Adoption Consent Form - Wyoming

WYOMING PARENTAL CONSENT TO ADOPTION

AND RELINQUISHMENT OF PARENTAL RIGHTS

TABLE OF CONTENTS

1. Document Header
2. Definitions

3. Operative Provisions
   3.1 Consent & Relinquishment
   3.2 Effective Date; Execution and Acknowledgment
   3.3 Revocation & Withdrawal of Consent
   3.4 Counseling Acknowledgment
   3.5 Conditions Precedent to Finalization

4. Representations & Warranties

5. Covenants & Restrictions
6. Default & Remedies
7. Risk Allocation (N/A)
8. Dispute Resolution
9. General Provisions
10. Execution Block

1. DOCUMENT HEADER

This Parental Consent to Adoption and Relinquishment of Parental Rights (this “Consent”) is made and entered into as of [EFFECTIVE DATE] (the “Effective Date”) by:

• [LEGAL NAME OF CONSENTING PARENT] (“Consenting Parent”); and
• [OPTIONAL: LEGAL NAME OF SECOND CONSENTING PARENT] (“Second Consenting Parent,” and together with Consenting Parent, the “Consenting Parties”),

in favor of:

• [LEGAL NAMES OF PROSPECTIVE ADOPTIVE PARENT(S)] (individually and collectively, the “Petitioners”).

Recitals

A. The child identified below (the “Child”) was born on [DATE OF BIRTH] in [CITY/COUNTY], Wyoming.
B. The Consenting Parties are the legal parent(s) of the Child and possess full authority to execute this Consent under applicable Wyoming adoption statutes.
C. Petitioners intend to file a Petition for Adoption in the ☐ Judicial District Court, State of Wyoming (the “Family Court”).
D. The Consenting Parties desire to irrevocably relinquish all parental rights to the Child and consent to the Child’s adoption by the Petitioners. Under Wyo. Stat. Ann. § 1-22-109(d), a written consent and relinquishment are irrevocable unless obtained by fraud or duress, subject only to the narrow statutory exception set forth in Section 3.3.

NOW, THEREFORE, in consideration of the mutual promises herein and other good and valuable consideration, the receipt and sufficiency of which are acknowledged, the Consenting Parties agree as follows:

2. DEFINITIONS

For purposes of this Consent, the following terms shall have the meanings set forth below. Any capitalized term not defined herein shall have the meaning ascribed in the operative provisions of this Consent.

“Child” means the minor child named in Section 1(A).

“Counseling” means any pre-consent counseling offered or arranged in connection with the adoption. Wyoming's adoption statutes (Wyo. Stat. Ann. §§ 1-22-101 through 1-22-117) do not impose a general statutory counseling prerequisite to a valid parental consent; confirm any counseling required by a certified placement agency or by court practice.

“Effective Date” has the meaning set forth in the Document Header.

“Family Court” has the meaning set forth in Recital C.

“Petitioners” has the meaning set forth in the Document Header.

3. OPERATIVE PROVISIONS

3.1 Consent & Relinquishment

(a) Pursuant to Wyo. Stat. Ann. § 1-22-109, the Consenting Parties hereby unconditionally:
(i) consent to the adoption of the Child by the Petitioners;
(ii) relinquish all legal and physical custodial rights, responsibilities, and obligations with respect to the Child; and
(iii) waive any right to receive future notice of adoption proceedings, except as otherwise required by statute.

(b) The written relinquishment of custody and written consent to adoption shall be filed with the Petition to Adopt (Wyo. Stat. Ann. §§ 1-22-104(c)(i)–(ii), 1-22-109(a)). The consent to adoption and the relinquishment of custody may be contained in this single instrument (§ 1-22-109(e)).

(c) Upon entry of a final decree of adoption by the Family Court, all parent-child legal relationships between the Consenting Parties and the Child shall be permanently terminated and vested in the Petitioners.

3.2 Effective Date; Execution and Acknowledgment

(a) Timing. Under Wyo. Stat. Ann. § 1-22-109(c), the consent to adoption may be signed at any time after the birth of the Child. Wyoming law imposes no minimum waiting period after birth before a consent may be validly executed.

