Fillable AGREEMENT FOR POST-ADOPTION CONTACT OR COMMUNICATION (Vermont Judiciary)

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AGREEMENT FOR POST-ADOPTION CONTACT OR COMMUNICATION (Vermont Judiciary)

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400-00126 – Agreement for Post-Adoption Contact or Communication (07/29/2016) Page 1 of 4
STATE OF VERMONT
SUPERIOR COURT
FAMILY DIVISION
Unit
Docket No.
In Re:
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’s Name)
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).
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. Following Court approval of this agreement the former parents and the adoptive parents may mutually agree to
modify the terms of contact but any such modifications shall not be enforceable by the Court. The former
parents can seek enforcement of the terms of this agreement but cannot ask the Court to modify the terms of
this agreement.
400-00126 – Agreement for Post-Adoption Contact or Communication (07/29/2016) Page 2 of 4
2. Before the adoptive parents can seek modification of this agreement or before either party can seek
enforcement of this agreement by the Court, the parties to this agreement must participate in mediation or
other dispute resolution process of their choice. If these efforts are not successful, a party must contact the
Probate Court having jurisdiction over such proceedings. (If the Probate Court location is unknown, the Vermont
Adoption Registry can provide that information.)
3. If the Probate Court is asked to enforce or change the agreement, the Court considers the child’s best interest.
E. Rights of Parents
1. 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.
2. This agreement does not limit the parents from moving to another town, state, or country.
F. Rights of Adoptive Parents
1. 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.
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. Parties acknowledge that the adoptive parent’s judgment
regarding the child is in the child’s best interests.
3. This agreement does not limit the adoptive parents from moving to another town, state, or country.
G. Terms of Post–Adoption Contact
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 (when and where; time of day, limitations regarding time of day), 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 parties do not provide each other with a
current address.)
☐ Does not apply
☐ Does apply and is described specifically:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Written contact through the Vermont Adoption Registry. If this is the plan, the parents and adoptive parents will notify
the Vermont Adoption Registry of any change of address. (The obligation to send items stops if the parents do not
provide a current address to the Vermont Adoption Registry.)
☐ Does not apply
☐ Does apply and is described specifically:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
The DCF Release of Identifying Information form will be provided to the Adoption Registry.
400-00126 – Agreement for Post-Adoption Contact or Communication (07/29/2016) Page 3 of 4
Phone contact (including texting)
☐ Does not apply
☐ Does apply and is described specifically:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
In-person contact (including who else may or will be present; who, where, when, how)
☐ Does not apply
☐ Does apply and is described specifically:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Other contact (including all forms of electronic/mobile communication devices, including but not limited to, social
media)
☐ Does not apply
☐ Does apply and is described specifically:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Other contact (continued)
☐ The following contact is specifically not allowed:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
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.
400-00126 – Agreement for Post-Adoption Contact or Communication (07/29/2016) Page 4 of 4
Date
_____________________________ ______________________________________
Child’s Parent
I have had an opportunity to discuss this with a
lawyer.
Date
_____________________________ ______________________________________
Child’s Parent
I have had an opportunity to discuss this with a
lawyer.
Date
_____________________________ ______________________________________
Intended Adoptive Parent
Date
_____________________________ ______________________________________
Intended Adoptive Parent
Signed and sworn to before me:
Signed and sworn to before me:
I agree with the post-adoption contact or communication as set forth above.
Date
_____________________________ ______________________________________
Signature of DCF Social Worker
Date
_____________________________ ______________________________________
Signature of Guardian ad Litem
Date
_____________________________ ______________________________________
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)
Date
_____________________________ ______________________________________
Signature of the Child
Date Signature of Notary Public Expiration Date
Date Signature of Notary Public Expiration Date
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AGREEMENT FOR POST-ADOPTION CONTACT OR COMMUNICATION (Vermont Judiciary)

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Completed 30 July 2020

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