AGREEMENT FOR VISITATION BY NATURAL PARENTS
A visitation agreement was entered into on
_______________(Date), between
__________________________________ and _______________________________ (Names), husband and wife, residing at
_____________________________________
___________________________________________ (Address)
and herein referred to as adopting parents; and _______________________________
(Name), residing at
_____________________________________________________________ (Address), and herein referred to as
natural mother; and __________________________________ (Name), residing at
_____________________________________________ (Address),
and herein referred to as natural father.
In consideration of this parental visitation
agreement, and other good and valuable consideration, the parties to the
agreement agree as follows:
1. The
referenced adopting parents hereby agree to formally adopt _______________ (Name), the child of the above-named
natural mother and natural father.
2. The
natural mother and natural father hereby consent to the formal adoption of
their child, ____________________________________ (Name), by the adopting parents.
3. The
parties to the agreement concur that it is in the best interests of the child,
_____________________________________ (Name),
that contact be maintained between _____________ (Him/Her) and the natural mother and natural father. The contact will consist of
_____________(____) (Number)
visits during each year between the child, _______________________________ (Name), and the natural parents. The visits will commence on or about
______________(Date), at
________________ _________________________________________ (Address). Should the designated visitation site become unsuitable for
visitation purposes, the parties to this agreement will select another mutually
acceptable site.
4. This
agreement will be in effect until _______________________________ (Child) reaches the age of eighteen
(18). Should this agreement prove at
any time to be detrimental to the best interests of
____________________________________ (Child),
the parties to the agreement will endeavor to cooperate fully and affect any
changes mutually agreed upon. If the
parties to the agreement cannot negotiate a mutual resolution, they hereby
agree to submit to mediation in order to resolve their dispute. The mediation
will be conducted by _________________________________________ (Set
Forth Terms of Mediation, as Prescribed in the Applicable Rules of the American
Arbitration Association).
Dated: ______________
____________________________________________
Signature of Adoptive Parent
____________________________________________
Signature of Adoptive Parent
____________________________________________
Signatures of Natural Parent
____________________________________________
Signatures of Natural Parent