(b) Acknowledgment or court approval. The consent shall be acknowledged before (i) a person authorized to take acknowledgments, (ii) a representative of the Wyoming Department of Family Services, or (iii) a representative of the certified agency to whom custody of the Child is being relinquished for adoption (§ 1-22-109(c)(i)). If not so acknowledged, the consent may instead be approved by the court after the person giving consent appears before the court in an informal hearing in chambers and the court finds that the consent is knowingly and voluntarily given (§ 1-22-109(c)(ii)).

3.3 Revocation & Withdrawal of Consent

(a) Irrevocability. Under Wyo. Stat. Ann. § 1-22-109(d), the consent to adoption and the relinquishment of the Child for adoption are irrevocable unless obtained by fraud or duress. There is no statutory period during which a validly executed consent may be withdrawn as of right, and Wyoming law provides no "best interests" withdrawal standard for a consenting parent.

(b) Narrow statutory exception. If the court denies the adoption on account of a claim or objection of the putative father of the Child, the court may allow the mother of the Child to withdraw her consent and relinquishment (§ 1-22-109(d)).

(c) Minor parent. A consent or relinquishment given by a parent who is a minor is valid and may not be revoked solely because of the parent's minority (§ 1-22-109(d)).

(d) Procedure. A Consenting Party seeking to set aside this Consent on the ground of fraud or duress (or under the narrow exception in subsection (b)) must raise the matter by appropriate motion in the Family Court; the burden rests on the party seeking to withdraw.

3.4 Counseling Acknowledgment

The Consenting Parties each acknowledge that:
(a) they have been offered any Counseling made available regarding the emotional and legal consequences of adoption;
(b) they have (check one) ☐ accepted ☐ waived such Counseling; and
(c) any Counseling required by a certified placement agency or by the Family Court has been completed prior to execution of this Consent, as evidenced by the attached Counselor’s Certificate (Exhibit A), if applicable.

3.5 Conditions Precedent to Finalization

The effectiveness of the adoption (as distinct from the irrevocability of this Consent under Section 3.3) is subject to:
(a) the filing of a Petition for Adoption by the Petitioners, with the required documents under Wyo. Stat. Ann. § 1-22-104(c);
(b) issuance of all clearances required by the Interstate Compact on the Placement of Children (if applicable); and
(c) entry of a decree of adoption by the Family Court.

Failure to satisfy the foregoing conditions shall not revive any relinquished parental rights unless expressly ordered by the Family Court, except as provided in Section 3.3.

4. REPRESENTATIONS & WARRANTIES

Each Consenting Party represents and warrants that, as of the Effective Date:

4.1 Capacity. He/she is mentally competent and is executing this Consent knowingly and voluntarily, free of fraud, duress, coercion, and the influence of drugs or alcohol. A Consenting Party who is a minor may nonetheless give a valid consent and relinquishment, which may not be revoked solely because of minority (Wyo. Stat. Ann. § 1-22-109(d)).

4.2 Exclusive Parental Rights. He/she is a legal parent of the Child and no other person’s consent (other than any Second Consenting Parent identified herein or any other person whose consent is required by Wyo. Stat. Ann. § 1-22-109(a)) is required for the Child’s adoption.

4.3 No Prior Transfer. He/she has not previously assigned or transferred custody or parental rights to any third party, other than temporary placements authorized by law.

4.4 Full Disclosure. He/she has disclosed to Petitioners all known health, medical, and genetic information concerning the Child and the child’s biological family.

4.5 Legal Advice. He/she has been advised of the right to independent legal counsel and (check one) ☐ has retained counsel ☐ has knowingly waived such right.

The foregoing representations and warranties shall survive the Effective Date and be enforceable by Petitioners until entry of the final decree of adoption.

5. COVENANTS & RESTRICTIONS

5.1 No Interference. Consenting Parties shall not interfere with Petitioners’ custody of the Child or with any adoption proceedings in the Family Court.

