Adoption Consent Form

CONSENT OF PARENT TO ADOPTION AND RELINQUISHMENT OF PARENTAL RIGHTS

(Washington State – RCW ch. 26.33 Compliant)

TABLE OF CONTENTS

1. Document Header
2. Definitions
3. Operative Provisions
4. Representations & Warranties
5. Covenants & Restrictions
6. Default & Remedies
7. Dispute Resolution
8. General Provisions
9. Execution Block
10. Notarial Acknowledgment

1. DOCUMENT HEADER

1.1 Title.
CONSENT OF [CONSENTING PARENT NAME] TO THE ADOPTION OF [CHILD LEGAL NAME] AND RELINQUISHMENT OF PARENTAL RIGHTS

1.2 Parties.
• “[Consenting Parent]”: [CONSENTING PARENT FULL LEGAL NAME], currently residing at [ADDRESS].
• “[Child]”: [CHILD LEGAL NAME], born [DATE OF BIRTH] in [CITY/COUNTY], Washington.
• “[Prospective Adoptive Parent(s)]”: [ADOPTIVE PARENT NAME(S)], residing at [ADDRESS(ES)].
• “[Agency]” (if applicable): [LICENSED CHILD-PLACEMENT AGENCY NAME], a Washington-licensed child-placing agency, License No. ☐.

1.3 Recitals.
A. Consenting Parent is the [biological/legal] parent of the Child and possesses the legal capacity to execute this Consent.
B. Consenting Parent desires permanently to relinquish all parental rights to the Child and to consent to the Child’s adoption by the Prospective Adoptive Parent(s).
C. This Consent is executed in compliance with, and shall be governed by, the Washington Adoption Act, RCW ch. 26.33 (“WA Adoption Act”).
D. Consideration for this Consent includes, without limitation, the prospective adoptive placement of the Child and the promises and undertakings herein.

1.4 Effective Date.
This Consent becomes effective on the later of (i) the date signed by the Consenting Parent and (ii) [COURT NAME] Superior Court approval (“Effective Date”).

2. DEFINITIONS

“48-Hour Waiting Period” means the statutory minimum forty-eight (48) hour period after the Child’s birth before which this Consent may not be executed, as mandated by RCW ch. 26.33.

“Agency” has the meaning set forth in Section 1.2.

“Child,” “Consenting Parent,” and “Prospective Adoptive Parent(s)” have the meanings set forth in Section 1.2.

“Court” means the Superior Court of Washington for [COUNTY] (Family & Juvenile Court).

“Revocation Period” means the period during which this Consent may be revoked for any reason: (a) until Court approval, or (b) within one (1) year after Court approval solely upon proof of fraud or duress, all as provided in RCW ch. 26.33.

3. OPERATIVE PROVISIONS

3.1 Consent to Adoption.
Subject to Section 3.2 and the Revocation Period, Consenting Parent irrevocably (i) consents to the adoption of the Child by the Prospective Adoptive Parent(s), and (ii) requests the Court to enter a final decree of adoption in favor of the Prospective Adoptive Parent(s).

3.2 Timing Compliance.
Consenting Parent affirms that:
a. The Child was born on [DATE OF BIRTH];
b. This Consent is executed no earlier than forty-eight (48) hours after such birth; and
c. Execution prior to the expiration of the 48-Hour Waiting Period would render this Consent void under RCW ch. 26.33.

3.3 Relinquishment of Parental Rights.
Effective upon Court approval, Consenting Parent permanently and unconditionally relinquishes all parental rights, duties, and obligations with respect to the Child, including but not limited to custody, control, support, and inheritance rights.

3.4 Counseling Acknowledgment.
Consenting Parent acknowledges having:
a. Been offered adoption-related counseling by [AGENCY/COUNSELOR NAME];
b. Either (i) participated in at least one (1) counseling session on [DATE], or (ii) voluntarily and knowingly waived such counseling (see Section 4.4(a)); and
c. Received the statutory notice of the right to independent legal counsel at Consenting Parent’s own expense.

