SUPERIOR COURT Unit In Re: STATE OF VERMONT FAMILY DIVISION Docket No. DOB: AGREEMENT FOR POST-ADOPTION CONTACT OR COMMUNICATION This agreement is entered into by the following people: Parent(s): Intended Adoptive Parent(s): This agreement is about communication or contact between or about (Child'sName) __________________________ __________________________ and the parent(s) listed above after the child is adopted by the intended adoptive parent. This agreement is allowed by Vermont law, Title 33, Section 5124. Each parent and each intended adoptive parent understand and agree to the following: A. This Agreement is Voluntary and Enforceable 1. I am entering into this agreement for contact or communication voluntarily. I am not being forced to enter into this agreement by anyone. 2. I intend to follow this agreement. 3. I understand that this agreement is enforceable in Probate Court. 4. The agreed upon details for contact or communication are attached to this document. B. Duration and Effect of Agreement 1. This agreement will become enforceable only after all of the following occur: a. The parent signing this agreement voluntarily surrenders parental rights to the child; b. The Family Court Judge agrees that the agreement is in the child's best interest and approves this agreement through a Court order; and c. The child is legally adopted in Vermont by the adoptive parents who signed this agreement. 2. This agreement remains in effect until the child's 18th birthday. It is no longer enforceable if the adoption dissolves (if the child is no longer in the custody of the adoptive parents). 3. This agreement does not limit the parents or adoptive parents from moving to another town, state, or country. C. Judge's Order to Terminate Parental Rights is Final 1. I understand that the termination of parental rights cannot be undone and remains permanent, even if the intended adoption does not happen, the adoptive parent(s) do not follow the terms of this agreement, or the adoption is later dissolved. D. Changing or Enforcing the Agreement 1. The former parents and the adoptive parents may change the terms of this agreement at a later date if they agree to the change. Those changes between the parties are not enforceable in the Probate Court. 2. If this agreement includes a plan for any visits, the adoptive parents can cancel the visit if the child is sick, or there is another good reason for cancelling it. If the former parent appears to be under the influence of alcohol or drugs, the adoptive parent can refuse a visit. 3. The former parents can ask the Probate Court to enforce the terms of this agreement if the adoptive parents are not following the agreement. The burden will be on the former parents to prove that enforcement is in the child's best interest. 4. The adoptive parents can ask the Probate Court to change or end the agreement if they believe that is in the child's best interest. The burden will be on the adoptive parents to prove that this is in the child's best interest. 400-00126 ­ Agreement for Post-Adoption Contact or Communication (08/2015) Page 1 of 5 American LegalNet, Inc. www.FormsWorkFlow.com 5. Before going to Probate Court, the parties to this agreement must first try to work out their differences. The law requires the parties to first meet with a mediator or participate in a dispute resolution process of their choice. If these do not work, contact the Probate Court at the following address1: 6. If the Probate Court is asked to enforce or change the agreement, the law requires that the Judge presume that the adoptive parents know what is best for the child. I/We enter into this agreement knowingly and voluntarily. This agreement is signed as my free act and deed, and not as the result of coercion, fraud, or duress. I/We do not rely on any representations other than those contained in this agreement. Dated _____________________________ ______________________________________ Child's Parent Dated _____________________________ ______________________________________ Child's Parent Dated _____________________________ ______________________________________ Intended Adoptive Parent Dated _____________________________ ______________________________________ Intended Adoptive Parent Signed and sworn to before me: Date Signature of Notary Public Expiration Date Signed and sworn to before me: Date Signature of Notary Public Expiration Date 1 If between the time the agreement is signed and the adoption is finalized, it is determined that the adoption will be finalized in a different Vermont Probate Court, the Department for Children and Families (or its representative) will send updated information about the address of that court to both the parents and the adoptive parents. 400-00126 ­ Agreement for Post-Adoption Contact or Communication (08/2015) Page 2 of 5 American LegalNet, Inc. www.FormsWorkFlow.com I agree with the post-adoption contact or communication as set forth above. Dated _____________________________ ______________________________________ Signature of DCF Social Worker Dated _____________________________ ______________________________________ Signature of Guardian ad Litem Dated _____________________________ ______________________________________ Signature of Attorney for the Child If child is 14 years of age or older: I, __________________________________, agree to the post-adoption contact or communication as set forth above. (Name of Child) Dated _____________________________ ______________________________________ Signature of the Child 400-00126 ­ Agreement for Post-Adoption Contact or Communication (08/2015) American LegalNet, Inc. www.FormsWorkFlow.com Page 3 of 5 Plan for Post ­Adoption Contact Child's Name: Parent(s) Names: Intended Adoptive Parent(s) Names: Date of Agreement: The parents and intended adoptive parents agree on the following types of communication or contact. Please be clear about how often the contact will occur, who the contact will be with, and who else will be present other than the child. Written contact by mail or email. (The obligation to send items stops if the parents do not update any change in address or provide a current address to the Vermont Adoption Registry as appropriate.) Does not apply Does apply and is described specifically: Date of Birth: ____________________________________________________________________________ ____________________________________________________________________________ _______________________