TASC Legal Support Document*
This agreement is made on _______________________, between ________________________________________
__________________________ (hereinater referred to as "Surrogate), and __________________________________
________________________________, phone ____________________ (hereinafter referred to as "Biological Father" or "BF")
SECTION ONE. As used herein, "Surrogate" refers to a female who voluntarily desires to conceive and carry the biological child of ____________________ to term. As used herein, "Child" includes all children born pursuant to the insemination of Surrogate, as in multiple births.
SECTION TWO. Surrogate agrees not to attempt to form a parent-child relationship with any child conceived pursuant to the provisions of this contract, unless such a relationship is desired by the Child at a later date when the Child is able and of age to make an informed decision to form such a relationship. Surrogate further agrees to follow the applicable state laws prior to and after the child is born so that BF's name is placed on the child's birth certificate as the biological father.
SECTION THREE. Surrogate agrees to be artificially inseminated with the sperm of BF. Upon becoming pregnant, Surrogate shall carry the fetus until delivery at full term, if same is possible to do so without placing Surrogate's life in medical jeopardy. Delivery shall occur in __________________ it medically practical. Surrogate agrees that she will institute proceedings as soon as possible after the birth of said child to terminate her parental rights to said child, and sign any and all necessary consents, affidavits and other documents to effectuate the intents and purposes of this agreement. Surrogate understands that she is NOT consenting to terminate her parental rights by signing this specific agreement, but is simply indicating her intention to aid ________________ in acquiring sole custody of any child(ren) resulting from performance of this contract. Surrogate and BF will comply with the applicable state laws after the child is born. BF agrees to pay for any legal expenses incurred by Surrogate with regard to terminating her parental rights to child.
SECTION FOUR. Surrogate agrees that once this contract is signed. Surrogate bears the responsibility NOT to become pregnant through insemination by any male other than the BF for one year after the signing of this contract, or until BF informs Surrogate by certified mail at her last known mailing address that no (additional) attempts by BF to generate a pregnancy with Surrogate will be made, whichever occurs first. Surrogate agrees that if Surrogate does become pregnant by someone other than BF, she will inform BF immediately, and Surrogate will reimburse BF of any expenses incurred by BF on behalf of Surrogate up to that time.
SECTION FIVE. Surrogate agrees to keep BF informed of all medical testing, results, and expected delivery date. Surrogate also agrees to inform BF of the actual delivery date within twenty-four hours after the child's birth. Surrogate agrees not to smoke, not to drink any alcohol, or to knowing place the normal development of the fetus/embryo at risk through her personal behavior. Surrogate agrees NOT to consent to any elective procedures or surgery on child prior to agreement of BF, except procedures required to save the life of Surrogate or child.
SECTION SIX. In consideration for this agreement, the following provisions shall apply:
(A) BF agrees to pay Surrogate a total of _______________________dollars ($___________) by the time of delivery of child(ren) as contemplated below in this agreement. Said consideration is for Surrogate's services of carrying said child to term, and is NOT intended in any manner to be interpreted as being paid for Surrogate's consent to the termination of her parental rights. Surrogate agrees to cooperate with BF if BF requests that paternity testing be completed before the aforementioned __________________________ dollars sum is disbursed to Surrogate, and BF will pay for any paternity testing that BF requests.
(B) If Surrogate does not have health insurance, BF will be responsible for acquiring and paying for health insurance for Surrogate until a resonable time after delivery of said child(ren). Reasonable time is defined as six (6) weeks for natural delivery or eight (8) weeks for cesarean section delivery. BF agrees to pay al expenses incurred by Surrogate resulting from pregnancy. More specifically, all medical, hospital, pharmaceutical, and laboratory testing expenses whenever not covered by Surrogate's present health insurance carrier are the responsibility of BF. This obligation is no way supercedes the contractual obligation of the insurance carrier to pay for such expenses; rather, BF shall pay for such expenses only after such expenses have been submitted to and declined by Surrogate's health insurance carrier. If Surrogate has existing medical and obstetrical insurance coverage, Surrogate is to maintain such coverage during the entire period of this contract f pregnancy by BF, whichever is longer.
