SURROGATE AGREEMENT

 

THIS AGREEMENT is made and entered into this         day of , 19  , by and between                         

, whose address is              , hereinafter referred to as

"natural mother", and                                                ,

whose address is                                                    ,

hereinafter referred to as "natural father".

WITNESSETH:

            WHEREAS, the parties hereto are each over the age of twenty­one (21) years and desire to produce a child under circumstances other than wedlock; and

            WHEREAS, the parties desire that the natural mother be the sole person to have parental rights to the child.

NOW, THEREFORE, in consideration of the mutual promises

contained herein, the parties agree as follows:

1.  The natural mother warrants that she is fertile, of

sound mind and has undergone physical examinations, including testing for venereal diseases and AIDS, to ascertain that her health and well-being are satisfactory for carrying and bearing a child.  The natural mother further warrants that she has the financial and other resources available to adequately care for a child.

            2.  The natural father warrants that he is fertile, of sound mind and has undergone physical examinations, including testing for venereal diseases and AIDS, and that the result of said examinations show that his health and well-being are satisfactory for the fathering of a child.  The natural father further warrants that he has the financial resources available to pay his expenses enumerated herein.

            3.  The parties acknowledge that the conception of the child contemplated herein may require either or both of them to travel to each other's place of residence, or other mutually agreed upon place, on a monthly basis during the natural mother's fertile period (ovulation), and each party agrees to pay his or her own travel expenses, including transportation costs, meals, incidentals and lodging, if necessary.

            4.  The parties intend to meet in a monthly basis to conceive the child until such time as the natural mother becomes pregnant.  The parties agree to use their best efforts to ensure that said monthly meetings take place.

            5.  Each party agrees to pay his or her own medical expenses incurred in furtherance of this Agreement.

            6.  The natural mother agrees to pay all medical and hospital expenses related to her pregnancy and the birth of the child.

            7.  Wherever birth occurs, the natural father agrees to take all steps, legal, administrative, or otherwise, to sign all documents necessary under the laws of the state where the child is born, to place his name on the child's birth certificate.

8.  Immediately after the birth of the child and his name

being placed on the child's birth certificate as said child's

natural and biological father, the natural father agrees that he shall terminate all of his parental and legal rights to said child, and transfer the sole care, custody and control of said child to the natural mother.

     9.  The natural father shall pay the cost of the termination of is parental rights action, to be filed by him in

the court of appropriate jurisdiction, including attorney's fees.

10.  The natural mother hereby waives any and all rights

that she may have, now and in the future, against the natural father, for the support of the parties' child and for her confinement expenses; provided, however, that the natural father has terminated all of his parental and legal rights to said child.

11.  Subsequent to the termination of his parental rights,

the natural father may visit and/or correspond with the child upon such terms and conditions as the natural mother may agree.

  12.  "Child" as referred to in this Agreement shall include

all children born as a result of this Agreement.

13.  In the event that the natural mother has not become

pregnant after a reasonable number of monthly meetings, this Agreement may be terminated by either party.

14.  In the event that the natural mother's physician

advises her that an abortion is necessary for the physical health of the natural mother or the child has been determined by said physician to be physiologically abnormal, the natural mother shall be the only person having the right to decide whether or not to have an abortion.

15.  In the event any of the provisions of this Agreement

are deemed to be invalid or unenforceable, the same shall be deemed severable from the remainder of this Agreement and shall not cause the invalidity of unenforceability of the remainder of this Agreement.  If such provisions shall be deemed invalid due to its scope of breadth, such provision shall be deemed valid to the extent of the scope of breadth permitted by law.

           16.  This Agreement can be amended only by a written

agreement signed by the parties hereto.

17.  Each party acknowledges that he or she fully

understands the terms of this Agreement and its legal effect, that he or she is signing the same freely and voluntarily and that neither party has any reason to believe that the other did not freely and voluntarily execute said Agreement.

           18.  This Agreement shall be executed in two (2) or more

counterparts, each of which shall be an original, but all of which shall constitute one and the same instrument.

Signed, sealed and delivered

in the presence of

Witness                                   "Natural Mother"

Witness

Witness                                   "Natural Father"

 

Witness

STATE OF           COUNTY OF