Fill and Sign the Assignment Rights Document Form

Assignment of Rights to Frozen Embryos Agreement made on the _________________________ (date) , between _____________________________________________ (Names of Owners of frozen embryos) , of ___________________________________________________________________________ _________________________________________ (street address, city, county, state, zip code) , hereinafter called Assignors , and __________________________________________ (Names of Recipients of frozen embryos) of __________________________________________________ _______________________________ (street address, city, county, state, zip code) , hereinafter called Assignees . Whereas, Assignors are the owners of certain frozen embryos located at ____________ ___________________________ (name of facility) at _________________________________ _________________________________________ (street address, city, and state, zip code) ; and Whereas Assignors desire to give the embryos to ______________________________ (Name) , one of the Assignees, who is the sister of _______________________________ (Name of Owner who is brother) for the purpose of adoption and implantation in order to enable her to have children; and Whereas, the undersigned Assignors do not desire to have a parental relationship with any children born pursuant to this Agreement and believe _______________________________ ___________________________ (Names of Recipients of frozen embryos) will make excellent parents; Now, therefore, for and in consideration of the mutual covenants contained in this agreement, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties agree as follows: 1. Assignors do hereby assign all of their rights, title and interest in and to said frozen embryos to Assignees . 2. Assignors do not desire to have a parental relationship with any child born pursuant to this Agreement and believe that any such children born to Assignees to be morally and legally the issue of Assignees. 3. It is the desire of Assignors and their intent and understanding that any children resulting from the implantation of said embryos into ___________________________ (Name of Sister) will be the legitimate children of Assignees, and neither Assignor will ever attempt to form a parent-child relationship with any child or children born as a result of this procedure. 4. Assignees accept the donation of the embryos and acknowledge that any and all children so produced to be the legitimate children of the prospective Assignees. 5. No Waiver The failure of either party to this Agreement to insist upon the performance of any of the terms and conditions of this Agreement, or the waiver of any breach of any of the terms and conditions of this Agreement, shall not be construed as subsequently waiving any such terms and conditions, but the same shall continue and remain in full force and effect as if no such forbearance or waiver had occurred. 6. Governing Law This Agreement shall be governed by, construed, and enforced in accordance with the laws of the State of _____________________. 7. Notices Any notice provided for or concerning this Agreement shall be in writing and shall be deemed sufficiently given when sent by certified or registered mail if sent to the respective address of each party as set forth at the beginning of this Agreement. 8 . Mandatory Arbitration Any dispute under this Agreement shall be required to be resolved by binding arbitration of the parties hereto. If the parties cannot agree on an arbitrator, each party shall select one arbitrator and both arbitrators shall then select a third. The third arbitrator so selected shall arbitrate said dispute. The arbitration shall be governed by the rules of the American Arbitration Association then in force and effect. 9. Entire Agreement This Agreement shall constitute the entire agreement between the parties and any prior understanding or representation of any kind preceding the date of this Agreement shall not be binding upon either party except to the extent incorporated in this Agreement. 10. Modification of Agreement Any modification of this Agreement or additional obligation assumed by either party in connection with this Agreement shall be binding only if placed in writing and signed by each party or an authorized representative of each party. 11. Assignment of Rights The rights of each party under this Agreement are personal to that party and may not be assigned or transferred to any other person, firm, corporation, or other entity without the prior, express, and written consent of the other party. 12. Counterparts This Agreement may be executed in any number of counterparts, each of which shall be deemed to be an original, but all of which together shall constitute but one and the same instrument. WITNESS our signatures as of the day and date first above stated. ___________________________________ ____________________________________ ASSIGNORS ASSIGNEES ____________________________________ ____________________________________ (P rinted or typed name) (P rinted or typed name) ____________________________________ ____________________________________ (P rinted or typed name) (P rinted or typed name) (Acknowledgment for may vary by state) STATE OF _______________ COUNTY OF _____________________ Personally appeared before me, the undersigned authority in and for said County and State, on this ___ day of __________________, ___________, within my jurisdiction, the within-named ___________________________________________ (Names of Assignors) , who acknowledged that they each executed the above and foregoing instrument. ___________________________ NOTARY PUBLIC My Commission Expires: ______________________ STATE OF _______________ COUNTY OF _____________________ Personally appeared before me, the undersigned authority in and for said County and State, on this ___ day of __________________, _______, within my jurisdiction, the within- named _________________________________________________ (Names of Assignees) , who acknowledged that they each executed the above and foregoing instrument. ___________________________ NOTARY PUBLIC My Commission Expires: _____________________