5.2 Future Contact. Any post-adoption contact shall occur only as set forth in a written Post-Adoption Contact Agreement approved by the Family Court.

5.3 Further Assurances. Consenting Parties agree to execute and deliver such further instruments and take such additional actions as may be reasonably requested to effectuate the purposes of this Consent.

6. DEFAULT & REMEDIES

6.1 Events of Default. A Consenting Party’s breach of Section 5 constitutes a default.

6.2 Remedies. Upon default, Petitioners may seek:
(a) specific performance;
(b) injunctive relief to protect the Child’s permanent placement; and
(c) any additional relief the Family Court deems just and proper.

6.3 Attorneys’ Fees. The prevailing party in any action to enforce this Consent shall be entitled to reasonable attorneys’ fees and costs as determined by the Family Court.

7. RISK ALLOCATION

Indemnification, limitation of liability, and insurance provisions are not applicable to this Consent. Nothing herein shall be construed to expand any party’s liability beyond that provided under Wyoming law.

8. DISPUTE RESOLUTION

8.1 Governing Law. This Consent shall be governed by and construed in accordance with the adoption statutes of the State of Wyoming, without regard to its conflict-of-laws principles.

8.2 Exclusive Forum. The parties submit to the exclusive jurisdiction of the ☐ Judicial District Court, State of Wyoming, for all proceedings arising out of or relating to this Consent.

8.3 Arbitration. Arbitration is not available for disputes concerning adoption or parental rights under Wyoming law.

8.4 Jury Waiver. In family-law proceedings before the Family Court, jury trials are not available.

8.5 Injunctive Relief. Nothing in this Section shall limit the Family Court’s authority to issue orders necessary to ensure the Child’s permanent placement and welfare.

9. GENERAL PROVISIONS

9.1 Amendments; Waivers. No amendment or waiver of any provision of this Consent shall be effective unless in writing and signed by the party against whom enforcement is sought and approved by the Family Court.

9.2 Assignment. Neither this Consent nor any rights hereunder may be assigned by any party.

9.3 Successors. This Consent shall bind and inure to the benefit of the parties hereto and their respective heirs, legal representatives, and permitted assigns.

9.4 Severability. If any provision of this Consent is held invalid or unenforceable, the remaining provisions shall remain in full force to the maximum extent permitted by law.

9.5 Entire Agreement. This Consent constitutes the entire agreement of the parties concerning the subject matter hereof and supersedes all prior understandings, whether written or oral.

9.6 Counterparts; Electronic Signatures. This Consent may be executed in counterparts, each of which shall be deemed an original. Because a valid Wyoming consent must be acknowledged before an authorized officer or approved by the court (Wyo. Stat. Ann. § 1-22-109(c)), confirm that the acknowledging officer and the court accept the chosen signature method before relying on a facsimile, PDF, or electronic signature.

10. EXECUTION BLOCK

10.1 Consenting Parent

_____________________________________
[PRINTED NAME], Consenting Parent

State of Wyoming
County of ______________________

The foregoing instrument was acknowledged before me on this _____ day of __________, 20____, by [PRINTED NAME], who is personally known to me or produced satisfactory identification.

_____________________________________
Notary Public
My Commission Expires: ____________

10.2 Second Consenting Parent (if applicable)

_____________________________________
[PRINTED NAME], Second Consenting Parent

State of Wyoming
County of ______________________

The foregoing instrument was acknowledged before me on this _____ day of __________, 20____, by [PRINTED NAME], who is personally known to me or produced satisfactory identification.

_____________________________________
Notary Public
My Commission Expires: ____________

10.3 Agency or DFS Representative (if required)

_____________________________________
[PRINTED NAME & TITLE], Authorized Representative
[LICENSED CHILD PLACING AGENCY / WYOMING DFS]

Date: _______________________

EXHIBIT A – COUNSELOR’S CERTIFICATE

[Attach statement signed by licensed counselor or social worker confirming compliance with any applicable Wyoming counseling requirements.]