3.5 Consideration.
No payment or inducement of any kind, other than statutorily permitted pregnancy-related expenses and Court-approved adoption costs, has been offered or accepted in exchange for this Consent.

4. REPRESENTATIONS & WARRANTIES

Consenting Parent represents and warrants, as of the Execution Date and reaffirmed as of Court approval, that:

4.1 Capacity & Authority. Consenting Parent is over eighteen (18) years of age, has not been adjudicated incompetent, and holds sole legal authority to execute this Consent.

4.2 No Prior Relinquishment. No prior relinquishment or consent to adoption concerning the Child has been executed or remains in force.

4.3 Voluntariness. This Consent is executed voluntarily, without fraud, duress, or undue influence.

4.4 Counseling & Advice.
a. Consenting Parent has either (i) received counseling pursuant to Section 3.4, or (ii) knowingly waived such counseling in writing.
b. Consenting Parent has been advised of the right to consult independent legal counsel and either (i) has done so, or (ii) knowingly waives such right.

4.5 Accuracy of Information. All information provided herein and in any supporting affidavits is true, correct, and complete to the best of Consenting Parent’s knowledge.

5. COVENANTS & RESTRICTIONS

5.1 Cooperation. Consenting Parent shall execute all additional documents and perform all acts reasonably necessary to effectuate the adoption.

5.2 No Contact/Interference. Consenting Parent shall not interfere with the placement of the Child or initiate contact with the Child contrary to any post-adoption contact agreement or Court order.

5.3 Confidentiality. Consenting Parent shall keep confidential any identifying information about the Prospective Adoptive Parent(s) except as required by law.

6. DEFAULT & REMEDIES

6.1 Attempted Revocation or Interference. Any attempted revocation or interference in violation of RCW ch. 26.33 after the Revocation Period constitutes a default.

6.2 Remedies. Upon default, the Prospective Adoptive Parent(s) or Agency may seek:
a. Specific performance compelling compliance;
b. Temporary or permanent injunctive relief ensuring placement stability; and
c. Recovery of reasonable attorneys’ fees and Court costs as permitted under RCW ch. 26.33.

7. DISPUTE RESOLUTION

7.1 Governing Law. This Consent shall be governed by and construed in accordance with the laws of the State of Washington, including RCW ch. 26.33.

7.2 Exclusive Forum. The Superior Court of Washington for [COUNTY], Family & Juvenile Court, shall have exclusive jurisdiction.

7.3 Arbitration. Arbitration is not available for matters arising under this Consent.

7.4 Jury Trial Waiver. Pursuant to WA family-law practice, all issues shall be tried to the Court without a jury.

7.5 Injunctive Relief. Nothing herein limits the Court’s equitable power to grant injunctive or other relief necessary to protect the Child’s best interests and placement stability.

8. GENERAL PROVISIONS

8.1 Entire Agreement. This Consent constitutes the entire agreement of the parties with respect to the subject matter and supersedes all prior agreements or understandings.

8.2 Amendments & Waivers. No amendment or waiver of any provision shall be effective unless in writing and signed by the Consenting Parent 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 effect to the maximum extent permitted by law.

8.4 Successors & Assigns. This Consent binds and benefits the parties and their respective heirs, representatives, successors, and assigns.

8.5 Counterparts; Electronic Signatures. This Consent may be executed in counterparts and via electronic signature, each deemed an original, together constituting one instrument.

9. EXECUTION BLOCK

Executed this ____ day of __________, 20____, at _______________________, Washington.

______________________________________
[CONSENTING PARENT NAME]
Consenting Parent

______________________________________
Witness Signature
Name: _________________________________
Address: _______________________________

10. NOTARIAL ACKNOWLEDGMENT

State of Washington )
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 whose name is subscribed to the foregoing instrument, and acknowledged that he/she executed the same for the purposes therein contained.

IN WITNESS WHEREOF, I hereunto set my hand and official seal.

______________________________________
Notary Public in and for the State of Washington
My commission expires: __________________