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EMBRYO DONATION AGREEMENT/CONTRACT
THIS AGREEMENT
(“the Agreement”) is made as of the date set forth below by and between
Jim R. Rec and Betty R. Rec, embryo donation recipients, and John J.
Doe and Jane J. Doe, embryo donors. The embryo donation
recipients shall sometimes be referred to herein as “the Recs” or
“Recipients”. The embryo donors shall sometimes be referred to
herein as “the Does” or “Donors”.
RECITALS:
WHEREAS, John J. Doe and Jane J. Doe are a married couple residing in
San Francisco County, California who desire to donate five (5)
cryopreserved embryos to Jim and Betty Rec; and
WHEREAS, the Does have the five (5) cryopreserved embryos available for
donation to the Recs stored at Some Fertility Center in San Francisco,
California; and
WHEREAS, Jim R. Rec and Betty R. Rec are a married couple residing in
Harris County, Texas who desire to receive the five (5) cryopreserved
embryos from the Does for use in assisted reproduction procedures known
as embryo implantation; and
WHEREAS, the Recs are working with Dr. Amanda Somedoctor at the Some
Fertility Center in San Francisco, California, and Dr. Brenda
Otherdoctor at the Center of Reproduction in Houston, Texas regarding
the medical procedures involved with embryo implantation; and
NOW THEREFORE, in consideration of the voluntary mutual promises
contained herein, the parties enter into this binding contractual
agreement that shall be effective immediately to transfer any and all
ownership and parental rights of the embryos from the Does to the Recs
and accept and agree to the following conditions:
REPRESENTATIONS BY THE DONORS:
1. John and Jane Doe acknowledge that they are the sole owners of the
five (5) cryopreserved embryos, and as sole owners, each represents
that they are entitled to transfer ownership of them to the Recs.
2. John and Jane Doe accept the fact that the original donors of the
embryos are each a donor as that term is defined under Texas Family
Code Sec. 160.102 (6) and that the Does have received a copy of the
statutory definition.
3. John and Jane Doe agree to provide the Recs with a complete medical
history questionnaire relevant to the original donors physical and
mental health as well as the health of family members including but not
limited to their children, siblings, parents and grandparents within 30
days of the agreement.
4. John and Jane Doe represent that each has cooperated fully with all
requirements for the cryopreservation and storage of embryos
established by Some Fertility Center including providing all necessary
medical, educational and genetic history.
5. John and Jane Doe represent that each has voluntarily executed all
documents provided by Some Fertility Center regarding embryo donation
and signed an informed consent document indicating his and her
permission to use the embryos for embryo donation.
6. John and Jane Doe represent that each understands the following in confirming his /her informed consent:
a. Each relinquishes all rights, whether personal or property, as a
donor to the embryos and to any child or children that may result from
the transfer of such embryos; and
b. Each is aware that there may be inadvertent loss or damage to the embryos; and
c. Each understands that the Recs will determine the disposition of any
remaining embryos not used by the Recs; and if for some reason the Recs
have not used the embyros after one year from the date of this
contract, the Recs will sign a designated donation to Some Fertility
Center transferring ownership back to the Does; and
d. The Does agree to remain in contact with the Recs and provide
current address information via electronic mail and/or postal service
in the event there are any children resulting from any transfers from
embryos donated by the Does so that biological siblings may initiate
contact in the future if they so desire.
e. Each understands that the psychological issues involved in embryo
donation are complex and that each has determined whether or not
psychological counseling is necessary and have acted in accordance with
both Some Fertility Center and any physician associated with the embryo
donation program; and
f. No compensation is requested or offered for the embryos.
REPRESENTATIONS BY THE RECIPIENTS:
1. Jim and Betty Rec agree to use the donated
embryos in assisted reproduction as that term is defined under Texas
Family Code Sec. 160.102 (2) and that each has received a copy of the
statutory definition.
2. Jim and Betty Rec accept the fact that there may be inadvertent
damage to the embryos during the process of thawing and implantation.
3. Jim and Betty Rec accept all responsibility for the expenses of
cryopreservation after receipt of the embryos by the Does and the Some
Fertility Center.
4. Jim and Betty Rec release the donors from any and all liability from
any potential complications of the pregnancies, congenital
abnormalities, heritable diseases or other complications of the embryo
transfer.