(C) BF shall provide all travel expenses for the Surrogate in achieving pregnancy, including air or bus fare and hotel accommodations. BF must agree that contemplated travel plans are reasonable before BF has any financial obligation for such travel and accommodations.
(D) Surrogate shall maintain preexisting health insurance coverage during pregnancy, and submit all laboratory, physician, and hospital charges to same insurance. BF will pay for deductibles and co-pays for Surrogate, as well as uncovered services. BF will reimburse Surrogate for any reasonable expenses relating to in-home supportive services necessary by bed-rest and ordered by Surrogate's physician. BF will not be responsible for any medical or psychological expenses occurring more that six (6) weeks after birth of said child by natural delivery or eight (8) weeks if child is delivered by cesarean section delivery. BF shall not be responsible for any lost wages of Surrogate, or any other expenses not specifically described in this contract. A maternity allowance of _____________________ dollars ($___________) when she becomes pregnant , and a maternity allowance of _______________________dollars ($_________________) shall be paid to Surrogate in every month of her pregnancy, and a maternity allowance of __________________________ dollars ($_______________) shall be paid to Surrogate upon delivery of child(ren), all amounts to be used by her as she deems appropriate. Surrogate agrees that Surrogate will NOT be compensated for any expenses unless she provides appropriate documentation of such expenses, including receipts, vouchers, etc. BF will pay the cost of term life insurance policy on the Surrogate payable to her children or any other named beneficiary of the Surrogate in the sum of ______________________________dollars ($_________________). Said one-year policy will be acquired by BF for Surrogate within one month after pregnancy is confirmed. BF agrees to make appropriate arrangements in his Will for support and rearing of said child, should he predecease same. It is the responsibility of the estate of the BF to rear any child(ren) resulting from insemination of Surrogate by BF, and NOT the responsibility of Surrogate.
(E) Both parties shall be tested for sexually transmitted disease, and any other communicable diseases as requested by either party, including, but not limited to AIDS, syphilis, and gonorrhea, prior to any attempts of insemination of Surrogate by BF. Both parties authorize, by signing this agreement, any and all medical personnel to release medical information directly to the other party with regard to the result of said tests performed. The costs of this testing shall be the responsibility of BF, if no covered by medical insurance.
SECTION SEVEN. Surrogate agrees NOT to abort the child, except as necessary to save the life of Surrogate, of if the child has been determined to suffer from genetic or physical abnormalities, unless extenuating, urgent circumstances arise, and both parties with to terminate the pregnancy due to said circumstances. If BF request prenatal testing, Surrogate agrees to allow same if the physician does not object to such procedure.
SECTION EIGHT. In the event that custody of any child resulting from this contract is awarded to Surrogate, BF shall be indemnified by the Surrogate for any and all moneys that he is required by law to pay for said child's support or pregnancy expenses pursuant to court order. BF shall also be entitled to immediate reimbursement from the Surrogate for all money or other forms of consideration paid to Surrogate pursuant to the agreement.
SECTION NINE. In the event that paternity testing should exclude the possibility that _____________________________ is the true biological father of Surrogate's child, then Surrogate agrees to indemnify _______________________________for any and all money that he is required by law to pay for said child's support or reimbursement from the Surrogate for all money or other forms of consideration paid to Surrogate pursuant to this agreement.
SECTION TEN. The Surrogate understands that pregnancy has certain medical risks associated with it, including the possibility of death, and agrees to assume any and all risks associated with and incident to the pregnancy contemplated herein. Surrogate understands that any initially uneventful pregnancy can take sudden and catastrophic turns, and Surrogate agrees to any and all risks associated with the contemplated pregnancy Specifically. Surrogate agrees to release and hold harmless ___________________ from any effects by this contemplated pregnancy on the personal health of Surrogate.
