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RELEASE TO USE YOU AS A REFERENCE

For most families contemplating embryo adoption, their best resource is families who have completed an embryo adoption. By your signatures below, you are giving EA permission to provide your first name(s), and telephone number and/or e-mail address to prospective adopting families through our literature and web site until you withdraw such permission in writing.

____________________________________________      _________________________________________

Signature                                                   Date                               Signature                                          Date   

RELEASE TO USE PICTURES

As part of EA’s continuing work, we 1) prepare written materials and brochures that include pictures of children and adoptive parents to distribute at informational seminars and other public venues; 2) place news articles or information about EA in clinics, infertility groups, website, embryo adoption related publications and on occasion non-adoption related publications that may include pictures of children and or adoptive parents; 3) prepare displays for infertility or adoption seminars and or fertility clinics that include pictures of children and adoptive parents; and 4) have produced from time to time an introductory video/CD about embryo adoption that includes pictures of children and adoptive parents. The rights to use referral pictures we provide to you with your referral remain with EA. By your signature below you are giving EA permission to use pictures you send to us of you and/or your adopted child(ren) as part of these materials without any identifying information (e.g., name, telephone number, etc.) until such permission is withdrawn by you in writing.

 
____________________________________________      _________________________________________

Signature                                                   Date                               Signature                                             Date  

REFUND POLICY & FISCAL MANAGEMENT

We strive to provide our families with exceptional service and a true feeling of security and comfort. For that reason, we have established our fee structure so that you pay as little as possible at the time of application and the remainder of your EA fees at the time you are matched for adoption. Because our work is ongoing, when any EA fee is submitted, it is non-refundable. For example, when you submit your application fee, the application fee is non-refundable. The same applies when you submit to EA the disclaimer and the balance of your agency and matching fees.

____________________________________________         _________________________________________

Signature                                                   Date                                Signature                                          Date