs, personal representatives, and permitted assigns. No party may assign or delegate rights or obligations without Court approval.
8.5 Counterparts; Electronic Signatures. This Consent may be executed in one or more counterparts, each of which is deemed an original, and all of which together constitute one instrument. Facsimile, PDF, and approved e-signature formats are acceptable to the same extent as originals.
9. EXECUTION BLOCK
IN WITNESS WHEREOF, the undersigned have executed this Consent as of the Effective Date.
CONSENTING PARENT
[BIRTH PARENT FULL LEGAL NAME]
Date: _______
PROSPECTIVE ADOPTIVE PARENT(S)
[ADOPTIVE PARENT #1 NAME]
Date: _______
[ADOPTIVE PARENT #2 NAME] (if applicable)
Date: _______
AGENCY / ATTORNEY (if any)
[AUTHORIZED REPRESENTATIVE NAME & TITLE]
[LICENSE NO.]
Date: _______
NOTARY PUBLIC
State of Maryland )
County of ____ ) ss.:
On this _ day of _, 20__, before me, the undersigned Notary Public, personally appeared ____, known to me (or satisfactorily proven) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged that he/she/they executed the same for the purposes therein contained.
In witness whereof I hereunto set my hand and official seal.
Notary Public
My Commission Expires: _______
COUNSELOR’S CERTIFICATION
I, [COUNSELOR NAME], a qualified adoption counselor licensed in the State of Maryland, hereby certify under penalty of perjury that I provided Counseling to the Consenting Parent as described in Section 3.3 on [DATE].
[COUNSELOR NAME & CREDENTIALS]
License No.: ___
Date: ____
[// GUIDANCE: Attach the following statutory exhibits as applicable:
• Exhibit A – Statement of Parental Rights and Responsibilities
• Exhibit B – Counseling Disclosure Statement
• Exhibit C – Open Adoption/Contact Agreement (if any)
• Exhibit D – Financial Disclosure of Allowable Expenses]