5. Jim and Betty Rec agree to complete all requirements of the Some
Fertility Center prior to implantation of any embryos, including but
not limited to testing for disease, blood work and psychological
evaluation, or provide existing current medical records of such testing.
6. The Recs agree to remain in contact with the Does and provide
current address information via electronic mail and/or postal service
in the event there are any children resulting from any transfers from
embryos donated by the Does so that biological siblings may initiate
contact in the future if they so desire.
7. No compensation is requested or offered for the embryos.
DETERMINATION OF PARENTAGE:
John and Jane Doe understand that as a result of the
donation of the five (5) cryopreserved embryos to the recipients, no
parental rights are established between the Does and the embryos.
Also, upon the birth of a child or children from any of the embryos,
Jim R. Rec and Betty R. Rec are the legal parents with all the rights,
duties and responsibilities both moral and financial for the resulting
child or children.
DISPOSITION OF EXCESS EMBRYOS:
Jim and Betty Rec will have the exclusive right to
determine the disposition of any remaining viable, unused embryos after
the Recs have made the decision that they will no longer need any
remaining embryos. If for some reason the Recs have not used the
embyros after one year from the date of this contract, the Recs agree
to sign a designated donation to Some Fertility Center transferring
ownership back to the Does. The recipients assume all financial
responsibility for maintaining each remaining cryopreserved embryo
while they are in their ownership.
CONFIDENTIALITY:
John Doe and Jane Doe and Jim R. Rec and Betty R. Rec agree that no one
will provide, nor allow his/her agents to provide, any information
regarding this contract/agreement to the public, news media or any
other individual or group that could lead to the disclosure of the
identify of any party or any child born as a result of this
agreement/contract.
SUCCESSORS AND ASSIGNS:
This agreement/contract is binding on each party’s respective
representatives, successors, executors, administrators and assigns.
GOVERNING LAW:
This agreement/contract shall be governed by, construed and enforced in accordance with the laws of the State of Texas.
AMENDMENT:
This agreement/contract cannot be modified or amended except by a writing signed by all parties.
SIGNATURES:
Each signatory to this agreement/contract affirms that each has read
this agreement/contract and understands it. Each further warrants that
he/she has had the benefit of legal counsel if so desired and that
he/she will not execute any other agreement that contradicts any
element of this agreement/contract.
IN WITNESS WHEREOF, the parties have executed this Agreement in duplicate originals.
___________________________________ ___________________________________
Betty R. Rec
Date
Jane J. Doe
Date
___________________________________ ___________________________________
Jim R. Rec
Date
John J. Doe
Date
ACKNOWLEDGMENT
THE STATE OF TEXAS _
_
COUNTY OF HARRIS _
BEFORE ME, the undersigned authority, on this day personally appeared
Betty R. Rec, known to me to be the person whose name is subscribed to
the foregoing instrument, and acknowledged to me that she executed the
same for the purposes and consideration therein expressed.
Given under my hand and seal of office on this the _______ day of _______________ 2004.
______________________________________
Notary Public, State of Texas
THE STATE OF TEXAS _
_
COUNTY OF HARRIS _
BEFORE ME,
the undersigned authority, on this day personally appeared Jim R. Rec,
known to me to be the person whose name is subscribed to the foregoing
instrument, and acknowledged to me that he executed the same for the
purposes and consideration therein expressed.
Given under my hand and seal of office on this the _______ day of ______________ 2004.
_____________________________________
Notary Public, State of Texas
ACKNOWLEDGMENT
THE STATE OF CALIFORNIA _
_
COUNTY OF SAN FRANCISCO _
BEFORE ME, the undersigned authority, on this day personally appeared
Jane J. Doe, known to me to be the person whose name is subscribed to
the foregoing instrument, and acknowledged to me that she executed the
same for the purposes and consideration therein expressed.
Given under my hand and seal of office on this the _______ day of _______________ 2004.
______________________________________
Notary Public, State of California
THE STATE OF CALIFORNIA _
_
COUNTY OF SAN FRANCISCO _
BEFORE ME,
the undersigned authority, on this day personally appeared John J. Doe,
known to me to be the person whose name is subscribed to the foregoing
instrument, and acknowledged to me that he executed the same for the
purposes and consideration therein expressed.
Given under my hand and seal of office on this the ______ day of ________________ 2004.
_____________________________________
Notary Public, State of California
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The Miracles Waiting, Inc. Team
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