SECTION ELEVEN. In the event that Surrogate miscarries unintentionally, or as the result of an accident, then from day sixty (60) to day two hundred fifty (250) of the pregnancy, she will be paid ___________________ dollars ($_____________) for each day she carried the fetus. In the event that a child is born and is not alive after day tow hundred fifty (250) of the pregnancy, then the Surrogate shall receive her full fee of ________________________________ dollars ($___________________). The Surrogate is under no obligation to be reinseminated in the event of such miscarriage of still birth, and this contract shall terminate.
SECTION TWELVE. The Surrogate authorizes, by signing this agreement, any and all medical personnel to release medical information to BF directly, including discussing with BF the Surrogate progress during her pregnancy. In the event that pregnancy has not occurred after six trials to get Surrogate pregnant, then this agreement shall terminate by written notice using certified mail from either part to the other party at that party's last known mailing address.
SECTION THIRTEEN. All parties agree NOT to provide any information to the news media or any other individual/organization that would lead to disclosure of the identity of any party of child, unless all parties have consented to each other in writing to such disclosure, prior to the birth of said child.
SECTION FOURTEEN. In the event that Surrogate violates any of the provisions herein, BF may, at his opinion, terminate this contract without any further liability thereafter. In the event that this contract is terminated because of such a breach, the Surrogate shall be liable for any and all moneys expended on her behalf, plus attorney's fees.
SECTION FIFTEEN. In the event that _______________________ predeceases the birth of said child, then said child shall be placed in the custody of ______________________________________, ___________________________________________ ____________________________, phone _______________________________. In the event that both _________________ _____________ and _________________________________________ predecease the birth of said child, then said child shall be placed in the custody of _________________________________________, ______________________________________ _________________________, phone __________________________________. In al such events, the estate of __________ _______________________ shall assume financial responsibility for any and all expenses as outlined in this agreement. ___________________________________ agrees to assume legal responsibility for any child(ren) born pursuant to this agreement, unless paternity testing reveals that said child(ren) cannot be the biological child(ren) of _______________________.
SECTION SIXTEEN. The Surrogate agrees to inform BF of any material changes in Surrogate's circumstances which might reasonable affect this contract, including, but not limited to changes of address, or phone number, employment or marital status, physical and mental health, and the existence of/or changes in health insurance coverage. This agreement may be amended, changed or otherwise altered only by a written and notarized agreement signed by Surrogate and BF.
SECTION SEVENTEEN. In the event that Surrogate relocates out of the United States of America during her pregnancy and/or delivery of said child(ren), BF may, at his opinion, terminate because of such a breach, the Surrogate shall be liable for any and all moneys expended on her behalf, plus attorney's fees.
SECTION EIGHTEEN. This agreement set forth the entire agreement between BF and Surrogate, and supersedes any and all prior agreements between BF and Surrogate, either oral or written. All agreements, convenants, representations, and warrantees, express or implied, oral or written, are contained herein. No other agreements have been made by either party to the other regarding the subject matter of this agreement. All prior conversations, negotiations, possible and alleged agreements and representations with respect to the subject matter herein are waived or merged herein. This agreement shall be governed by and enforced inaccordance with the laws of the State of __________________________ . The parties agree that venue for any action to recover under this contract shall be in the State of ______________________________ with attorney's fees recoverable. In the event that any of provisions of this agreement are deemed invalid or unenforceable, the same shall be deemed severeable from the remainder of this agreement, and shall not cause the invalidity or unenforceabililty of the remainder of this agreement. If provisions are deemed invalid because of the scope of breadth, then such provisions shall be deemed valid to the extend of the scope or breadth permitted by law. This agreement is binding on each party's respective heirs, representatives, successors, executors, administrators, and assignees.
SECTION NINETEEN. Surrogate acknowledges that she is entering in this contract for the benefit of herself, and as a goodwill gesture and effort for ___________________________ and perspective child of his family. Upon the birth of said child(ren), Surrogate to surrender al custody rights of said child(ren) born as a result of this contract to ___________________________.