Fill and Sign the Rights Grandparents Form

Adoption Agreement giving right of Visitation to Natural Grandparents Agreement made the       day of       , 20       , between       and       , (Name of Adopting Father) (Name of Adopting Mother) husband and wife, of       (the Adopting Parents ), (Street Address, City, County, State, Zip Code) and       , of       (Name of Natural Mother) (Street Address, City, County, State, Zip Code) (the Natural Mother ), and       , of (Name of Natural Father)       (the Natural Father), and (Street Address, City, County, State, Zip Code)       and       , (Name of Natural Grandfather ) (Name of Natural Grandmother) of       , the parents of (Street Address, City, County, State, Zip Code)       and (the Natural Grandparents ) of the Child (Name of Natural Parent)       of Natural Mother and Natural Father; (Name of Child) For and in consideration of the mutual covenants contained in this Agreement, and other good and valuable consideration, the parties agree as follows: 1. Adopting Parents agree to adopt the Child,       , (Name of Child) hereinafter called the Child of Natural Mother and Natural Father. 2. Natural Mother and Natural Father consent to the adoption of their Child by Adopting Parents. 3. The parties agree that it is in the best interests of the Child that there be contact between the Child and his Natural Grandparents. The contact will consist of       visits (number of visits) during each year between the Child and the Natural Grandparents, or either of Natural Grandparents. The visits will take place on or about       , (list of dates of visits) at       . If this visitation site becomes unsuitable for (Street Address, City, County, State, Zip Code) this purpose, the parties will select another mutually agreeable site. 4. This Agreement will be in effect until the Child reaches the age of 18. If this Agreement becomes contrary to the best interests of the Child, the parties will attempt to mutually agree on any necessary changes. If the parties cannot come to a mutual agreement, they agree to submit to Adoption Agreement Page 1 of 2 mediation in order to resolve their dispute. Mediation will be conducted by the terms of mediation, as prescribed in the rules of the American Arbitration Association . Witness our signatures this the       day of       , 20       . By: By: (Signature of Adopting Father) (Signature of Adopting Father)             (Printed Name of Adopting Father) (Printed Name of Adopting Mother) By: By: (Signature of Natural Mother) (Signature of Natural Father)             (Printed Name of Natural Mother) ` (Printed Name of Natural Father) By: By: (Signature of Natural Grandfather) (Signature of Natural Grandmother)             (Printed Name of Natural Grandfather) (Printed Name of Natural Grandmother) Adoption Agreement Page 2 of 2