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1. Parties: Identification of the biological parent(s) or legal guardian giving consent, including full legal names, addresses, and contact information
2. Background: Brief context about the child and the reason for adoption consent
3. Definitions: Key terms used in the document including 'consent', 'adoption', 'rights and responsibilities', etc.
4. Child Details: Full information about the child including name, date of birth, place of birth, and current residence
5. Declaration of Consent: Clear statement of voluntary consent to the adoption and understanding of its implications
6. Rights Understanding: Acknowledgment of understanding that consent terminates all parental rights and responsibilities
7. Cooling-Off Period: Statement acknowledging the legal cooling-off period during which consent can be withdrawn
8. Medical History Authorization: Authorization to release relevant medical history of the child and biological family
9. Witness Statement: Section for witness details and signatures confirming the voluntary nature of consent
10. Execution: Formal signing section including date, place, and signatures of all required parties
1. Tribal/Ethnic Considerations: Required when the child belongs to a specific tribe or ethnic group with additional customary requirements
2. Religious Preferences: Section specifying any religious considerations or preferences for the adoptive family
3. International Adoption Provisions: Additional provisions required if the adoption may involve foreign adoptive parents
4. Interpreter Declaration: Required when the consent form has been explained through an interpreter
5. Financial Disclosure: Statement regarding any financial arrangements or support, required in some jurisdictions
6. Birth Father Rights: Additional section required when dealing with unknown or absent birth father situations
1. Schedule A - Identity Documents: Copies of identification documents of the consenting party(ies)
2. Schedule B - Child's Birth Certificate: Copy of the child's original birth certificate or other proof of birth
3. Schedule C - Medical Records: Summary of relevant medical history and records
4. Schedule D - Counseling Verification: Documentation proving that appropriate counseling has been received
5. Schedule E - Court Orders: Copies of any relevant court orders or legal documents
6. Appendix 1 - Consent Withdrawal Form: Standard form for withdrawing consent within the cooling-off period
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Administrative Support
Government Relations
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Client Services
Social Worker
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Court Registrar
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Child Protection Specialist
Family Court Judge
Adoption Agency Director
Government Social Services Officer
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