WYOMING PARENTAL CONSENT TO ADOPTION
AND RELINQUISHMENT OF PARENTAL RIGHTS
[// GUIDANCE: This template is designed for use in private, agency, step-parent, and relative adoptions governed by Wyoming law. Customize all bracketed fields, verify statutory citations, and attach any agency-specific forms required by Wyo. DFS or the presiding family court.]
TABLE OF CONTENTS
- Document Header
- Definitions
- Operative Provisions
3.1 Consent & Relinquishment
3.2 Effective Date; Statutory Waiting Period
3.3 Revocation & Withdrawal of Consent
3.4 Counseling Acknowledgment
3.5 Conditions Precedent to Finalization - Representations & Warranties
- Covenants & Restrictions
- Default & Remedies
- Risk Allocation (N/A)
- Dispute Resolution
- General Provisions
- 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, Family Division, 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, subject only to the limited statutory revocation rights set forth below.
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 the pre-consent counseling mandated or permitted under applicable Wyoming adoption statutes and Department of Family Services (“DFS”) regulations.
“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.
“Revocation Period” means the statutory period—if any—during which a validly executed consent may be withdrawn under Wyoming law, as specified in Section 3.3.
3. OPERATIVE PROVISIONS
3.1 Consent & Relinquishment
(a) 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) 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; Statutory Waiting Period
This Consent shall not be effective until the later of:
(a) [INSERT STATUTORY MINIMUM, e.g., “forty-eight (48) hours”] after the Child’s birth; and
(b) execution of this Consent before a duly authorized officer as set forth in Section 10.
[// GUIDANCE: Wyoming law generally permits consent any time after birth; however, confirm whether your county judge requires a minimum waiting period.]
3.3 Revocation & Withdrawal of Consent
(a) Revocation Period. Under current Wyoming adoption statutes, a signed consent is [IRREVOCABLE / REVOCABLE FOR ___ DAYS] after execution unless the Family Court finds, by clear and convincing evidence, that withdrawal is in the Child’s best interests.
Select the correct option based on Wyo. Stat. Ann. § 1-22-[SPECIFY]*.
(b) Procedure. To revoke this Consent, the Consenting Party must file a verified notice of withdrawal with the Family Court and deliver copies to Petitioners and any placement agency within the Revocation Period.
(c) Tolling. If the Revocation Period expires on a weekend or court holiday, it shall automatically extend to the next business day.
3.4 Counseling Acknowledgment
The Consenting Parties each acknowledge that:
(a) they have been offered Counseling regarding the emotional and legal consequences of adoption;
(b) they have (check one) ☐ accepted ☐ waived such Counseling; and
(c) any required Counseling has been completed prior to execution of this Consent, as evidenced by the attached Counselor’s Certificate (Exhibit A).
3.5 Conditions Precedent to Finalization
The effectiveness of this Consent is conditioned upon:
(a) the filing of a Petition for Adoption by the Petitioners within [180] days of the Effective Date;
(b) issuance of all clearances required by the Interstate Compact on the Placement of Children (if applicable); and
(c) approval of this Consent by the Family Court.
Failure to satisfy the foregoing conditions shall not revive any relinquished parental rights unless expressly ordered by the Family Court.
4. REPRESENTATIONS & WARRANTIES
Each Consenting Party represents and warrants that, as of the Effective Date:
4.1 Capacity. He/she is at least eighteen (18) years of age, mentally competent, and not under the influence of drugs, alcohol, coercion, or duress.
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) 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, Family Division, 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. Signatures transmitted by facsimile, PDF, or secure electronic signature platform shall be deemed effective and binding.
10. EXECUTION BLOCK
[// GUIDANCE: Wyoming requires either (a) execution before a judge, court commissioner, or delegated officer, OR (b) notarization before an authorized notarial officer. Confirm local practice.]
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 Wyoming counseling requirements.]
[// GUIDANCE: After completing all blanks and attaching required exhibits, file this Consent with the Petition for Adoption or as otherwise directed by the Family Court’s local rules.]